Blood CD4+CD25+ T Regulatory Cell: A Potential Predicting Marker of Following Miscarriage in Unexpained Recurrent Pregnancy Loss

SSRN Electronic Journal(2022)

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摘要
Objective: To investigate the relationship between pre-pregnancy blood immune status and unexplained recurrent pregnancy loss (URPL), and to explain the predictive value of pre-pregnancy blood Treg levels on the risk of following miscarriage in patients with URPL.Design: Retrospective cohort study.Setting: University-affiliated hospital.Patient(s): Women who have had two or more miscarriages before 24 weeks of gestation for no apparent reason. Women who had achieved live birth were taken as control group.Intervention(s): Flow cytometry analysis of peripheral blood CD4+ T cell, CD8+ T cell, NK cells, NKT cells, B cells, the NK cell subpopulations including CD56 bright NK cells, CD56 dim NK cells, and CD16+CD56 dim NK were conducted at luteal phase in URPL and control group. Reproductive outcomes of URPL patients were reviewed and analyzed.Main outcomes Measure(s): Miscarriage rate.Result(s): A total of 76 URPL patients and 74 controls were taken into analysis. Blood Tregs were significantly lower in URPL group than control group (1.89%±0.61% vs 2.15%±0.58%, P<0.01) at luteal phase pre-pregnancy. Besides, neither did blood CD4+T cells, CD8+T cells, B cells, NKT cells, NK cells, NK subpopulations (CD56bright NK, CD56dim NK, CD56dimCD16+NK, CD56brightCD16-NK) reached any difference between two groups. Receiver operating characteristic (ROC) curves were conducted to determine whether Treg levels predicted a following miscarriage. The areas under the ROC curves were 0.714, the cut off value was 1.35%, (sensitivity 0.556, specify 0.923). Based on cut off value, pregnant URPL patients were divided into two group, the following miscarriage rates in low Treg level group (<1.35%) were significantly higher than those in normal Treg level group (>1.35%) (71.43%vs14.29%, P<0.01).Conclusion(s): Pre-pregnancy blood Treg level was a potential marker predicting following miscarriage in URPL.
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