The role of lymphocytic cells in infertility and reproductive failures in women with antiphospholipid antibodies

Abstract

Background

The problem of pregnancy losses and infertility in autoimmune pathology is one of the most urgent problems of modern reproductive medicine. Antiphospholipid antibodies (aPL) are very often connected with reproductive failures such as miscarriage, antenatal fetal death, preeclampsia and even infertility and failure of in vitro fertilization (IVF) program.

Aim

To evaluate the difference in immune status of aPL-positive women with infertility compared to healthy women and explain the possible mechanism of pathological effects of aPL, a correlation analysis between the level of aPL and the lymphocytes subpopulation was performed.

Study design

We observed 280 women of reproductive age. Of these, 191 who met the inclusion and exclusion criteria were included in the study. All 191 women were tested for lupus anticoagulant (LA), antibodies (isotypes IgG, IgM) to cardiolipin (aCL), ß2-glycoprotein-1 (b2-GpI). Of these, 128 women had high level of aPL. The subpopulation of lymphocyte in aPL-positive women was compared with healthy women without reproductive pathology.

Results

In women with aPL, the absolute number of CD3⁺ lymphocytes, cytotoxic lymphocytes CD3⁺CD8⁺, T helpers CD3⁺CD4⁺, and the absolute levels of NK-cells and NK T-cells were significantly lower. In women with infertility and aPL circulation, we found the significantly higher absolute and relative level of CD19⁺ lymphocytes compared with healthy women.

Conclusion

T-regulatory cells play an important role in inducing tolerance to fetal alloantigens and limiting the intensity of the immune response. NK cells play an important role in processes of trophoblast invasion and spiral artery remodeling. Significantly reduced level of T-cells found in women with aPL may be associated with insufficient decidualization of endometrium for embryo invasion, which is clinically manifested by IVF failure.

Keywords:

• Antiphospholipid antibodies
• immune status
• lymphocyte subpopulations
• recurrent miscarriage
• reproductive losses

Disclosure statement

No potential conflict of interest was reported by the author(s).