Abstract
(1) Background: Prior studies suggested a significant impact of previous live births on peripheral natural killer cells (pNK) in patients with recurrent pregnancy loss (RPL). Patients with primary RPL (pRPL, no live birth) showed higher numbers of pNK than secondary RPL patients (sRPL, ≥ 1 live birth). (2) Methods: To further determine immunological differences between RPL patients and controls, we analysed pNK subpopulations and activation markers in pRPL (n = 47), sRPL (n = 24) and controls with previous live birth (sCtrl, n = 25) and nullipara (pCtrl, n = 60) within a prospective study. Percentages and numbers of CD56dimCD16bright cells, subpopulations and activation markers (CD57+, CD62L+, NKG2D+, NKp46+) were measured in non-pregnant RPL patients and n = 85 controls (n = 60 pCtrl, n = 25 sCtrl) in the mid-luteal phase by flow cytometry. (3) Results: Compared to sRPL patients, sCtrls showed higher CD56+ and CD56dimCD16bright numbers. Further, sRPL patients showed lower numbers of CD56dimCD16brightNKG2D+ and CD56dimCD16brightNKp46+ than sCtrls. (4) Conclusion: We suggest a chronic immune stimulation leading to a lower NK-cell count in sRPL patients with a lower NK cytotoxicity. This underlines the necessity to investigate pNK subpopulations as well as pRPL and sRPL separately to delineate the immune alterations in RPL.
Highlights
Recurrent pregnancy loss (RPL) is defined as two or more consecutive pregnancy losses from the time of conception until 24 weeks of gestation and affects approximately1–3% of couples trying to conceive [1,2]
Gravidity of patients were significantly higher in secondary RPL (sRPL) versus primary RPL (pRPL) patients
PCtrl were significantly younger than all other groups and showed a lower BMI than pRPL and sRPL. (Table 1)
Summary
Recurrent pregnancy loss (RPL) is defined as two or more consecutive pregnancy losses from the time of conception until 24 weeks of gestation and affects approximately1–3% of couples trying to conceive [1,2]. RPL can be differentiated into primary (pRPL) and secondary RPL (sRPL). Women with sRPL have experienced at least one livebirth before the pregnancy losses, while women with pRPL did not. Recent diagnostic focuses on immunologic risk factors such as natural killer (NK)-cells in the peripheral blood (pNK-cells) and uterine NK-cells (uNK), regulatory T-cells and dendritic cells [5,6,7,8,9,10,11,12]. Abstract: (1) Background: Prior studies suggested a significant impact of previous live births on peripheral natural killer cells (pNK) in patients with recurrent pregnancy loss (RPL). Patients with primary RPL (pRPL, no live birth) showed higher numbers of pNK than secondary RPL patients
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