RSA Patients Research Articles

IGF2BP3 participates in the pathogenesis of recurrent spontaneous abortion by regulating ferroptosis

The aberrant invasive capability of trophoblast cells is widely acknowledged as a primary mechanism underlying RSA. Recently, IGF2BP3 has been implicated in various cancers due to its influence on cellular invasion and migration. However, whether IGF2BP3 involve in the occurrence of RSA and the specific functions it assumes in the development of RSA remain elusive. In our study, we firstly collected villous tissues from RSA and those with normal pregnancies individuals to performed Protein sequencing and then detected the expression of IGF2BP3 through Western blot, qRT-PCR and immunohistochemistry. Secondly, we analyzed the single-cell data (GSE214607) to assess the expression of IGF2BP3 in invasive EVT trophoblasts. Thirdly, we utilized lentivirus technology to establish HTR-8/SVneo cell lines with stable IGF2BP3 knockdown and RNA-seq analysis was employed to investigate the GO functional pathway enrichment of IGF2BP3. Meanwhile, the effect of IGF2BP3 knockdown on trophoblast cells apoptosis, migration, and ferroptosis was evaluated through functional experiments. Additionally, LPS-induced abortion animal model was constructed to evaluate IGF2BP3 expression in placental tissues. A significant downregulation of IGF2BP3 was observed in the villous tissues of RSA patient, a finding corroborated by subsequent single cell sequencing results. Furthermore, it suggested that IGF2BP3 may be involved in the migration and apoptotic processes of trophoblast cells. Mechanistic research indicated that IGF2BP3 knockdown could compromise GPX4 mRNA stability, leading to the promotion of ferroptosis. Finally, our investigation observed the down-regulation of IGF2BP3 expression in placental villous tissues of an LPS-induced abortion animal model. Our findings revealed that IGF2BP3 was downregulated in the villous tissues of RSA patients. Mechanically, down-regulation of IGF2BP3 may induce RSA by promoting GPX4-mediated ferroptosis and inhibiting trophoblast invasion and migration. Our study may provide new targets and research directions for the pathogenesis of RSA.

Press-fit humeral implants in revision shoulder arthroplasty are as effective as cemented arthroplasty: a retrospective cohort study

BackgroundRevision shoulder arthroplasty (RSA) is an increasingly common procedure that can involve cemented or uncemented humeral implants. Although cement fixation is often advocated, it is not clear if the outcome is comparable to that of press-fit fixation. This study evaluated the survivorship and outcomes of cemented and press-fit humeral components in patients undergoing RSA at our institution. MethodsMedical records from adult patients who underwent RSA were reviewed retrospectively. Demographics and surgical data as well as subjective and objective outcome measures were collected. Patients were stratified into 3 groups according to their humeral revision type: cemented, uncemented, and retained stems. ResultsA total of 70 RSA patients with an average follow-up of 51.8 ± 43.9 months were included in the analysis: stems were cemented in 18.6% of the patients, uncemented in 61.4%, and retained in 20.0%. There were no significant group differences in patient characteristics. Follow-up data were available for 54 (77.1%) patients 2 or more years after RSA. There were no differences in patient-reported outcome measures among the groups. Active abduction at 1 year was greater for uncemented revisions than for cemented and retained stem components (128.9° ± 49.7° vs. 98.1° ± 55.7° and 100.8° ± 49.9°, respectively; P < .05). Patients in the uncemented and retained stem cohorts had greater strength in forward flexion, abduction, and external rotation than those in the cemented cohort, whereas patients in the cemented stem group had lower internal rotation strength at 1 and 2+ years of follow-up (P < .05). Postoperative radiographs indicated that none of the stems were at risk for failure. However, humeral bone loss was more common among those with uncemented stems (P = .02); in most of the cases, the loss was attributable to stress shielding. Survivorship of the implants did not differ among the groups, ranging from 91.1% to 92.3%. ConclusionPress-fit humeral components may be a viable option for RSA in patients with adequate humeral bone stock.

A comprehensive Bayesian analysis assessing the effectiveness of lymphocyte immunotherapy for recurrent spontaneous abortion

Abstract Recurrent spontaneous abortion (RSA) affects 2%–5% of couples worldwide and remains a subject of debate regarding the effectiveness of lymphocyte immunotherapy (LIT) due to limited retrospective studies. We conducted a comprehensive Bayesian analysis to assess the impact of LIT on RSA. Using data from the Shenzhen Maternity and Child Healthcare Hospital (2001–2020, n = 2316), a Bayesian generalized linear model with predictive projection feature selection was employed. Our analysis revealed a significant improvement in live birth rates for RSA patients undergoing LIT. Notably, LIT had a greater impact compared to the other 85 factors considered. To mitigate research bias, we conducted a Bayesian meta-analysis combining our dataset with 19 previously reported studies (1985–2021, n = 4246). Additionally, we developed an empirical model highlighting the four key factors, which are the LIT result, age, paternal blood type, and anticardiolipin antibody. Younger age (19–27), paternal blood type B, and a positive anticardiolipin antibody (IgM) were associated with better therapeutic outcomes in LIT for RSA. These findings aid clinicians in identifying suitable candidates for LIT and improving treatment outcomes.

Proteomic profiling analysis of human endometrium in women with unexplained recurrent spontaneous abortion

Unexplained recurrent spontaneous abortion (URSA) seriously affects female reproductive health, causing a great burden to patients both physically and mentally. Endometrial decidualization plays an important role in pregnancy, and impaired decidualization is an essential cause of URSA, but the cause of the damage is still poorly understood. This study aimed to reveal the pathogenesis of URSA by analyzing the differential protein expression profiles in the decidual tissue of patients with recurrent abortion compared to those with normal pregnancy. Morphological analysis revealed abnormal decidualization of endometrial tissue in patients with URSA. Quantitative proteomics analysis showed that a total of 146 differentially expressed proteins were identified between the two groups, among which 95 proteins were downregulated and 51 proteins were upregulated. Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways revealed that the protein expression profile and signaling pathways of endometrium in patients with URSA changed significantly, and cytoskeleton remodeling and morphological transformation disorders were associated with abortion induced by incomplete decidualization. Meanwhile, transcription factors analysis showed that the 3 most affected families were zf-C2H2, MYB and HMG. Therefore, our study may provide a basis for searching for potential markers of decidualization injury. SignificanceAt present, there are still about 50% of RSA patients with unknown causes, which brings great difficulties and blindness to clinical diagnosis and treatment.The limited proteomic studies on URSA further contribute to the lack of understanding in this field. However, in this study, the focus was on proteomic profiling analysis of the human endometrium in URSA patients compared to normal women. The findings revealed that cytoskeletal remodeling disorder is a significant contributor to the failure of decidualization in URSA patients. This insight highlights the potential role of cytoskeleton-related proteins in the pathogenesis of URSA, providing valuable information for further research and potential therapeutic interventions.

The immunomodulatory effect of intradermal allogeneic PBMC therapy in patients with recurrent spontaneous abortion

BackgroundThere has been limited study on the impact of PBMC therapy in RSA patients with immunological disorders such as Th17 and Treg cell dysregulation, as well as their associated factors. This study aimed to assess the efficacy of PBMC therapy in modulating immune cell frequency, cytokine production, transcription factors, and miRNAs implicated in the regulation of their function, as well as their potential superiority to routine treatments. MethodsFifty RSA women who had received PBMCs and 50 matched-paired control RSA women who had received the routine treatments were recruited and followed for three months. The frequencies of Th17, Treg, NK, and B cells were assessed using flow cytometry. Thereafter, the gene expression level of the transcription factors and related miRNAs of Treg cell and Th17 cell was quantified using RT-PCR. Then ELISA was employed to assess the cytokine production of Th17 and Treg cells. Finally, the live birth rate and miscarriage rate were evaluated as clinical outcomes in this study. ResultsFlow cytometry analysis revealed that PBMC therapy significantly reduces the frequencies of Th17 and NK cells while enhancing the frequency of Treg cells. RT-PCR analysis confirmed that PBMC therapy significantly downregulates RORγt and upregulates FoxP3. Likewise, RT-PCR analysis showed that PBMC therapy reduces the expression of miR-25, miR-155, and miR-326 while increasing the expression of miR-10a. ELISA results demonstrated that PBMC therapy considerably decreases the concentration of inflammatory cytokines IL-1β, IL-17, and TNF-α and enhances the concentration of anti-inflammatory cytokines IL-10 and TGF-β. Following PBMC therapy live birth rate raised while miscarriage rate reduced. ConclusionOur findings suggested that, in contrast to routine treatments, PBMC therapy can significantly modulate the maternal immune system by enhancing the Treg/Th17 paradigm and regulating the expression of Treg and Th17 cell-associated cytokines, transcription factors, and miRNAs. This treatment also can increase the live birth rate in RSA patients.

Reproductive outcomes after uterine septum resection in patients with recurrent miscarriage or infertility: a retrospective study in Chinese women.

Septate uterus is the most common structural uterine anomaly, which is related to the adverse pregnancy outcomes in women of childbearing age. This article provides a retrospective review of hysteroscopic uterine septum resection performed in our hospital during recent years, focusing on the patients with recurrent miscarriage and primary infertility, and also to identify which patients are more likely to benefit from the surgery. This is a single-center retrospective study. Cases of women who underwent hysteroscopic septum resection at West China Second Hospital of Sichuan University from January 2014 to December 2019, retrieved through the medical record system, were divided into three groups: Group A was the recurrent miscarriage group, Group B had a history of pregnancy with spontaneous abortion once at most, and Group C was the primary infertility group. Each patient was followed up by telephone about further pregnancy, miscarriage and live birth for at least 1year. A total of 176 surgical patients were included in this study. Group A, B, and C include 42, 74, and 60 cases, respectively. The postoperative pregnancy rates of the three groups were 71.4, 82.4, and 75.0%; live births rates were 50.0, 74.3, and 71.7%; and spontaneous abortion rates were 21.4, 17.6, and 13.3%. 62 patients had a complete uterine septum and 114 had a partial uterine septum. For patients with complete septate uterus, the preoperative pregnancy rate was 54.84% and the pregnancy rate increased to 85.48% after surgery; and yet the preoperative and postoperative pregnancy rates in patients with partial septate uterus were close (from 71.9 to 72.8%). After uterine septum resection, the pregnancy rate and spontaneous abortion rate in RSA patients were not significantly different from the other two groups, but the live birth rate was still significantly lower. Patients with complete uterine septum may benefit more from surgery. The surgical indications should be carefully and strictly evaluated.

Utilization of comorbidity indices to predict discharge destination and complications following total shoulder arthroplasty.

Comorbidity indices can help identify patients at risk for postoperative complications. Purpose of this study was to compare different comorbidity indices to predict discharge destination and complications after shoulder arthroplasty. Retrospective review of institutional shoulder arthroplasty database of primary anatomic (TSA) and reverse (RSA) shoulder arthroplasties. Patient demographic information was collected in order to calculate Modified Frailty Index (mFI-5), Charlson Comorbidity Index (CCI), age adjusted CCI (age-CCI), and American Society of Anesthesiologists physical status classification system (ASA). Statistical analysis performed to analyze length of stay (LOS), discharge destination, and 90-day complications. There were 1365 patients included with 672 TSA and 693 RSA patients. RSA patients were older and had higher CCI, age adjusted CCI, ASA, and mFI-5 (p < 0.001). RSA patients had longer lengths of stay (LOS), more likely to have an adverse discharge (p < 0.001), and higher reoperation rate (p = 0.003). Age-CCI was most predictive of adverse discharge (AUC 0.721, 95% CI 0.704-0.768). Patients undergoing RSA had more medical comorbidities, experienced greater LOS, higher reoperation rate, and were more likely to have an adverse discharge. Age-CCI had the best ability to predict which patients were likely to require higher-level discharge planning.

Differential expression of urine-circulating micro-RNAs in Chlamydia trachomatis-induced recurrent spontaneous aborters

Studies behind mechanisms of Chlamydia trachomatis-induced recurrent spontaneous abortion is still in its infancy. Possible strategy for preventing recurrent spontaneous abortion at molecular level is needed. Despite its multifactorial aetiology, Chlamydia trachomatis is important cause of RSA. However, mechanism leading to RSA in C. trachomatis-positive patients is not understood and novel strategies are needed. It is hypothesized that microRNAs play important role in RSA regulation during infection. Study aimed to elucidate expression/role of urine-circulating miRs-320b, 221-3p, 146b-5p,-16,-24,-559 in recurrent spontaneous aborters with C. trachomatis infection and to find their target genes by bioinformatic analysis. First-void urine was collected from 30 non-pregnant women with RSA (Group I) and 30 non-pregnant women with ≥2 successful deliveries (Group II; Controls) attending Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College, Safdarjung hospital, New Delhi (India). PCR was performed to detect C. trachomatis. Expression of miRNAs was studied by quantitative real-time PCR while target genes/functional annotations were predicted by GO/KEGG databases. Data was statistically evaluated. 05 RSA patients were C. trachomatis-positive. Group I was subdivided into Group Ia (C. trachomatis-positive RSA; n = 5) and Group Ib (C. trachomatis-negative RSA; internal controls). miR-320b, -221-3p, −146b-5p, −16, −24 were significantly upregulated (miR-16 showed maximum 4.3 fold-change) while miR-559 was downregulated (0.5 fold-change) in Group Ia versus controls (‘p’<0.001). Bioinformatic analysis revealed that target genes of miRNAs in RSA are involved in apoptosis and AMPK signalling pathways. Results showed differential expression of miRNAs implyingmiR-16 and miR-559 as potential biomarkers of RSA in infected women. Furthermore, network of genes of differentially expressed miRNAs regulates RSA by targeting gene function in apoptosis, cell adhesion and angiogenesis.

Extracellular Vesicle-Mediated Secretion of HLA-E by Trophoblasts Maintains Pregnancy by Regulating the Metabolism of Decidual NK Cells.

Extracellular vesicles derived from trophoblasts (T-EVs) play an important role in pregnancy, but the mechanism is not entirely clear. In this study, we found that HLA-E, which is mostly confined to the cytoplasm of trophoblast cells, was secreted by T-EVs. The level of HLA-E in T-EVs from unexplained recurrent spontaneous abortion (URSA) patients was lower than that in normal pregnancy (NP) and RSA patients who had an abnormal embryo karyotype (AK-RSA). T-EVs promoted secretion of IFN-γ and VEGFα by decidual NK (dNK) cells from URSA patients via HLA-E, VEGFα was necessary for angiogenesis and trophoblast growth, and IFN-γ inhibited Th17 induction. Glycolysis and oxidative phosphorylation (OxPhos) were involved in this process. Glycolysis but not OxPhos of dNK cells facilitated by T-EVs was dependent on mTORC1 activation. Inhibition of T-EV production in vivo increased the susceptibility of mice to embryo absorption, which was reversed by transferring exogenous T-EVs. T-EVs promoted secretion of IFN-γ and VEGFα by dNK cells to maintain pregnancy via Qa-1 in abortion-prone mouse models. This study reveals a new mechanism of pregnancy maintenance mediated by HLA-E via T-EVs.

Natural resolution of non-anaphylactic shrimp allergy in patients diagnosed 10 years earlier by oral food challenge.

Shrimp allergy is considered a lifelong condition. The natural resolution of shrimp allergy is not well studied. To investigate the natural resolution of shrimp allergy among a cohort of patients diagnosed with shrimp allergy 10 years earlier by oral shrimp challenge. A prospective study recruited patients diagnosed with shrimp allergy to Penaeus monodon (Pm), Macrobrachium rosenbergii (Mr), or both from a study conducted during 2005-2006. The current oral shrimp challenges were conducted during 2015-2016. The negative oral shrimp challenge was designated 'resolved shrimp allergy' (RSA), with a positive challenge designated 'persistent shrimp allergy' (PSA). Skin prick and prick-to-prick testing to shrimp were used to determine sensitization. Sixty patients who had positive shrimp challenge from the previous cohort were contacted. Patients who had previous anaphylactic reaction (8 subjects) or allergic reaction after shrimp ingestion within 6 months (6 subjects), were not included. Nine patients refused to participate and 20 patients could not be contacted. Seventeen patients were included. Three were previously diagnosed with allergy to Pm, 3 to Mr, and 11 to both species. RSA was observed in 1 patient with isolated Pm allergy, and in 3 patients with isolated Mr allergy. Three of 9 patients with dual allergy had RSA to both species. RSA patients had significantly smaller size of shrimp skin test than PSA patients at both diagnosis and follow-up. At ten years after diagnosis, 46% of patients had RSA. These patients had significantly smaller size of shrimp skin test than PSA patients.

Early clinical and radiographic results of reverse shoulder arthroplasty with press-fit metaphyseal humeral fixation

BackgroundReverse shoulder arthroplasty (RSA) has seen a recent transition from cemented to press-fit humeral stems. Several press-fit designs have focused on proximal fixation, yet there remains a paucity of data on their performance. The purpose of this study is to report early radiographic and clinical results of a third-generation RSA system, featuring metaphyseal porous metal fixation. MethodsA retrospective review was performed on primary RSA patients treated with a single third-generation standard-length implant system incorporating proximal osteointegration features with a minimum 2-year follow-up. Patient-reported outcome measures, including the Simple Shoulder Test, American Shoulder and Elbow Surgeons, Visual Analog Scale for pain, and Single Assessment Numeric Evaluation, as well as measured active motion (forward elevation, external, and internal rotation) were recorded at pre- and postoperative intervals. Immediate postoperative radiographs were used to measure filling ratios at the epiphyseal, metaphyseal, and diaphyseal levels. Most recent radiographs were also reviewed for bone adaptations, acromial fractures, scapular notching, and humeral loosening. ResultsThere were 90 patients included in the study, with an average age of 73 years (± 7.23) and clinical follow-up of 32 months (± 7.25). Indications included osteoarthritis with a rotator cuff tear (51%), osteoarthritis without a cuff tear (40%), fracture sequelae (2%), and locked anterior dislocation (2%). There were significant improvements in all measured motions and patient-reported outcome measures at the most recent follow-up, with good to excellent satisfaction in 91.1% of patients. High mean epiphyseal (0.90 ± 0.06) and metaphyseal (0.83 ± 0.07) filling ratios together with low mean diaphyseal filling ratio (0.48 ± 0.07) represented proximal fixation. There were 6 cases with scapular notching, 5 postoperative acromial fractures, and 2 with temporary postoperative neuropathy. Proximal bone resorption was seen in 18.9% of cases, and there were no cases of humeral loosening, baseplate failure, or need for revision. ConclusionPrimary RSA with a third-generation press-fit humeral component with metaphyseal fixation provides excellent early outcomes with no loosening and low rates of proximal stress-shielding. Results of this study support the use of an inlay humeral component with osteointegration features that facilitate proximal stem fixation. Level of EvidenceTreatment Study

MALAT1 recruited the E3 ubiquitin ligase FBXW7 to induce CRY2 ubiquitin-mediated degradation and participated in trophoblast migration and invasion.

This study aimed to investigate the mechanism by which MALAT1 regulates CRY2 expression and participates in trophoblast migration and invasion. Three patients with unexplained recurrent spontaneous abortion, four patients with missed abortion, and four women who underwent artificial miscarriages were enrolled in this study. Quantitative reverse-transcription polymerase chain reaction and western blot analysis were used to detect RNA and protein expression, respectively. Trophoblast migration and invasion were detected by wound-healing and transwell invasion assays. RNA pull-down and Co-IP assays were used to indicate the interaction between MALAT1 and FBXW7 or the interaction between FBXW7 and CRY2. The results showed significantly decreased MALAT1 expression in the villous specimens from the RSA patients relative to that in the villous specimens from the missed abortion patients and the normal villous specimens. MALAT1 promoted trophoblast cell migration and invasion by negatively regulating CRY2 protein expression. MALAT1 recruited FBXW7 to impair CRY2 protein stability. In conclusion, MALAT1 downregulation in trophoblasts might be related to miscarriage. MALAT1 may recruit the E3 ubiquitin ligase FBXW7 to induce CRY2 ubiquitin-mediated degradation and participate in trophoblast migration and invasion.

The effects of DICER1 and DROSHA polymorphisms on susceptibility to recurrent spontaneous abortion.

BackgroundRecurrent spontaneous abortion (RSA) is a serious problem in pregnancy. The exact etiology of RSA is unknown in more than 50% of all the patients. However, genetic variations are known as susceptibility factors for idiopathic RSA. Considering the role of miRNA biosynthesis machinery in the miRNA production and effect of miRNAs on various diseases, this study aimed to evaluate the effects of DICER1 rs3742330 and DROSHA rs6877842 polymorphisms on RSA risk.MethodsIn this case‐control study, 150 RSA patients and 195 age‐matched healthy female controls were recruited. Both polymorphisms were genotyped using PCR‐RFLP method.ResultsThe frequency of DICER1 rs3742330AG genotype was higher in the control group (P = .022). There was a statistically significant association between rs3742330 polymorphism and a reduced RSA risk in dominant and allelic models (P = .013 and P = .007, respectively). No statistically significant association was found between DROSHA rs6877842 variant and RSA risk. The combination of AG and GC genotypes and G‐G alleles of DICER1 rs3742330 and DROSHA rs6877842 polymorphisms led to a decreased RSA risk. However, the synergic effect of rs3742330A and rs6877842G alleles (A‐G) and AA‐GG genotypes was associated with an increased RSA risk.Conclusionthe DICER1 rs3742330AG genotype and combination of AG and GC genotypes and G‐G alleles of DICER1 rs3742330 and DROSHA rs6877842 polymorphisms were associated with a reduced RSA risk.

Functional improvement is sustained following anatomical and reverse shoulder arthroplasty for fracture sequelae: a registry-based analysis.

Shoulder arthroplasty for proximal humerus fracture sequelae is known to provide significant patient improvement, yet this outcome varies with time, prosthesis type, and fracture sequelae. We outline the expected course of postoperative shoulder pain and function in patients with anatomical (ASA) or reverse (RSA) shoulder arthroplasty following different fracture sequelae. Of 111 consecutive patients from our local shoulder arthroplasty registry, 32 underwent ASA for Boileau type 1 sequelae and 77 RSA patients were identified with Boileau types I, III, and IV. By 5year post-surgery, there were 72 patients available. All patients underwent standardised ASA or RSA procedures with anatomical (Promos Standard; Lima SMR™; Arthrex Eclipse™; Univers™ II) or reverse prostheses (Promos Reverse®; Lima SMR™ Reverse; Univers Revers™; Aequalis® Reversed). Range of motion, Constant-Murley, Disability of the Arm, Shoulder and Hand (DASH), and Shoulder Pain and Disability Index (SPADI) scores were compared at 6, 12, 24, and 60months postoperatively. We used generalised linear mixed models or random-effects ordered logistic regression to investigate postoperative changes of outcome parameters from baseline to follow-up time points for each group as well as for group comparisons. Range of motion and clinical scores improved until 24months postoperatively and did not deteriorate thereafter, except for internal rotation of Boileau type III and IV patients and external rotation of RSA patients with type I and IV sequelae. At all follow-ups, ASA patients with Boileau type I sequelae had significantly better internal and external rotation versus patients with RSA and/or other Boileau types (p < 0.001), while Constant, DASH, and SPADI scores were not significantly different between groups. In humeral fracture sequelae, ASA and RSA lead to sustained clinical improvements. Surgeons may primarily consider implantation of ASA in type I sequelae.

Increased Risk of Phthalates Exposure for Recurrent Spontaneous Abortion in Reproductive-Aged Women: Taiwan Female Infertility Study (TIFF)

Background/AimRecurrent spontaneous abortion (RSA) is the termination of pregnancies, usually before 20 weeks of gestation. Some studies indicated that phthalates may involve in the pathogenesis of RSA, and that Taiwan's reproductive-aged women were still exposed to high levels of DEHP and DBP after 2011 DEHP exposure episode. We aimed to assess the risk of phthalates in Taiwanese women with RSA using a case-control study design.MethodsWe recruited 103 RSA patients and 76 controls from the department of obstetrics and gynecology in a hospital in southern Taiwan from 2013 to 2017. Urine samples were analyzed for 11 phthalate metabolites through LC/MS-MS; subsequently, principal component analysis (PCA) and agglomerative hierarchical clustering analysis were performed to determine the main sources of phthalate exposure. Multivariate logistic regression was used to determine the RSA risk.ResultsMedian levels (ng/mL) of mono-n-butyl phthalate (MnBP), mono-iso-butyl phthalate (MiBP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), &amp;#931;DBPm, and &amp;#931;DEHPm were 3.1/27.2, 5.3/9.8, 8.1/11.4, 9.5/12.9 ng/mL, 0.10/0.18 nmol/mL, and 0.12/0.15 nmol/mL respectively, in control/RSA. PCA revealed three primary components of phthalate exposure: DEP, DBP, and DEHP. Plastic food container use and medication use were identified as the main phthalate exposure sources. After adjustment for creatinine, age, age at menarche, educational level, plastic food container use, and food preservation bag use, we observed significantly high odds ratios for RSA: 3.15 (p&amp;#61; 0.03), 3.31 (p&amp;#61; 0.04), and 2.57 (p&amp;#61; 0.07) in the third tertile for MiBP, &amp;#931;DEHPm, and &amp;#931;DBPm, respectively.ConclusionsOur findings support the hypothesis that exposure to phthalates increases RSA risk in Taiwanese women. The development of the strategy to avoid using phthalate coatings for oral medications and plastic products among reproductive-aged women should be emphasized.

P106: Change of RSA patients' subsequent pregnancy after lymphocyte active immunotherapy

American Journal of Reproductive ImmunologyVolume 80, Issue S1 p. 101-101 ABSTRACTS P106: Change of RSA patients' subsequent pregnancy after lymphocyte active immunotherapy First published: 26 June 2018 https://doi.org/10.1111/aji.105_12984Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume80, IssueS1Special Issue: American-Sino Joint Meeting of Reproductive Immunology (ASRI-CSI 2018), June 28-1 July, 2018 Shanghai, ChinaJune 2018Pages 101-101 RelatedInformation

NEOPTERIN AND RECURRENT SPONTANEOUS ABORTÄ°ON (RSA): THE EFFECT OF CELLULAR IMMUNE SYSTEM ACTIVATION ON SUBSEQUENT PREGNANCY

Background: Recurrent miscarriages are common complications in pregnancy. Neopterin is one of the immunologic biomarkers of several diseases related to activation of the cellular immune system. RSA is associated with immune system related abnormalities.Objectives: We aimed to investigate the effectiveness of neopterin levels in the early diagnosis of RSA.Methods: Eighty RSA patients and forty-three healthy controls were included in the study. The neopterin concentrations were determined by the enzyme-linked immunosorbent assay (ELISA) method. For the statistical analysis, Mann-Whitney U test and Pearson correlation test were used the; p&lt;0.05 was considered statistically significant.Results: Serum mean neopterin levels were 16.47±0.095 nmol/L in RSA group and 6.14±0.041 nmol/L in control group, respectively. Compared to the control group, a statistically significant increase (p=0.0183) in the serum neopterin levels of the patients was observed. There was a negative correlation between serum neopterin level and age in both the control (R=0.0774, p=0.6236) and RSA groups (R=0.1415, p=0.2089). However, this correlation was not statistically significant (p&gt;0.05).Conclusions: With overstimulation of interferon-γ (INF-γ) during pregnancy, the production of neopterin increases by monocytes/macrophages. The measurement of neopterin levels in the serum contributes to the early diagnosis of pregnancy losses.

Risk factors associated with blood transfusion after shoulder arthroplasty

BackgroundClosed-suction drainage has been studied extensively in hip and knee arthroplasty literature. However, little is known about outcomes in patients treated with drainage after shoulder arthroplasty, particularly relative to transfusion requirements.MethodsAll primary total and reverse total shoulder arthroplasties (TSAs and RSAs) performed at a single institution during a 5-year period were retrospectively reviewed. Data collected included patient demographic information, estimated blood loss (EBL), drain output, length of drain use, changes in hemoglobin (Hgb) level postoperatively, transfusions, and complications. A multivariable regression analysis was performed to identify independent risk factors for transfusion.ResultsThere were no differences in surgery duration, EBL, or complications between TSA and RSA patients (P > .05). Patients undergoing RSA were older (74.0 vs. 68.4 years; P < .001) and had lower preoperative and postoperative Hgb levels (P < .001) compared with TSA patients. Reverse arthroplasty was also associated with longer hospital stays (2.8 vs. 2.2 days; P < .001), longer drain durations (1.6 vs. 1.2 days; P < .001), increased total wound drainage (209 vs. 168 m; P = .006), and higher transfusion rates (11.7% vs. 3.1%; P = .002). Independent risk factors for transfusion included low preoperative Hgb levels in both TSA (P = .024) and RSA (P = .002) and higher EBL in TSA (P = .031).ConclusionLow preoperative Hgb level is an independent risk factor for requiring blood transfusion after TSA and RSA. Increased wound drainage was not a risk factor for transfusion, and the 40-mL increase in wound drainage found in RSA is of questionable clinical significance.

Lipid infusion in RSA and RIF patients with elevated uterine natural killer cells

Lipid infusion in RSA and RIF patients with elevated uterine natural killer cells

Uterine and peripheral natural killer cells do not correlate in RSA and RIF patients

Uterine and peripheral natural killer cells do not correlate in RSA and RIF patients