RESUMEN
Proper evaluation of immunological factors connected with pregnancy establishment increased the possibility for exact treatment in high risk gestation cases. Hormonal changes during an ovarian cycle may affect immune response, which is crucial for the embryonic implantation. Peripheral Natural killer (pNK) cells are key components of immune systems and their activities could be regulated by sex hormones. In the present study we investigated the effects of estrogen fluctuation on the number of NK cells in vivo during the early follicular and middle luteal phase of menstrual cycle. In 63 healthy women with at least one full term pregnancy and regular menstrual cycle with duration between 24 and 32 days, blood samples have been collected twice for investigation of CD3/CD16/CD56 positive lymphocytes. The mean pNK count in follicular phase was 11.6% with 4.7% variation. The median was 10.6%. The mean pNK count in luteal phase was 12.1% with 5.1% variation, respectively median for cell number 11.8%. The two-tailed t-test comparison did not find any statistical difference despite the slight elevation of pNK cells count in luteal phase. The insignificant variation in pNK cells count objected the suggestion to evaluate immunological status in women with adverse pregnancy outcome in specific phase of menstrual cycle.
Asunto(s)
Estrógenos/inmunología , Fase Folicular , Células Asesinas Naturales/citología , Fase Luteínica , Adulto , Complejo CD3/análisis , Antígeno CD56/análisis , Implantación del Embrión , Femenino , Humanos , Células Asesinas Naturales/inmunología , Recuento de Linfocitos , Embarazo , Receptores de IgG/análisis , Adulto JovenRESUMEN
The increased number of peripheral blood NK (pNK) cells has been discussed as a factor for embryo implantation failure and early pregnancy loss. However, the assessment of activated pNK cells with increased cytotoxic activity could be a distinct marker for immune dysregulation leading to pregnancy complications. CD69 membrane receptor expression has been measured by flow cytometry in different subtypes of pNK cells in 55 women with two or more pregnancy loss between six and twelve week of gestation with absence of any hormonal, anatomical or inherited cause for pregnancy loss and in 43 healthy women with at least one delivery at term and no history for reproductive failure. Increased expression of CD69 in CD56 positive pNK cells was found in the study group compared to controls (12.2% versus 6.5%, p<0.005). In addition, the subpopulation of CD56dim and CD56brightpNK cells in women with recurrent pregnancy loss showed increased percent of CD69 activation marker expression compared to controls (respectively 13.2% versus 7.2 p<0.005; and 4.6% versus 3.1% p=0.04). CD56brightCD16negative pNK cells (identical with those in uterine endometrium) in the investigated group has been found with higher CD69 expression compared to controls (3.3% versus 1.7%, p=0.03). Primary dysregulation in NK cells activity could be supposed in women with repeated early pregnancy loss without another underlined pathology. Investigation of active status of NK cells but not only NK cell count could be evaluation marker of impaired immunology regulation in early pregnancy development.