In malaria-endemic areas, by young adulthood people have developed functional immunity to malaria. However, during pregnancy this immunity is breached and infection occurs, leading to increased risks for mother and child. In the past this effect has been attributed to nonspecific immunosuppression, but recent research has revealed a specific pathogenic mechanism, involving the adherence of rare parasite variants to the placenta. This commentary explores the current state of research in this area and proposes a model of immune evasion and placental colonization. This model points the way to the development of future therapeutic interventions.
Female ; Humans ; Malaria, Falciparum - immunology ; Pregnancy ; Pregnancy Complications ; Parasitic - immunology

OBJECTIVETo investigate the phenotypes and functions of cord blood dendritic cells of fetuses whose mothers are patients with chronic hepatitis B.

METHODSPeripheral blood and cord blood mononuclear cells (PBMC) were isolated from whole blood by density gradient centrifugation with Ficoll-Hypaque. The adherent cells were cultured in AIM-V medium containing recombinant human IL-4, TNF-alpha and GM-CSF. On day 9, mature DCs (mDC) were harvested and used for phenotype analysis. The amounts of IL-12 which dendritic cells produced were measured. The dendritic cells that were studied and compared were from cord blood of fetuses of both CHB positive and negative mothers and from CHC adult peripheral blood.

RESULTSThe expression rate of CD80 and CD83 of chronic hepatitis B mother cord blood dendritic cells was low compared with that of the healthy cord blood, healthy adult peripheral blood, and chronic hepatitis B adult peripheral blood, P < 0.05. The amount of IL-12 produced by chronic hepatitis B mother cord blood dendritic cells was lower than that of healthy cord blood, healthy adult peripheral blood, chronic hepatitis B adult peripheral blood (P < 0.05). The T lymphocyte proliferation inducing ability of dendritic cells of healthy adult peripheral blood was higher in inducing cord blood T lymphocytes proliferation, which was greater than that of the healthy adult peripheral blood in inducing adult T lymphocytes and was greater than that of the healthy cord blood dendritic cells in inducing cord blood T lymphocytes, which was greater than that of the healthy cord blood in inducing adult T lymphocytes, which was greater than that of chronic hepatitis B mothers in inducing cord blood T lymphocytes, which was greater than that of chronic hepatitis B mother cord blood in inducing adult T lymphocytes.

CONCLUSIONThe maturation and functioning of CHB mother cord blood dendritic cells were lower than those of healthy cord blood, healthy adult peripheral blood and CHB adult peripheral blood.

Adult ; Cells, Cultured ; Dendritic Cells ; cytology ; immunology ; Female ; Fetal Blood ; immunology ; Hepatitis B, Chronic ; immunology ; Humans ; Phenotype ; Pregnancy ; Pregnancy Complications, Infectious ; immunology ; T-Lymphocytes ; immunology

OBJECTIVETo analyze the effect of autoimmune disorders on the outcome of in vitro fertilization and embryo transfer (IVF-ET) in infertile women.

METHODSA total of 236 infertile women underwent IVF-ET, including 34 with antiphospholipid antibody (APA) positive, 33 anti-trophoblast antibody (ATA) positive, 35 anti-hCG antibody (hCGAb) positive, 32 anti-endometrium antibody (EmAb) positive, and 102 with antibodies negative that comprised the control group. Those with two or more antibodies positive were excluded in this study. Comparisons were made in the rates of embryo implantation, clinical pregnancy, miscarriage and biochemical pregnancy between the positive groups and the negative controls.

RESULTSThere were no significant differences in the rates of embryo implantation and clinical pregnancy between the positive and negative groups (P > 0.05). The rate of biochemical pregnancy was higher in the APA, ATA and hCGAb positive than in the EmAb positive and the control group (P < 0.05). The miscarriage rate was higher while the ongoing pregnancy rate was lower in the positive groups than in the negative control (P < 0.05).

CONCLUSIONSuch autoantibodies as APA, ATA, HCG-Ab and EmAb may cause miscarriage in infertile women undergoing IVF and consequently reduce the rate of ongoing pregnancy, which necessitates the determination of these antibodies in these patients.

Adult ; Autoantibodies ; analysis ; Autoimmune Diseases ; complications ; immunology ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; etiology ; immunology ; therapy ; Pregnancy ; Pregnancy Outcome

Jr(a) is a high-frequency antigen found in all ethnic groups. However, the clinical significance of the anti-Jr(a) antibody has remained controversial. Most studies have reported mild hemolytic disease of the newborn and fetus (HDNF) in Jr(a)-positive patients. Recently, fatal cases of HDNF have also been reported. We report the first case of HDNF caused by anti-Jr(a) alloimmunization in twins in Korea. A 33-yr-old nulliparous woman with no history of transfusion or amniocentesis was admitted at the 32nd week of gestation because of vaginal bleeding caused by placenta previa. Anti-Jr(a) antibodies were detected in a routine laboratory examination. An emergency cesarean section was performed at the 34th week of gestation, and 2 premature infant twins were delivered. Laboratory examination showed positive direct antiglobulin test and Jr(a+) phenotype in the red blood cells and the presence of anti-Jr(a) antibodies in the serum in both neonates. The infants underwent phototherapy for neonatal jaundice; this was followed by conservative management. They showed no further complications and were discharged on the 19th postpartum day. Preparative management to ensure the availability of Jr(a-) blood, via autologous donation, and close fetal monitoring must be performed even in cases of first pregnancy in Jr(a-) women.
Adult ; Blood Group Antigens/immunology ; *Blood Group Incompatibility ; Diseases in Twins/diagnosis/*immunology ; Erythroblastosis, Fetal/*diagnosis/immunology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Isoantigens/immunology ; Jaundice, Neonatal/complications/immunology/therapy ; Male ; Phenotype ; Phototherapy ; Pregnancy ; Pregnancy Complications, Hematologic/diagnosis/*immunology ; Twins

PURPOSE: The effects of maternal systemic lupus erythematosus (SLE) on neonatal prognosis were examined by comparing clinical features of full-term babies born to lupus mothers and age- and parity-matched controls. PATIENTS and METHODS: From January 2000 to December 2005, 39 singletons were born to 37 SLE women. Excluding 11 cases of prematurity and preeclampsia, 28 full-term neonates formed the lupus group. The control group included 66 full-term babies. The retrospective study examined medical records and compared gestational age, birth weight, days of hospital stay, small for gestational age (SGA) frequency, Apgar scores < 7, and parity. Lupus neonates were tested for anti-nuclear antibody (ANA) and platelet count, and electrocardiogram was performed. RESULTS: Average gestational age (38 vs. 39 weeks, p < 0.05) and birth weight (2,775 vs. 3,263g, p < 0.05) were significantly different between the SLE and control groups. SGA frequency was higher in the SLE group (25% vs. 4.5%, p < 0.05). No significant difference was observed in Apgar score, birth weight, gestational age, SGA frequency, and platelet count between lupus subgroups formed based on anti-dsDNA antibody levels and antiphospholipid antibody status. CONCLUSION: The association of maternal ANAs, antiphospholipid antibodies, and drug history with neonatal prognosis could not be elucidated. However, even in uncomplicated pregnancies, maternal lupus is disadvantageous for gestational age, birth weight, and SGA frequency.
Adult ; Antibodies, Antinuclear/immunology ; Antibodies, Antiphospholipid/immunology ; Disease Susceptibility/immunology/pathology ; Female ; Humans ; Infant, Newborn ; Lupus Erythematosus, Systemic/*complications/immunology ; Male ; Platelet Count ; Pregnancy ; *Pregnancy Complications ; *Pregnancy Outcome ; Prognosis ; Risk Factors

OBJECTIVETo explore the effects of hepatitis B immune globulin (HBIG) in prevention of mother-to-infant hepatitis B virus (HBV) transmission.

METHODA total of 279 pregnant women positive for HBsAg alone or for both HBsAg and HBeAg were enrolled into this study from January 2001 to May 2005. They were respectively divided into two groups at random, namely, only HBsAg-positiveexperimental group (n = 80), only HBsAg-positive control group (n = 60), both HBsAg and HBeAg-positive experimental group (n = 79) and both HBsAg and HBeAg-positive control group (n = 60). The two experimental groups were injected with HBIG once every four weeks until labor. The two control groups received no HBIG. The infants received intramuscular HBIG 16 hours after birth and two weeks later, in addition to routine immunization with hepatitis B vaccine. The infants were followed up and HBsAg was determined.

RESULTSThe HBsAg infection rates of babies in the four groups were respectively 3%, 13%, 10%, 32%. The infection rate of the infants whose mothers were injected with HBIG was significantly lower than that of the control group.

CONCLUSIONThe HBIG could effectively prevent HBV transmission from mothers to infants and reduce the HBV infection rate.

Female ; Hepatitis B ; transmission ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B Vaccines ; immunology ; Hepatitis B e Antigens ; immunology ; Hepatitis B virus ; immunology ; Humans ; Immunoglobulins ; immunology ; Infant ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious ; prevention & control

The causes of abortion are complicated and variable. Genetic abnormalities, immune disorders, endocrine disorders, and sperm abnormalities are the most common etiologies. Other risk factors include infections, genital malformation and diseases, systemic diseases, environmental factors, psychiatric problems, fections, genital malformation and diseases, systemic diseases, environmental factors, psychiatric problems, surgery, and maternal trauma. In forensic assessment of abortion and its etiology, trauma-induced abortion can only be determined after exclusion of all other non-traumatic causes.
Abortion, Spontaneous/immunology* ; Chromosome Aberrations ; Expert Testimony ; Female ; Forensic Medicine ; Genital Diseases, Female/complications* ; Humans ; Pregnancy ; Wounds and Injuries/complications*

BACKGROUNDThe management of patients with recurrent miscarriage (RM) and antiphospholipid antibody syndrome (APS) includes prolonged treatment with heparin and aspirin, starting from the confirmation of pregnancy and continuing until 6 weeks after birth. This study was conducted to determine the relationship between changes in antiphospholipid antibody titers and clinical outcomes. The effect of a shortened treatment regimen was also evaluated.

METHODSA prospective study of 123 patients with RM and APS between March 2012 and May 2014 was conducted. Patients were pretreated with a low dose of prednisone plus aspirin before pregnancy, and heparin was added after conception. The levels of antiphospholipid antibodies and pregnancy outcomes were evaluated.

RESULTSAll patients were positive for anti-β2-glycoprotein 1 (anti-β2-GP1) IgM. After prepregnancy treatment with low-dose prednisone plus aspirin, 99 of 123 patients became pregnant, and 87 of those pregnancies resulted in successful live births, while 12 resulted in miscarriage, showing a success rate of 87.9%. In the live birth group, levels of anti-β2-GP1 were 56.8 ± 49.0 RU/ml before the pretreatment regimen, 32.1 ± 26.0 RU/ml after 2 months of pretreatment, and 24.1 ± 23.1 RU/ml during early pregnancy (P < 0.05). In the miscarriage group, antiphospholipid antibody titers were 52.8 ± 30.7 RU/ml before pretreatment, 38.5 ± 34.2 RU/ml after pretreatment, and 33.9 ± 24.7 RU/ml during early pregnancy; the decrease in antiphospholipid antibodies was lower in the miscarriage group than in the live birth group (P < 0.05). Of the 24 infertile patients, the average antibody titer did not decline after pretreatment (P = 0.802).

CONCLUSIONSAnti-β2-GP1 IgM was the predominant form of antibody in patients with RM and APS. The decreases in antiphospholipid antibody titers correlated with better pregnancy outcomes. The shorter treatment regimen was effective and economical.

Abortion, Habitual ; immunology ; prevention & control ; Adult ; Antibodies, Antiphospholipid ; immunology ; Anticoagulants ; therapeutic use ; Antiphospholipid Syndrome ; drug therapy ; immunology ; Aspirin ; therapeutic use ; Female ; Heparin ; therapeutic use ; Humans ; Live Birth ; Prednisone ; therapeutic use ; Pregnancy ; Pregnancy Complications ; prevention & control ; Pregnancy Outcome ; Prospective Studies

Toxoplasma gondii is one of the major agents of infectious abortions and due to its worldwide distribution can threat healthy pregnant women who had no previous exposure to this parasite. The present study was designed to investigate the contribution of T. gondii to spontaneous abortions in Zanjan, Northwest of Iran, using ELISA method. Blood Samples were collected from 264 mothers referred to the provincial hospitals of Zanjan due to spontaneous abortion. The sera were isolated and subjected to evaluate the anti-Toxoplasma IgG, IgM and IgA antibodies. The results showed IgG positive (IgG+) in 99 cases (37.5%). A total of 68 women (25.8%) showed seroconversion with IgM or IgA or both IgM and IgA. They included: IgM+ in 21 (8.0%), IgA+ in 23 (8.7%) and both IgM+ and IgA+ in 24 (9.1%) subjects. In 23 cases, positive titers of IgM and IgG were accompanied. In general, the analysis of anti-Toxoplasma antibody patterns, showed that about 17% of the spontaneous abortions were associated with serological patterns of acute infection. According to these findings, a considerable proportion of spontaneous abortions can be attributed to T. gondii in the study area.
Abortion, Spontaneous/immunology/*parasitology ; Antibodies, Protozoan/*blood ; Cross-Sectional Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin A/blood ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Iran/epidemiology ; Mothers ; Pregnancy ; Pregnancy Complications, Parasitic/*immunology/parasitology ; Toxoplasma/*immunology ; Toxoplasmosis, Congenital/*immunology/parasitology

OBJECTIVEAbnormal maternal thyroid function is associated with preterm birth. However, this association stays dubious in relevant individual studies for ethnic difference reasons and lack of direct supporting data. This study aimed to evaluate the relationship between preterm birth and thyroid dysfunction or autoimmunity based on ethnic differences.

METHODSRelevant studies were identified through searches of MEDLINE, Excerpta Medica, Wan Fang, China Biological Medicine disc, and China National Knowledge Infrastructure from inception to June 15, 2016. Original articles in which an incidence or prevalence of thyroid dysfunction or autoimmunity before second trimester of pregnancy could be extracted were included.

RESULTSThirty-two unique studies were included for the final meta-analysis. Patients involved were divided into two groups: Group 1 (G1) and Group 2 (G2) comprising of Asian and Caucasian populations, respectively. Positive thyroid antibodies were associated with the occurrence of preterm birth in both G1 [odds ratio (OR): 3.62, 95% confidence interval (CI): 2.83-4.65] and G2 (OR: 1.35, 95% CI: 1.17-1.56); hypothyroidism, only in G2 (OR: 1.20, CI: 1.09-1.33); and subclinical hypothyroidism or hypothyroxinemia, in neither group.

CONCLUSIONThyroid autoimmunity may be a more favorable factor leading to preterm birth among pregnant women of different ethnicities, compared with thyroid dysfunction.

Autoimmune Diseases ; ethnology ; immunology ; physiopathology ; Autoimmunity ; Female ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Complications ; ethnology ; immunology ; physiopathology ; Premature Birth ; ethnology ; immunology ; physiopathology ; Thyroid Diseases ; ethnology ; immunology ; physiopathology ; Thyroid Gland ; physiopathology