Quenby S, Kalumbi C, Bates M, Farquharson R, Vince G. Prednisolone reduces preconceptual endometrial natural killer cells in women with recurrent miscarriage.
Fertil Steril 2005;
84:980-4. [PMID:
16213853 DOI:
10.1016/j.fertnstert.2005.05.012]
[Citation(s) in RCA: 153] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Revised: 05/31/2005] [Accepted: 05/31/2005] [Indexed: 11/27/2022]
Abstract
OBJECTIVE
To test the hypothesis that high numbers of uterine natural killer (uNK) cells in the endometrium of women with recurrent miscarriage (RM) could be reduced with prednisolone.
DESIGN
A before and after study.
SETTING
A tertiary referral teaching hospital.
PATIENT(S)
Eighty-five women with idiopathic RM recruited from all over the UK and 18 women attending for sterilization (controls).
INTERVENTION(S)
An endometrial sample was taken on day 21 +/- 2 of the menstrual cycle. Immunohistochemistry was used to identify uNK (CD56+, CD16-, CD3-). Twenty-nine women with RM and >5% uNK agreed to take 20 mg oral prednisolone daily from day 1 to 21 of their menstrual cycle, when a second biopsy was obtained and analyzed.
MAIN OUTCOME MEASURE(S)
The percentage of stromal cells that were uNK. The normal range was defined using control samples as <5%.
RESULT(S)
Women with RM had significantly more uNK than the controls (P=.008). Prednisolone treatment significantly reduced the number of CD56 cells in the endometrium, from a median of 14% (before) to 9% (after) (P=.0004).
CONCLUSION(S)
We have demonstrated that high numbers of uNK in preimplantation endometrium of women with recurrent miscarriage can be reduced with administration of prednisolone.
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