Immunological studies on women receiving leukocyte immunotherapy

Birds, babies and blood

This is an autobiographical review describing the author's career in immunology research and summarizing his current understanding of the areas involved. Contributions to autoimmunity, immune deficiency, transfusion immunology, HLA-disease associations, reproductive immunology, cellular therapies, and innate immunity are included; also discussion of medical research ethics and various research-related activities.

Soluble interleukin-2 receptors in recurrent miscarriage and the effect of leukocyte immunotherapy

The relationship between soluble interleukin-2 receptors (IL-2R) and pregnancy outcome was investigated in women with a history of miscarriage, some of whom were treated with partner-specific leukocyte immunotherapy. IL-2R were significantly elevated in patients with a poor obstetric history possessing cardiolipin antibodies, and higher levels were also found in recurrent aborters without cardiolipin antibodies who had particularly bad histories. Furthermore, values obtained during early pregnancy were lower in patients who subsequently had successful pregnancies than in those who aborted again. Eight out of 35 patients immunised with their partners' lymphocytes, but none of 16 patients immunised with their own cells, showed a marked decrease in IL-2R levels a month later. It is possible that the minority who respond to immunotherapy with a marked drop in IL-2R may be the same minority who may derive benefit from this treatment.

Cardiolipin antibody levels are not influenced by leukocyte immunotherapy in patients experiencing recurrent spontaneous abortion

OBJECTIVE

To confirm that leukocyte immunotherapy stimulates the production of cardiolipin antibodies and to relate changes to pregnancy outcome.

PATIENTS

Fifty patients with idiopathic recurrent abortion were studied. Thirty-six patients received injections of their partners' leukocytes; 14, injected with their own cells, served as controls.

DESIGN

Cardiolipin antibodies were measured a month before and after leukocyte immunization. Patients who became pregnant were immunized a second time in early pregnancy, and cardiolipin antibodies were again measured a month later.

RESULTS

Thirty-six patients immunized with their partners' leukocytes showed no appreciable change in cardiolipin antibody levels a month after vaccination. Twenty-nine of them subsequently became pregnant and were immunized again in early pregnancy: again, no change in cardiolipin antibody level was observed. There was no difference between the minority who aborted again and the majority who subsequently had successful pregnancies nor between those who responded to immunotherapy by producing cytotoxic antilymphocyte antibodies and those who did not.

CONCLUSION

Leukocyte immunotherapy does not stimulate cardiolipin antibody production in women with normal pretreatment levels of the autoantibody.