CLINICAL EFFECTS OF HUMAN IMMUNOGLOBULIN ADMINISTRATION IN WOMEN WITH RHESUS SENSITIZATION AT THE PRE-GRAVID STAGE
DOI:
https://doi.org/10.11603/24116-4944.2019.2.10913Keywords:
pregnancy, rhesus sensitization, human immunoglobulin for intravenous administrationAbstract
The aim of the study – to evaluate changes in cellular immunity in rhesus-sensitized women in response to IVIG administration and the prognostic effectiveness of a method for the prevention of isoimmunization in the next pregnancy.
Materials and Methods. The study was performed on the basis of City Maternity Hospital No. 7" (Odesa) in 2014–2019. 37 rhesus-sensitized women were randomly splited in two clinical groups: main clinical group (n=19) where patients received human immunoglobulin for intravenous administration, and control group (n=18) where patients did not receive IVIG.
Results and Discussion. The state of cellular immunity in rhesus-sensitized women is characterized by a moderate decrease in the absolute and relative indices of T-lymphocytes while increasing the number of B-lymphocytes. The NK cell population did not differ from the control group. When analyzing subpopulations of T-lymphocytes, it can be concluded that the number of T-helper cells is increased and the number of T-suppressors is proportionally reduced. These changes explain the increase in the number of B-lymphocytes as a result of increasing antigenic load on cell receptors. In the group of women who received IVIG therapy, the ratio of chances of normalization of cellular immunity was 18.41 (95 % CI 2.62–166.74), T-helper – 14.93 (95 % CI) 2.45–107.8), T-suppressors – 14.57 (95 % CI 2.13 –127.57) and B-lymphocytes – 31.87 (95 % CI 4.1–333.41). According to the ROC analysis, the quality of the statistical model of IVIG application corresponds to AUC = 0.843 (95 % CI 0.689–0.941) According to the ROC analysis, the level of β-lymphocytes in the compared AUC groups = 0.58 (95 % CI 0.405–0.742).
References
Latysheva, T.V. (2005). Printsipy zamestitelnoy terapii vnutrivennymi immunoglobulinami [Principles of replacement therapy with intravenous immunoglobulins]. Tsitokiny i vospaleniye – Cytokines and Inflammation, 4, 3, 58-62 [in Russian].
Nakaz MOZ Ukrainy № 676 vid 31.12.2004 “Pro zatverdzhennia klinichnykh protokoliv z akusherskoi ta hinekolohichnoi dopomohy – vedennia vahitnosti u zhinok z imunnymy konfliktamy“ [Order of the Ministry of Health of Ukraine No. 676 of December 31, 2004 “On Approval of Clinical Protocols on Obstetric and Gynecological Assistance – Pregnancy in Women with Immune Conflicts”]. Retrieved from: https://z-l.com.ua/ru/new319/ [in Ukrainian].
Nakaz MOZ Ukrainy № 417 vid 15.07.2011 “Pro orhanizatsiiu ambulatornoi akushersko-hinekolohichnoi dopomohy v Ukraini” [Order of the Ministry of Health of Ukraine No. 417 of 15.07.2011 “On the organization of outpatient obstetric and gynecological care in Ukraine”]. Retrieved from: https://z-l.com.ua/upload//moz %20docs/417.pdf [in Ukrainian]. DOI: https://doi.org/10.5664/JCSM.1216
Chaigne, B., & Mouthon, L. (2017). Mechanisms of action of intravenous immunoglobulin. Transfus Apher. Sci., 56 (1), 45-49. DOI: https://doi.org/10.1016/j.transci.2016.12.017
Introduction to Flow Cytometry: A Learning Guide. Retrieved from: https://www.bu.edu/flow-cytometry/files/2010/10/BD-Flow-Cytom-Learning-Guide.pdf
Reproductive Immunology: Basic Concepts: Immune Cells and Reproduction by Gil G. Mor MD PhD Academic Press; 1 edition (April 16, 2019).
Sperling, J.D., Dahlke, J.D., Sutton, D., Gonzalez, J.M., & Chauhan, S.P. (2018). Prevention of RhD Alloimmunization: A Comparison of Four National Guidelines. Am J Perinatol., 35 (2), 110-119. DOI: https://doi.org/10.1055/s-0037-1606609
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
