题目：

抗心磷脂抗体、抗β2糖蛋白1抗体与体外受精不良结局相关

期刊：

Frontier Immunology

发表时间：

2022年 11月

关键词：

anticardiolipin, anti-β2-glycoprotein-I, antiphospholipid syndrome, IVF outcomes, pregnancy outcome

摘要翻译：

研究目的：

评估抗磷脂抗体（主要纳入抗心磷脂、抗β2-糖蛋白-1抗体）对体外受精-胚胎移植(IVF)结果的影响。

方法：

研究组为 接受胚胎移植周期的抗磷脂抗体阳性的不孕妇女。对照组为 输卵管病因所致不孕的抗磷脂抗体阴性妇女。比较抗磷脂抗体对研究组和对照组生殖结局(如卵母细胞质量、胚胎质量和着床能力)的影响。此外，通过流式细胞术分析外周血T细胞亚群，如辅助性T细胞(th1)、Th2、Th17和T调节细胞(Treg)和细胞因子。分析研究组与对照组之间的差异。

结果：

共有132名不孕症妇女，包括44名抗磷脂抗体妇女，和88名对照者被依次招募参加本研究。抗磷脂抗体阳性患者的总胚胎数量和优胚/可用胚胎数量较低，MII卵母细胞、囊胚形成、优胚和可用胚胎、着床、临床妊娠和成功抱娃的比例均较低。此外，与对照组相比，抗磷脂抗体阳性患者的Th1/Th2和Th17/Treg比例失衡，血清IL-2、TNF-a、IFN-g和IL-17A水平显著升高，血清IL-4水平显著降低。

结论：

患有抗心磷脂抗体和/或抗β2-糖蛋白-1抗体阳性的女性与不良IVF结果相关。应考虑对接受体外受精的夫妇进行早期aPL筛查和适当咨询。

原版英文摘要

Objective:

The purpose of the study is to evaluate the effects of anticardiolipin (aCL) and/or anti-β2-glycoprotein-I (aβ2GPI) antibodies, namely antiphospholipid antibodies (aPL), on in vitro fertilization (IVF) outcomes.

Materials and methods:

The study group comprised infertile women with aPL undergoing IVF-ET cycles. Controls were infertile women with tubal etiology without aPL. The impact of aPL on reproductive outcomes, such as oocyte quality, embryo quality, and implantation capacity, was compared between the study group and controls. Additionally, peripheral blood T cell subsets, such as T helper (Th)1, Th2, Th17, and T regulatory (Treg) cells and cytokines, were analyzed by the flow cytometry. Differences between the study group and controls were analyzed.

Result:

A total of 132 infertile women, including 44 women with aPL, and 88 controls were sequentially recruited for this study. Women with aPL had lower numbers of total and perfect/available embryos and lower rates of MII oocytes, blastocyst formation, perfect and available embryos, implantation, clinical pregnancy, and take-home baby. Additionally, imbalanced Th1/Th2 and Th17/Treg ratios, significantly higher levels of serum IL-2, TNF-α, IFN-γ, and IL-17A, and a significantly lower serum IL-4 were noticed in women with aPL compared to controls.

Conclusion:

Women with aPL such as aCL and/or aβ2GPI antibodies were associated with adverse IVF outcomes. Early screening for aPL and appropriate consultation for couples undergoing IVF should be considered. In addition, underlying immunopathology and inflammatory immune mechanisms associated with aPL should be further explored.

参考文献：

Wu L, Fang X, Lu F, Zhang Y, Wang Y, Kwak-Kim J. Anticardiolipin and/or anti-β2-glycoprotein-I antibodies are associated with adverse IVF outcomes. Front Immunol. 2022 Nov 2;13:986893. doi: 10.3389/fimmu.2022.986893.