A ratio of specific immune cells—CD3+IL-17+ T cells to CD4+Foxp3+ regulatory T cells—was a vital marker for diagnosing and predicting pregnancy outcomes in women with idiopathic recurrent pregnancy loss, according to results from a study published recently in the American Journal of Reproductive Immunology. Recurrent pregnancy loss can be related to fetal and neonatal autoimmune thrombocytopenia (FNAIT).
This ratio from the study could help identify patients who might benefit from intravenous immunoglobulin (IVIG) therapy. The results offer promising advancements for women facing this challenging condition.
“Our study demonstrates that IVIG treatment can significantly improve LBR [live birth rate] in women with a high Th17/Treg cell ratio, offering a promising therapeutic approach for this challenging condition. Further research is warranted to validate these findings and explore additional treatment strategies,” explained this study’s authors.
Researchers evaluated 49 women with idiopathic recurrent pregnancy loss and 75 controls, examining various immune cell ratios using flow cytometry. Among these, the CD3+IL-17+ T/CD4+Foxp3+ T cell ratio emerged as the most effective predictor of pregnancy outcomes. Women with a ratio of 1.096 or higher had significantly improved live birth rates (78.57%) when treated with IVIG compared to those untreated (28.57%). Conversely, IVIG showed no significant benefit in women with lower ratios.
Read more about FNAIT causes and risk factors
This immune cell imbalance was also found to be independent of other immune factors such as NK cell activity or Th1/Th2 ratios, underscoring its potential as a standalone diagnostic and prognostic tool. This study highlighted the high prevalence of an elevated Th17/Treg cell ratio among women with recurrent pregnancy loss, indicating its relevance in understanding development of the condition.
In terms of safety and efficacy, IVIG therapy demonstrated substantial promise for women with high Th17/Treg ratios, paving the way for more personalized approaches to treating idiopathic recurrent pregnancy loss. These results could transform how clinicians select and implement immunotherapy for patients struggling with unexplained pregnancy loss.
By identifying patients likely to benefit from IVIG therapy, doctors could potentially improve pregnancy outcomes while minimizing unnecessary interventions. The live birth rate for women in the high-ratio group nearly tripled with treatment, highlighting the importance of this tailored approach.
