The Study Of PIBF Serum Level And The Effect On Th1/Th2in Immunological Recurrent Spontaneous Abortion Patients

ObjectiveThis study was designed to detect the levels of progesterone-induced blocking factor (PIBF), interferon gamma (IFN-gamma) and interleukin4(IL-4) and to understand the effect on IFN-y and IL-4in immunological recurrent spontaneous abortion (RSA) patients. Besides, the pathogenesis of immunological recurrent spontaneous abortion would be further studied, and it layed the foundation for the clinical diagnosis and treatment of such patients.Methods60cases of immunological recurrent spontaneous abortion patients formed study group.28cases who had been received regular anti-abortion treatment formed group I. The rest of them, who have been received immunotherapy plus regular anti-abortion treatment, formed study group II.23cases of normal early pregnant women formed control group. The concentrations of serum PIBF, IFN-yand IL-4of the study group and the control group were measured by enzyme-linked immunosorbent assay. Median serum concentrations of PIBF, IFN-yand IL-4among different groups were compared by Mann-Whitney U Non-parametric test/Wilcoxon signed-rank test or t test for their significance of difference. The correlation between PIBF and IFN-y, PIBF and IL-4was analyzed by Spearman correlation method.Results1. In the study group, the levels of PIBF, IFN-y and IL-4were83.31pg/ml,260.00ng/ml and257.74ng/ml. In the control group, the levels of PIBF, IFN-y and IL-4were129.27pg/ml,226.00ng/l and319.28ng/l. Comparing with the control group, the levels of PIBF and IL-4of the study group were significantly lower, IFN-y significantly higher (P<0.05). In the study group I, the levels of PIBF, IFN-y and IL-4were79.43pg/ml,228.84and275.24ng/l. In the study group II, the levels of PIBF, IFN-y and IL-4were88.27pg/ml,260.64ng/l and247.59ng/l. No significant difference was seen between the two groups (P>0.05)2. In the treated study group, the levels of PIBF, IFN-yand IL-4were135.35pg/ml,214.14ng/l and336.88ng/1. Comparing with the study group, the levels of PIBF and IL-4of the treated study group were significantly higher, IFN-y significantly lower (P<0.05). In the treated study group I, the levels of PIBF, IFN-yand IL-4were105.88pg/ml,200.96ng/l and275.24ng/l. Comparing with the study group I, the levels of PIBF and IL-4of the treated study group I is significantly higher, IFN-y significantly lower (P<0.05). In the treated study group II, the levels of PIBF, IFN-y and IL-4were156.00pg/ml,229.75ng/l and439.13ng/l. Comparing with the study group II, the levels of PIBF and IL-4of the treated study group Ⅱ is significantly higher, IFN-y significantly lower (P<0.05). In the study group Ⅰ, the change values between before and after the treat of PIBF, IFN-y and IL-4were32.10pg/ml,-16.60ng/l and21.91ng/l. In the study group Ⅱ, the change values between before and after the treat of PIBF, IFN-y and IL-4were50.97pg/ml,-106.83ng/l,56.77ng/l. Comparing with the study group I, the change values of PIBF and IL-4of the study group II were significantly higher, IFN-γ significantly lower (P<0.05).3. In the study group, the serum level of PIBF negatively correlats with that of IFN-y,and positively correlats with that of IL-4(P<0.05).Conclusions1. The serum level of PIBF decreased, the balance of Thl/Th2biases to Thl cytokine. This may be the cause of immunological recurrent spontaneous abortion.2. After treated with regular anti-abortion therapy and immunotherapy, PIBF increased, the balance of Thl/Th2biases to Th2cytokine. It also suggests that PIBF can be considered as clinical observational indexes.3. After being treated with immunotherapy on the basis of conventional anti-abortion therapy, PIBF increased and the Th1/Th2balance biased to Th2cytokine more significantly. In immunological recurrent spontaneous abortion patients, it illustrates that the effecay of immunotherapy is more obvious than conventional anti-abortion therapy.