Sunday, January 27, 2008

Blocking Antibodies

As I travel in this journey of getting pregnant and preventing a future miscarriage, I have stumbled upon Reprodutive Immunology. I have enumerated some superficial causes of miscarriage from my previous posts but I never thought that I would consider seeing a reproductive immunologist before. I thought everything will be corrected easily like cure infections, healthy thyroids and avoiding sugar.

Recently, a colleague who had 3 miscarriages (less than 12 age of gestation) finally found the culprit of her miscarriages. Apparently, her tissues and her husband's are too alike that they could be an organ donor of each other which is not ideal when you have plans of getting pregnant. How ironic? Too much alike yet incompatible.

I have talked about APAS or antiphospolipid antibody syndrome or sticky blood syndrome, that prones you to clotting and can starve your baby to nutrition because it shuts off the blood vessels that goes into the placenta.

Blocking Antibodies

Early in pregnancy, the mother's immune system receives signals from the tiny fetus. Many of the signals are hormonal, but others come directly from genetic messages that the father has contributed. Some of the messages involve the tissue type, also known as the human leukocyte antigens (HLA) and the white blood cell (leukocyte) type. HLA are expressed on white blood cells. They are unique to each individual and allow the body to identify anything foreign to it such as infections, cancers, transplanted organs and fetuses.

One half of the fetus's HLA type is contributed by mother and the other half by father. When a woman becomes pregnant, her body's immune system usually recognizes the father's HLA as different from her own, and the white blood cells in her uterus produce protective, blocking antibodies. These antibodies coat the baby's cells and protect the fetus from mother's killer cells. If father's HLA is too similar to mother's, her cells may not recognize differences that are vital to the production of blocking antibodies.

Treatment for Blocking Antibodies

Two treatments have been offered for low blocking antibody levels: paternal white cell immunizations and IVIg. Immunizing the mother with concentrates of the father's white blood cells amplifies the HLA signal. Approximately 50% of patients have a discernible increase in the blocking antibody level after 2 treatments. The other 50% require additional white cell immunizations. To determine if additional preparations will be required, the blocking antibody level should be measured 3 to 4 weeks after the second and all subsequent immunizations. When blocking levels are elevated, prior to conception, the rate of successful pregnancy is nearly 80%

According to my colleague's repro immunologist, most miscarriages that occur under 12 weeks is most of the time caused by the above. Now, I am thinking to get this test first before APAS cuz its cheaper. I am not a cheapskate, I am just practical.Haha!


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