Document Type: Original Article
Authors
- Mitra Rafiee 1
- Marjan Gharagozloo 1
- Ataollah Ghahiri 2
- Ferdous Mehrabian 2
- Mohammad R. Maracy 3
- Shirin Kouhpayeh 1
- Ina Laura Pieper 4
- Abbas Rezaei 1
1 Department of Immunology, School of Medicine
2 Department of Gynecology and Obstetrics, Al-Zahra University Hospital
3 Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Institute of Life Science, College of Medicine, Swansea University, Swansea, United Kingdom
Abstract
Background: Recurrent miscarriage (RM) affects 2-5% of pregnant women. Paternal lymphocyte immunotherapy is a common treatment for RM patients but the outcome has not been consistent. Therefore, combined therapy with other immunosuppressive drugs such as 1 a, 25-dihydroxy-vitamin-D3 (vitamin D3) may improve the outcome.
Objectives: To investigate the effect of vitamin D3 on the balance of two essential T cells subsets, T helper (Th) 17 and T regulatory (Treg) cells, which contribute to the immune tolerance during pregnancy.
Methods: The expression levels of CD4 and forkhead box protein 3 (FOXP3) in Treg cells, and the expression levels of CD4 and IL- 17 in Th17 cells, were evaluated pre- and 3 months post-immunotherapy in RM patients treated with a combination of paternal lymphocytes and vitamin D3 compared with RM patients receiving lymphocyte immunotherapy alone.
Results: Vitamin D3 therapy decreased the frequency of Th17 cells in addition to reducing the Th17/Treg ratio in peripheral blood of RM patients compared with the control group (p <0.05).
Conclusion: Considering that RM patients have a higher Th17/Treg ratio in peripheral blood, vitamin D3 may be a candidate therapeutic approach in this disease.
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