مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
The Role of Immuno-Biotechnology in Reducing Recurrent Pregnancy Loss: Focus on IVIG and Immune Biomarkers
The Role of Immuno-Biotechnology in Reducing Recurrent Pregnancy Loss: Focus on IVIG and Immune Biomarkers
Tahereh Rezazadeh,1,*Roghaye Arezumand,2Hasan Namdar Ahmadabad,3
1. Department of Advanced Sciences and Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran 2. Department of Advanced Sciences and Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran 3. Department of Pathobiology and Laboratory Sciences Immunolog, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
Introduction: Recurrent pregnancy loss (RPL), defined as two or more consecutive miscarriages, affects 2–5% of couples and poses both clinical and psychological challenges. While chromosomal, anatomical, and endocrine abnormalities are established causes, a growing body of evidence highlights the role of immune dysregulation at the maternal–fetal interface. Successful pregnancy requires maternal tolerance toward the semi-allogeneic fetus, achieved through coordinated regulation of natural killer (NK) cells, T helper (Th) subsets, and regulatory T cells (Tregs). When this balance is disrupted, implantation failure and miscarriage may result.
Immuno-biotechnology provides valuable tools to both elucidate the mechanisms of immune imbalance and develop targeted therapies. Among available treatments, intravenous immunoglobulin (IVIG) has attracted significant attention for its ability to modulate immune responses. At the same time, advances in biotechnological assays support the identification of immune biomarkers that may predict patient response, paving the way toward personalized medicine in reproductive immunology.
Methods: The terms “Immuno-Biotechnology, Reducing Recurrent Pregnancy Loss, IVIG and Immune Biomarkers” were searched in PubMed, Science Direct, and Google Scholar, the selected articles were critically evaluated.
Results: 1. Immune Dysregulation in RPL
Elevated NK cell cytotoxicity and abnormal Th1/Th2 or Th17/Treg ratios are consistently reported in women with RPL. Autoantibodies, including anti-HLA and anti-phospholipid antibodies, further contribute to implantation failure.
2. Mechanisms and Efficacy of IVIG
IVIG reduces NK cell cytotoxicity, promotes Treg expansion, and modulates cytokine secretion toward a Th2-dominant profile. While outcomes vary, patients with immune abnormalities appear to benefit more from IVIG than unselected RPL populations.
3. Immuno-Biotechnology for Biomarker Discovery
Flow cytometry enables characterization of immune subsets, including NK cells and Tregs, predictive of pregnancy outcomes. Multiplex cytokine assays identify pro-inflammatory signatures (e.g., elevated TNF-α, IFN-γ) associated with miscarriage risk. NGS and transcriptomic profiling have revealed gene signatures such as FOXP3, perforin, and granzyme B, which may guide patient stratification. Combining biomarkers with clinical features improves prediction of IVIG responsiveness.
4. Emerging Biotechnological Applications
Monoclonal antibody engineering and recombinant cytokine therapies represent potential adjuncts or alternatives to IVIG. Early studies on exosome-based immunomodulation suggest novel approaches to restore maternal–fetal tolerance.
Conclusion: Immuno-biotechnology offers powerful strategies for understanding and managing recurrent pregnancy loss. IVIG remains the most widely studied immunotherapy, though its efficacy is maximized when guided by precise biomarker selection. Biotechnological tools such as flow cytometry, cytokine profiling, and sequencing have advanced the discovery of biomarkers, enabling tailored interventions. Future work should focus on large-scale clinical trials, standardized treatment protocols, and exploration of innovative immunotherapies beyond IVIG. Integrating biotechnology into clinical practice may significantly reduce miscarriage rates and improve live birth outcomes, marking an important step toward personalized reproductive medicine.