Evidence of a TH1 type response associated with recurrent miscarriage

Objective: To determine whether the T-H 1 cytokine interferon (IFN)-gamma is associated with miscarriage whereas the T-H 2 cytokine interleukin (IL)-10 is associated with successful pregnancy. Design: Controlled clinical study. Setting: Healthy volunteers in an academic setting. Patient(s): Group 1 comprised 10 nonpregnant women; group 2, 10 first-trimester primigravid women; group 3, 10 first-trimester primigravid women suffering spontaneous abortion; and group 4, 10 first-trimester pregnant women with a history of miscarriage. All women were pregnant at the time of sampling, but 5 miscarried later in the first trimester. Intervention(s): None of the patients received any medication. Main Outcome Measure(s): Serum levels of IL-10 and IFN-gamma. Result(s): Levels of IL-10 were significantly raised in normal pregnancy. Levels of IFN-gamma were raised in the recurrent-miscarriage group as compared with normal pregnancy. When patients in group 4 were divided into those whose pregnancies went to term and those who miscarried, we found that successful pregnancy was associated with a statistically significant increase in IL-10, whereas miscarriage was associated with significantly increased levels of IFN-gamma. Conclusion(s): These results support the view that miscarriage is associated with a T-H 1 type response. ((C) 2000 by American Society for Reproductive Medicine.)