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Effectiveness and potential mechanisms of intralipid in treating unexplained recurrent spontaneous abortion

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

A Correction to this article was published on 23 October 2021

This article has been updated

Abstract

Aim

Abnormal natural killer (NK) cell activity has been suggested to be a high-risk factor associated with unexplained recurrent spontaneous abortion (URSA). Intralipid, like immunoglobulin, is able to lower the activity of NK cells, which has been reported to be useful for improving URSA outcomes in pregnancy. This study aimed to determine whether intralipid could be used as an alternative treatment to intravenous immunoglobulin (IVIG) which is expensive and has many side-effects.

Methods

A prospective, randomized clinical trial was conducted from December 2010 to December 2012. Eligible participants were matched and sorted randomly into the intralipid and the IVIG group. The primary outcome was the rate of successful pregnancy. In addition, comparisons of peripheral NK cell activities were accessed by flow cytometry. Moreover, the effects of intralipid on trophoblasts were investigated using a Matrigel assay with the JEG-3 cell line.

Results

Seventy-six patients in the intralipid group and 78 in the IVIG group completed the trial. There were no statistically significant differences in successful pregnancy rates between the two groups (92.1 vs 88.2 %, P = 0.415). The reduced NK cell concentrations revealed the cytotoxic effects of the treatments in both groups. The invasive ability of JEG-3 cells was inhibited during co-culture with patient PBMCs. However, the inhibitory effect could be alleviated if the patient PBMCs were stimulated with intralipid.

Conclusions

Intralipid can be used as an alternative treatment to IVIG for URSA, and its potential mechanism of action may occur by regulating NK cell function and promoting trophoblast invasion.

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Acknowledgments

The authors thank Lu Huiqiong and Lan Tianyun for performing the flow cytometry. This study was funded by the Science and Technology Planning Project of Guangdong Province, China (2011B061200005), the Ph.D. Programs Foundation for youth scholars by the China Education Ministry (20110171120090), the National Natural Science Foundation of China (No. 81170625), 5010 projects at Sun Yat-San University (2012006), the Science and Technology Planning Project of Guangdong Province (2012B031800352), Guangdong Natural Science Foundation (S2013010014411), Fundamental Research Funds for the Central Universities (Youth Program 12ykpy29), and the research funds of Sun Yat-sen Memorial Hospital at Sun Yat-sen University (YY 002013001).

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, The Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Yanjiang Road 107#, Guangzhou, 510060, Guangdong Province, China

    Lili Meng, Libin Chen, Zhenhua Wang, Meilan Liu, Yukun Liu, Xin Chen, Liqiong Zhu, Hui Chen & Jianping Zhang

  2. Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China

    Jizong Lin

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  1. Lili Meng
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Correspondence to Hui Chen or Jianping Zhang.

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The author(s) declare that they have no competing interests.

Additional information

M. Lili, L. Jizong and C. Libin are equal contributors for this study.

The original online version of this article was revised due to correction in the figure 3

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Meng, L., Lin, J., Chen, L. et al. Effectiveness and potential mechanisms of intralipid in treating unexplained recurrent spontaneous abortion. Arch Gynecol Obstet 294, 29–39 (2016). https://doi.org/10.1007/s00404-015-3922-8

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  • DOI: https://doi.org/10.1007/s00404-015-3922-8

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