■已经证明,免疫紊乱是复发性妊娠丢失(RPL)的重要危险因素之一,食物不耐受的存在似乎在其中发挥了重要作用。然而,食物不耐受引起的免疫状态对RPL的影响尚未见报道。这项研究利用了针对性的饮食,尽可能避免食物不耐受,以调查其对自身免疫标志物阳性的RPL患者妊娠结局的影响。
■从2020年1月至2021年5月,共纳入58例RPL患者。他们根据自身抗体的存在分为两组:自身抗体阳性组(AP,n=29)和自身抗体阴性组(AN,n=29)。使用酶联免疫吸附测定(ELISA)测试了90种食物的食物特异性免疫球蛋白(Ig)G抗体。免疫参数的水平和胃肠道不适的存在(腹泻或便秘,湿疹,和口腔溃疡)在饮食调理之前和之后进行记录,然后分析妊娠结局。
■与AN组相比,AP组患者在基线时出现免疫紊乱,例如IL-4和补体C3的水平降低,以及IL-2和总B细胞的水平升高。在避免食物不耐受的饮食调理后,AP组中的这些参数显着改善。而AN组无明显变化。AP组患者对牛奶的食物特异性IgG抗体明显较高(89.66%vs.48.28%,p<.001),蛋黄(86.21%与27.59%,p<.001),竹笋(86.21%vs.44.83%,p<.001)与AN组相比。此外,肠胃不适,包括腹泻或便秘,湿疹,与AN组相比,AP组口腔溃疡更为常见。经过3个月的饮食调理,这些显著改善的特征仅在AP组中观察到(p<.001).最后,与AN组相比,AP组的抱婴率较高(p<0.05)。
■AN组的RPL患者没有出现免疫紊乱,而AP组患者出现免疫紊乱和胃肠道不适。对于自身抗体阳性的患者,饮食干预可以减轻免疫紊乱和胃肠道不适,提出了一种有希望的方法来提高妊娠结局。
UNASSIGNED: It has been proven that immune disorders are one of the vital risk factors of recurrent pregnancy loss (RPL), and the presence of food intolerance seems to play an essential role in this. However, the impact of immune status induced by food intolerance on RPL has not been reported. This study utilized a targeted diet avoiding food intolerance as much as possible for each participant to investigate their effects on pregnancy outcomes in RPL patients with positive autoimmune markers.
UNASSIGNED: From January 2020 to May 2021, fifty-eight patients with RPL were enrolled. They were divided into two groups based on the presence of autoantibodies: the autoantibody-positive group (AP, n = 29) and the autoantibody-negative group (AN, n = 29). Their food-specific immunoglobulin (Ig) G antibodies for 90 foods were tested using enzyme-linked immunosorbent assay (ELISA). The levels of immune parameters and the presence of gastrointestinal discomforts (diarrhea or constipation, eczema, and mouth ulcers) were recorded before and after dietary conditioning, followed by the analysis of pregnancy outcomes.
UNASSIGNED: Compared to the AN group, the patients in the AP group showed immune disorders at baseline, such as reduced levels of IL-4 and complement C3, and increased levels of IL-2 and total B cells. These parameters within the AP group were significantly improved after dietary conditioning that avoided food intolerance, while no significant changes were observed in the AN group. Patients in the AP group had significantly higher food-specific IgG antibodies for cow\'s milk (89.66% vs. 48.28%, p < .001), yolk (86.21% vs. 27.59%, p < .001), bamboo shoots (86.21% vs. 44.83%, p < .001) compared to those in the AN group. Additionally, gastrointestinal discomforts including diarrhea or constipation, eczema, and mouth ulcers were more common in the AP group than in the AN group. After 3-month dietary conditioning, these significantly improved characteristics were only observed in the AP group (p < .001). Finally, the baby-holding rate was higher in the AP group compared to the AN group (p < .05).
UNASSIGNED: The RPL patients in the AN group did not exhibit immune disorders, whereas those in the AP group experienced immune disorders and gastrointestinal discomforts. For patient with positive autoantibodies, dietary intervention may mitigate immune disorders and gastrointestinal discomforts, presenting a promising approach to enhance pregnancy outcomes.