Objective: To examine the effects of dydrogesterone on the production of Th1 and Th2 cytokines by lymphocytes from women undergoing unexplained recurrent spontaneous miscarriage (RSM). Design: Controlled prospective, clinical study conducted in a maternity hospital and a university-based immunology laboratory. Setting: Faculty of Medicine, Kuwait University and Kuwait Maternity Hospital. Sample: Thirty women with unexplained RSM. Methods: Peripheral blood mononuclear cells (PBMC) from women with unexplained RSM were isolated from venous blood by density gradient sedimentation and stimulated with phytohaemagglutinin (PHA). Culture supernatants assayed for interferon (IFN)-γ, tumour necrosis factor (TNF)-γ, interleukin (IL)-4, IL-6 and IL-10 by ELISA. Levels of the progesterone-induced blocking factor (PIBF) were also measured. Main outcome measures: Cytokine production in the presence and absence of progesterone and dydrogesterone. Results: Dydrogesterone significantly inhibited the production of the Th1 cytokines IFN-γ (P = 0.0001) and TNF-α (P = 0.005) and induced an increase in the levels of the Th2 cytokines IL-4 (P = 0.03) and IL-6 (P = 0.017) resulting in a substantial shift in the ratio of Th1/Th2 cytokines. The effect of dydrogesterone was blocked by the addition of the progesterone-receptor antagonist mifepristone, indicating that dydrogesterone was acting via the progesterone receptor. Dydrogesterone induced the production of PIBF. Conclusion: Dydrogesterone inhibits the production of the Th1 cytokines IFN-γ and TNF-α from lymphocytes and up-regulates the production of the Th2 cytokines IL-4 and IL-6, inducing a Th1 to Th2 cytokine shift.
|Number of pages||6|
|Journal||BJOG: An International Journal of Obstetrics and Gynaecology|
|Publication status||Published - Aug 1 2005|
ASJC Scopus subject areas
- Obstetrics and Gynaecology