Publication: Estudio de biomarcadores en sangre periférica en mujeres con fallo reproductivo recurrente
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2023-04-18
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Universidad Complutense de Madrid
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Abstract
El fallo reproductivo recurrente engloba dos entidades clínicas bien diferenciadas como son los abortos de repetición (AR) y el fallo de implantación recurrente (FIR). El AR se define como la pérdida de dos o más gestaciones antes de las 24 semanas de edad gestacional, mientras que para FIR no existe un consenso internacional en su definición, pero la más aceptada sería la no consecución del embarazo en mujeres menores de 40 años, tras haber transferido al menos 4 embriones de buena calidad, en un mínimo 3 transferencias (incluyendo tanto las realizadas en fresco como las de embriones criopreservados). Ambas patologías comparten algunas etiologías como pueden ser: causas anatómicas, genéticas, endocrinas, entre otras. Pero, en un gran número de pacientes, su origen permanece desconocido pudiendo alcanzar hasta un 50% en las pacientes con AR. El sistema inmunitario ha cobrado en los últimos años una vital importancia dentro de poder explicar un alto grado de pacientes que previamente permanecían como de causa desconocida. Se ha estudiado extensamente en los últimos 20 años el papel que las células NK tanto en número como en función, juegan en estas dos patologías. Asimismo, los monocitos, células clave también para el desarrollo del embarazo, han cobrado más importancia en los últimos años, aunque su estudio se ha centrado en su papel en otras patologías, principalmente en preeclampsia. Inicialmente se pensaba que un estado proinflamatorio durante el embarazo podría ser perjudicial para el correcto desarrollo del mismo...
Recurrent reproductive failure encompasses two well-differentiated entities: recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF). RPL is defined as the loss of two or more pregnancies before 24 weeks of gestational age, while for RIF, there is no international consensus on its definition, but the most accepted would be the non-achievement of pregnancy in women under 40 years of age, after having transferred at least four good quality embryos, in a minimum of 3 transfers (including both those made fresh and those of cryopreserved embryos). Both pathologies share some etiologies, such as anatomical, genetic, and endocrine causes, among others. Therefore, in many patients, its origin remains unknown and can reach up to 50% in patients with RPL. In recent years, the immune system has gained vital importance in explaining a high degree of patients who previously remained as of unknown cause. The role that NK cells play in these two pathologies, both in number and function, has been extensively studied in the last 20 years. Likewise, monocytes, also essential cells for the development of pregnancy, have become more important in recent years, although their study has focused on their role in other pathologies, mainly preeclampsia. Initially, it was thought that a pro-inflammatory state during pregnancy could be detrimental to its proper development...
Recurrent reproductive failure encompasses two well-differentiated entities: recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF). RPL is defined as the loss of two or more pregnancies before 24 weeks of gestational age, while for RIF, there is no international consensus on its definition, but the most accepted would be the non-achievement of pregnancy in women under 40 years of age, after having transferred at least four good quality embryos, in a minimum of 3 transfers (including both those made fresh and those of cryopreserved embryos). Both pathologies share some etiologies, such as anatomical, genetic, and endocrine causes, among others. Therefore, in many patients, its origin remains unknown and can reach up to 50% in patients with RPL. In recent years, the immune system has gained vital importance in explaining a high degree of patients who previously remained as of unknown cause. The role that NK cells play in these two pathologies, both in number and function, has been extensively studied in the last 20 years. Likewise, monocytes, also essential cells for the development of pregnancy, have become more important in recent years, although their study has focused on their role in other pathologies, mainly preeclampsia. Initially, it was thought that a pro-inflammatory state during pregnancy could be detrimental to its proper development...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 18-07-2022