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D C Kilpatrick

Publications and source records attributed to D C Kilpatrick.

At least 55 records · Page 3Linked to original sources
PubMed1995

Maternal HLA-DR homozygosity is not associated with an increased risk of fetal loss.

An attractive but controversial hypothesis holds that HLA similarity between mother and offspring predisposes to early fetal loss. Against this background, Hoff et al. (1992) have reported a significant association between maternal HLA-DR homozygosity and fetal loss in a cohort of multigravid American women. To re-examine this finding independently, a similar investigation was carried out on a comparable group of British subjects. The HLA-DR data of 75 multigravid women were analysed: the proportion of women who had experienced fetal loss did not differ between HLA-DR homozygous and heterozygous subjects.

Abortion, Spontaneous↗
PubMed1994

Immunohistochemical localization of a beta-D-galactoside-binding lectin at the human maternofetal interface.

The 14 kD S-type lectin from human placenta may have a role in regulating the maternal immune response to fetal antigens. In this study, an immunoperoxidase technique was used to determine the distribution of the lectin at the human maternofetal interface. Tissue obtained during the first trimester of pregnancy and at term was used. The lectin was not detectable in either the villous syncytiotrophoblast or the underlying cytotrophoblast in first-trimester tissue, although some cells of the cytotrophoblast columns were reactive. It was also not detectable in villous or extravillous trophoblast populations at term. In contrast, strong reactivity was found in decidual stromal cells throughout gestation, and endometrial stromal cells were also positive. The lectin is, therefore, not a component of the immunosuppressive factors associated with syncytiotrophoblast membranes, but may have a role in either the decidual control of trophoblast migration or some functions unrelated to pregnancy, or both.

Chorionic Villi↗
PubMed1994

Chlamydial serologic studies and recurrent spontaneous abortion.

OBJECTIVE: Our purpose was to investigate the putative association between immunoglobulin G antibodies to Chlamydia trachomatis and recurrent spontaneous abortions. STUDY DESIGN: Sera from 106 idiopathic recurrent aborters and 81 of their partners were tested for immunoglobulin G antichlamydial antibodies by whole inclusion immunofluorescence and compared with 3890 sera from a general antenatal population. Positive sera were further investigated by microimmunofluorescence to determine species (Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci) specificity. RESULTS: Twenty-six (24.5%) of women with recurrent spontaneous abortions had immunoglobulin G antichlamydial antibodies compared with 28 (34.6%) of their partners (chi 2 2.25, p < 0.05) and 788 (20.3%) of the general antenatal population (chi 2 1.16, p < 0.05), and the incidence of antibody positivity showed no trend with increasing number of previous abortions. Fourteen women with recurrent spontaneous abortions had antibodies to Chlamydia trachomatis, 12 to Chlamydia pneumoniae. The prevalence of antibodies to C. trachomatis did not differ significantly between women with recurrent spontaneous abortions and their partners, but the male partners had a significantly (p = 0.005) higher prevalence of Chlamydia pneumoniae antibodies. Chlamydial antibody seropositivity did not correlate with subfertility or subsequent pregnancy outcome. CONCLUSION: There is no association between immunoglobulin G antibodies to Chlamydia trachomatis and recurrent spontaneous abortion.

Abortion, Habitual↗
PubMed1994

Remote pregnancy outcome after leukocyte immunotherapy.

Twenty-eight recurrent miscarriage patients who had live births after leukocyte immunization were followed. Sixteen had subsequent pregnancies (without further treatment). One pregnancy was terminated, and five others were spontaneously aborted. The live birth rate was therefore 10 of 15 (67%). Any benefit from leukocyte immunotherapy does not appear to be long lasting.

Abortion, Habitual↗
PubMed1993

Influence of histocompatibility antigens in recurrent spontaneous abortion and its relevance to leukocyte immunotherapy.

A total of 108 couples with recurrent spontaneous abortion (RSA) were studied to investigate the possible influence of histocompatibility antigens (HLA) on their condition and its management. HLA-B18 was shown to be at a higher frequency in RSA women, but not significantly so after statistical correction. Just over half the RSA women shared two or more HLA-A, B or DR antigens with their partners (P < 0.01), but this group did not differ from the others in clinical or laboratory features, nor in subsequent pregnancy success rate. Leukocyte immunotherapy in which the donor shared at least one HLA-DR antigen with his partner was not associated with a significant improvement in subsequent pregnancy outcome compared with HLA-DR mismatched immunotherapy. HLA antibody production following leukocyte immunotherapy was influenced by both inoculum size and degree of HLA incompatibility, but had no effect on birthweight. Tissue-typing investigations are not indicated for individual RSA patients seeking advice or treatment.

Abortion, Habitual↗
PubMed1993

Parental HLA sharing, feto-maternal compatibility and neonatal birthweight in families with a history of recurrent spontaneous abortion.

The mean birthweight of babies eventually born to couples with a history of recurrent spontaneous abortion (RSA) is allegedly lower if the parents have a high degree of HLA antigen sharing (Reznikoff-Etievant et al., 1991), but this relationship has not been independently confirmed. We have re-investigated this question by analysing data from 36 families. In 22 instances, we were able to relate birthweight directly to feto-maternal HLA compatibility for the first time in such families. We were unable to confirm any appreciable influence of paternal or feto-maternal HLA sharing on birthweight or placental weight and conclude that RSA families do not differ markedly from normal families in this respect.

Abortion, Habitual↗
PubMed1992

Soluble interleukin-2 receptors in recurrent miscarriage and the effect of leukocyte immunotherapy.

The relationship between soluble interleukin-2 receptors (IL-2R) and pregnancy outcome was investigated in women with a history of miscarriage, some of whom were treated with partner-specific leukocyte immunotherapy. IL-2R were significantly elevated in patients with a poor obstetric history possessing cardiolipin antibodies, and higher levels were also found in recurrent aborters without cardiolipin antibodies who had particularly bad histories. Furthermore, values obtained during early pregnancy were lower in patients who subsequently had successful pregnancies than in those who aborted again. Eight out of 35 patients immunised with their partners' lymphocytes, but none of 16 patients immunised with their own cells, showed a marked decrease in IL-2R levels a month later. It is possible that the minority who respond to immunotherapy with a marked drop in IL-2R may be the same minority who may derive benefit from this treatment.

Abortion, Habitual↗
PubMed1992

Cardiolipin antibody levels are not influenced by leukocyte immunotherapy in patients experiencing recurrent spontaneous abortion.

OBJECTIVE: To confirm that leukocyte immunotherapy stimulates the production of cardiolipin antibodies and to relate changes to pregnancy outcome. PATIENTS: Fifty patients with idiopathic recurrent abortion were studied. Thirty-six patients received injections of their partners' leukocytes; 14, injected with their own cells, served as controls. DESIGN: Cardiolipin antibodies were measured a month before and after leukocyte immunization. Patients who became pregnant were immunized a second time in early pregnancy, and cardiolipin antibodies were again measured a month later. RESULTS: Thirty-six patients immunized with their partners' leukocytes showed no appreciable change in cardiolipin antibody levels a month after vaccination. Twenty-nine of them subsequently became pregnant and were immunized again in early pregnancy: again, no change in cardiolipin antibody level was observed. There was no difference between the minority who aborted again and the majority who subsequently had successful pregnancies nor between those who responded to immunotherapy by producing cytotoxic antilymphocyte antibodies and those who did not. CONCLUSION: Leukocyte immunotherapy does not stimulate cardiolipin antibody production in women with normal pretreatment levels of the autoantibody.

Abortion, Habitual↗
PubMed1992

Anticardiolipin antibodies and pregnancy outcome in women with human immunodeficiency virus infection.

Abnormal anticardiolipin antibodies are associated with adverse pregnancy outcome in the general obstetric population. We studied 55 pregnancies in women infected with human immunodeficiency virus type 1 (HIV-1) to examine two hypotheses: that a substantial proportion of these women would have raised anticardiolipin antibodies, and that the affected pregnancies would be more likely to be complicated by preterm delivery and intrauterine growth retardation. Blood was taken at the initial antenatal visit, and was also taken from 15 HIV-seronegative intravenous (IV) drug users and 20 controls with no drug history. The reference for immunoglobulin G class antibodies to cardiolipin was calculated from 50 healthy young adults, and the upper limit of normal was defined as 4 standard deviations above the mean for this reference series. Twenty-four percent of the infected women, but none of the HIV-seronegative IV drug users and none of the control group, had raised anticardiolipin antibodies. There was no statistically significant relationship with birth weight, standardized birth weight, length, gestation, occipitofrontal circumference, or adverse pregnancy outcome. No women gave a history of thromboembolism or recurrent abortion, and in no pregnancy was there clinically apparent thromboembolism. We conclude that abnormal anticardiolipin antibodies provoked by HIV infection are common, but probably have a narrow specificity for cardiolipin, are unrelated to phospholipid antibody syndrome, and cannot explain adverse pregnancy outcome in HIV-infected women.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Neurological disease associated with anticardiolipin antibodies in patients without systemic lupus erythematosus: clinical and immunological features.

Anticardiolipin antibodies (aCL), one of a group of antiphospholipid antibodies which include the lupus anticoagulant (LA), may occur in association with systemic lupus erythematosus (SLE) and are less commonly detected in other diseases. We retrospectively reviewed the clinical and immunological features of 39 consecutive patients with abnormal aCL identified by one laboratory, to examine the spectrum of neurological disease in those patients without SLE. Fourteen patients in this category are described, 6 of whom did not have evidence of LA. All but 1 presented with neurological symptoms. Stroke and migraine dominated the clinical presentation, but many patients had features to suggest the presence of a hypercoagulable state. This study lends support to the concept of a primary antiphospholipid syndrome.

Adult↗