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miscarriage
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home > pregnancy > conception > miscarriage > Natural killer cells play role in recurrent miscarriage
Natural killer cells play role in recurrent
miscarriage
JO ADETUNJI
September 23, 2013
Suffering a miscarriage can be a very distressing experience, but for many women their next
pregnancy is a normal one. For those who suffer recurrent miscarriage, where they have three or
more in a row, it can be utterly devastating.
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More frustrating still is that in many cases - more than half - doctors are unable to find an
underlying cause, or offer more than just a handful of options for treatment.
Now researchers from Warwick University claim to have made a breakthrough - not only by
making a firmer case for the role of natural killer (NK) immune cells in some cases of recurrent
miscarriage, but also in bridging the gap between scientists and the medical profession in what
has become a controversial area of research.
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Despite their name, NK cells actually play a beneficial role in the development of an embryo, but
abnormally high levels of NK cells are found in the uterus of around one-sixth of women who
recurrently miscarry. NK cells are a key player in the immune system, which can be triggered to
defend the body from infection; one theory is that in some cases they may stop an embryo
implanting in the womb.
However, little is known about this mechanism. And the potential role that NK cells might play in
recurrent miscarriage has caused significant controversy.
The authors of the new study, published in The Journal of Clinical Endocrinology & Metabolism,
make a link between more NK cells in the lining of the womb and not enough production of natural
steroids. Having this natural steroid deficiency in turn leads to a reduction in the fats and vitamins
that are needed in pregnancy, and this suggests that NK cells can be used as an indicator of
steroid deficiency.
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Steroids, which are thought to reduce the number of NK cells in the womb, are commonly used as
a treatment for recurrent miscarriage, and appear to help some women to go on to have a normal
pregnancy. But many experts agree this is based more on empirical evidence that a firm scientific
understanding.
Siobhan Quenby, Professor of Obstetrics at Warwick Medical School and one of the authors of the
study, said treatments for recurrent miscarriage often came "out of guesswork, not science", and
said the research provided an "excellent scientific justification for steroid-based treatment to
prevent miscarriage."
"If you have NK cells in the blood they do things like fight infection. In the uterus they also have a
good function - for example they help in the development of the blood supply to the foetus.
"But we now have some light at the end of the tunnel; in some ways everyone is right. NK cells
are good, but high-end NK cells are also associated with local steroid deficiency."
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Nick Macklon, Professor of Obstetrics and Gynaecology at Southampton University, said, "The
problem is that we haven't really understood the mechanisms behind recurrent miscarriage. We
now know that an important determinant is the lining of the womb and how it helps embryos to
implant. A lot of treatment has been empirical, adopting theoretical treatments not on the science.
"Quenby has done a lot of work to try and understand the role of NK cells, which hasn't been very
clear. The key thing is that the researchers aren't saying they are bad, but when there's an
http://www.essentialmums.co.nz/pregnancy/conception/miscarriage/9197637/Natural-killer-cells-play-role-in-recurrent-miscarriage[23/09/2013 10:20:24]
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Miscarriage breakthrough | Essential Mums
increase it might be a useful marker. It could allow for treatment to be rationalised.
"Steroids have side effects and have been used very blindly. But they do seem to make a
difference and also to the needs of doctors and patients looking for help."
Macklon said recurrent miscarriage was probably caused by a number of different factors across
different cases. "One possible cause is the ability of the lining of the womb to recognise and select
good embryos, and in some women it isn't able to do this early enough," he said.
- Essential Baby
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http://www.essentialmums.co.nz/pregnancy/conception/miscarriage/9197637/Natural-killer-cells-play-role-in-recurrent-miscarriage[23/09/2013 10:20:24]