#1
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Èììóíîöèòîòåðàïèÿ ïðè NLA ñîâìåñòèìîñòè (ïðè íåâûíàøèâàíèè áåðåìåííîñòè)
 àíàìíåçå íåâûíàøèâàíèå áåðåìåííîñòè - 2 âûêèäûøà.Îáñëåäîâàíà ïîëíîñòüþ.Ïðîáëåìíûå ìîìåíòû - à/ò ê ÕÃ× è ñîâìåñòèìîñòü ïî êëàññó 2 HLA ñèñòåìû.
ß DRB1 - 07,15 DQA1 - 0201,0102 DQB1 - 0201,0602-8 Ìóæ DRB1 - 08,13 DQA1 - 0401,0102 DQB1 - 0401/2,0602-8 Ãèíåêîëîã è ãåíåòèê ñêàçàëè,÷òî ïåðåä ïëàíèðîâàíèåì áåðåìåííîñòè (çà 1 ìåñÿö äî ïðåäïîëàãàåìîãî çà÷àòèÿ) íåîáõîäèìî ïðîâåñòè ÈÌÌÓÍÎÖÈÒÎÒÅÐÀÏÈÞËÈÌÔÎÖÈÒÀÌÈ ÌÓÆÀ..Íî â ëàáîðàòîðèè èììóíîëîãèè (ãäå áóäóò äåëàòü ïðîöåäóðó èììóíèçàöèè) ñêàçàëè, ÷òî ÈÌÌÓÍÈÇÀÖÈÞ ïðîâîäÿò îíè ËÈÌÔÎÖÈÒÀÌÈ ÄÎÍÎÐÀ.. ÂÎÏÐÎÑ - 1. êàêèõ ñëó÷àÿõ ïðèìåíÿåòñÿ èììóíèçàöèÿ ËÈÌÔÎÖÈÒÀÌÈ ÌÓÆÀ è â êàêèõ ñëó÷àÿõ ÈÌÌÓÍÈÇÀÖÈß ËÈÌÔÎÖÈÒÀÌÈ ÄÎÍÎÐÀ ? ×òî áîëåå ýôôåêòèâíî èììóíèçàöèÿ ëèìôîöèòàìè ìóæà èëè ëèìôîöèòàìè äîíîðà ? 2.Îáÿçàòåëüíî ëè ïåðåä ÈÌÌÓÍÈÇÀÖÈÅÉ ñäàâàòü àíàëèç íà ÑÊË (ñìåøàííàÿ êóëüòóðó ëèìôîöèòîâ) ? ×èòàëà â äðóãèõ ôîðóìàõ , ÷òî ïåðåä ýòîé ïðîöåäóðîé îáÿçàòåëüíî íàäî ñäàòü ýòîò àíàëèç, ìíå æå åãî íèêòî íå ðåêîìåíäîâàë ñäàâàòü. |
#2
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Óâàæàåìàÿ Èðèíà!
Ñîãëàñíî íåäàâíåé ñòàòüå èìåííî èììóíèçàöèÿ ëèìôîöèòàìè îòöà ïîâûøàëà óðîâåíü mixed lymphocyte reaction blocking antibodies (MLR-Bf) è ñïîñîáñòâîâàëà óñïåøíîìó âûíàøèâàíèþ (â 84% ñëó÷àåâ) ïî ñðàâíåíèþ ñ ëèìôîöèòàìè ñîáñòâåííûìè (33%) èëè äîíîðñêèìè (31%) èëè ïðîñòî ââåäåíèþ èçîòîíè÷åñêîãî ðàñòâîðà (25%). Î÷åâèäíî, àíàëèç íà MLR-Bf â îòå÷åñòâåííîé èíòåðïðåòàöèè çâó÷èò êàê ÑÊË. Èììóíèçàöèÿ ïðîâîäèòñÿ 1 ðàç â 4 íåäåëè è äî ïîâûøåíèÿ òèòðà ñâûøå 30 (ìàêñèìóì 6 ðàç). Òå îäíîé èììóíèçàöèè ëèìôîöèòàìè áóäóùåãî îòöà ìîæåò áûòü íåäîñòàòî÷íûì, íåîáõîäèìî ïîâûøåíèå ýòèõ àíòèòåë. Íà âñÿêèé ñëó÷àé ïðèâåäó ïîäðîáíóþ ñõåìó ïðèãîòîâëåíèÿ âàêöèíû, òê èíîãäà óñïåõ ìåðîïðèÿòèÿ çàâèñèò è îò ñîáëþäåíèÿ ïðîòîêîëà: 20 ml of peripheral blood was obtained from each member of the RSA couples and unrelated males (third party) on the basis of prerandomization. Peripheral mononuclear cells were separated aseptically on a Ficoll–Hypaque gradient and then incubated overnight at 37 °C and 5% CO2 atmosphere. Both the T and B cells were purified from peripheral mononuclear cells by using nylon wool columns, and were used for immunotherapy in women with RSA. For this purpose, each 5×106 autologous lymphocyte (AL), third party lymphocyte (TPL), or PL was finally suspended in 1 ml of sterile normal saline (NS), which was then equally distributed into four doses of 0.25 ml each. Each dose (0.25 ml) of cell suspension and neat sterile NS was injected through intradermal (i.d.), intramuscular (i.m.), subcutaneous (s.c.) and intravenous (i.v.) routes at four separate sites on the forearms of women with RSA under medical supervision. Immunization was repeated at four weekly intervals up to a maximum of six times, and was stopped when MLR-Bf titer of ≥30 was achieved. RSA Recurrent spontaneous abortion. èç Int Immunopharmacol. 2004 Feb;4(2):289-98. Induction of MLR-Bf and protection of fetal loss: a current double blind randomized trial of paternal lymphocyte immunization for women with recurrent spontaneous abortion. Pandey MK, Agrawal S. Molecular Medicine Program, Guggenheim -18, Mayo Clinic, 200, First Street, SW, Rochester, MN-55905, USA. |
#3
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Óâàæàåìûé Dr. Vad, ñïàñèáî, ÷òî îáðàòèëè âíèìàíèå íà ìîå ñîîáùåíèå.Ñåãîäíÿ ðàçãîâàðèâàëà ñ èçâåñòíûì ãèíåêîëîãîì,îíà ñêàçàëà, ÷òî íàäî ïåðåä èììóíèçàöèåé ñäàòü àíàëèç íà áëîêèðóþùèå ôàêòîðû â èíñòèòóòå ìàòåðè è ðåáåíêà íà Îïàðèíà â ëàáîðàòîðèè Âåðÿñîâà.Íî òàê êàê îíà áûëà î÷åíü çàíÿòà, íå ñìîãëà ìíå îáúÿñíèòü, ÷òî ýòî òàêîå.Åñëè Âû âëàäååòè èíôîðìàöèåé íå ìîãëè áû Âû îòâåòèòü íà ñëåäóþùèå âîïðîñû -
×òî òàêîå àíàëèç íà áëîêèðóþùèå ôàêòîðû ïðè NLA ñîâìåñòèìîñòè ? Äëÿ ÷åãî åãî äåëàþò ? Åñòü ëè ó íåãî ñèíîíèì (ó áëîêèðóþùåãî ôàêòîðà) ? |
#4
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óâàæàåìàÿ Èðèíà!
Êàê íåñïåöèàëèñòó, ñëîæíî âíèêàòü â ýòè òîíêîñòè, íî ïðèìåðíî ýòî âûãëÿäèò ñëåäóþùèì îáðàçîì: êîãäà ó áóäóùèõ ìàòåðè è îòöà ñóùåñòâóåò ïîâûøåííîå êîëè÷åñòâî îäèíàêîâûõ ëåéêîöèòàðíûõ àíòèãåíîâ (human leukocyte antigens - HLA), òî íàðóøàåòñÿ ñèíòåç ðàçëè÷íûõ àíòèòåë â ìàòåðèíñêîì îðãàíèçìå: öèòîòîêñè÷åñêèõ (ÀÐÑÀ), àíòè-èäèîïàòè÷åñêèõ (Ab2), áëîêèðóþùèõ ÑÊË (MLR-Bf). Âåðîÿòíî, òåðìèíîì "áëîêèðóþùèå ôàêòîðû" íàçûâàþò èëè ïîñëåäíèå (Bf - blocking factors) èëè âåñü êîìïëåêñ ýòèõ àíòèòåë. Àíàëèç íà ýòè ÁÔ äåëàþò äëÿ îïðåäåëåíèÿ íà÷àëüíîãî òèòðà ýòèõ àíòèòåë è â ïîñëåäóþùåì äëÿ ìîíèòîðèíãà ýôôåêòèâíîñòè èììóíèçàöèè. Çàðóáåæíàÿ ñèíîíèìè÷íàÿ àááðåâèàòóðà óêàçàíà âûøå, êàê èõ ïî äðóãîìó "âåëè÷àþò" íà íàøèõ ïðîñòîðàõ ìíå íåèçâåñòíî. |
#5
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Óâàæàåìûé äîêòîð Dr. Vad,ñïàñèáî çà îòâåò.
Î÷åíü áåñïîêîèò âîïðîñ - êàêèå ôèçè÷åñêè è ïñèõè÷åñêè çäîðîâûå äåòè ðîæäàþòüñÿ ïðè òàêîé ïàòîëîãèè.Áûâàþò ëè êàêèå ëèáî îòêëîíåíèÿ â ðàçâèòèè ðåáåíêà.Ìîæåò áûòü ëó÷øå íå ìó÷èòüñÿ è ðîäèòü ðåáåíêà îò äîíîðà ñïåðìû ? Î÷åíü ïðîøó îòâåòèòü åñëè ñìîæåòå. |
#6
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Óâàæàåìàÿ Èðèíà!
Òê äàííàÿ òåõíèêà óæå èñïîëüçóåòñÿ îêîëî 20 ëåò è îòñóòñòâóþò äàííûå î äåôåêòàõ â ðàçâèòèè ðîæäåííûõ òàêèì îáðàçîì äåòåé, òî âðÿä ëè äàííûé ñïîñîá êîíöåïöèè ÿâëÿåòñÿ ïîòåíöèàëüíî îïàñíûì. |
#7
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ïðîäîëæåíèå òåìû
Ñåãîäíÿ ñäåëàëè ïåðâûé êóðñ ËÈÒ.Âðà÷ óêîëîëà â ðóêó â 10 òî÷êàõ ïîäêîæíî è ñêàçàëà, ÷òî õîðîøàÿ ðåàêöèÿ ýòî êîãäà ìåñòî óêîëà ïðèïóõøî îêîëî 2-õ ñóòîê, ïëîõàÿ ðåàêöèÿ,åñëè ïðèïóõëîñòè íåò, à âèäíû òîëüêî ìåñòà óêîëîâ.Âðà÷ ñêàçàëà, ÷òî ïåðåä ïðîâåäåíèåì ïîâòîðíîãî êóðñà (ïëàíèðóåòñÿ â àâãóñòå)íåîáõîäèìî ñêàçàòü äîêòîðó,êàê âûãëÿäåëî ìåñòî óêîëà ïîñëå ËÈÒ.Íî ÿ íå ìîãó ïîíÿòü êàêàÿ ó ìåíÿ ðåàêöèÿ - ïëîõàÿ èëè õîðîøàÿ.
Âèçóàëüíî - ìåñòî óêîëà (ðàçìåð 7 ñì õ 1 ñì) íå ïðèïóõøî, íî âîêðóã èíúåêöèé ãèïåðåìèðîâàííîå ïÿòíî ðàçìåðîì 10 ñì õ 25 ñì. Ñïàñèáî. |
#8
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Îòâåò óæå íå íóæåí.
Ñïàñèáî. |
#9
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Ó ìåíÿ ïîõîæàÿ ïðîáëåìà. Âäðóã ïîâåçåò.
Óâàæàåìàÿ Èðèíà, ìåíÿ çîâóò Þëÿ. Ó ìåíÿ ïîõîæàÿ ïðîáëåìà. Òàêæå ñîâìåñòèìîñòü ñ ìóæåì ïî HLA, åùå ïëîõîå ðàñïîçíîâàíèå ïî ÑÊL.
Ïîëàãàþ, ÷òî Âû äîñêîíàëüíî èçó÷èëè òåìó èììóíèçàöèþ ëèìôîöèòàìè. Ïîäñêàæèòå ìíå, ïîæàäóéñòà, êàê åå ïðàâèëüíî ïðîâåñòè è ÷üìè ëèìôîöèòàìè? |