殺手細胞多 導致流產,彰化博元婦產科院長蔡鋒博將其子宮內膜切片及胚胎組織送往美國進行免疫特殊染色後，發現子宮內帶有許多自然殺手細胞。 P26 一位於緩解期的類風濕性關節炎併有近期不明原因流產患者以adalimumab治療降低子宮內過高的CD57+自然殺手細胞後成功懷孕之個案報告 A successful pregnancy after decrease of elevated uterine CD57+ natural killer cells by adalimumab therapy in a patient with rheumatoid arthritis in remission and a recent unexplained miscarriage 蔡鋒博*1 陳昭雯1 陳信華2 1彰化市 博元婦產科診所 試管嬰兒中心 2台中榮民總醫院過敏免疫風濕科 Feng-Po Tsai1, Chao-Wen Chen1, Hsin-Hua Chen2 1 Poyuan Women Clinic, IVF center; Section of Allergy, 2 Immunology and Rheumatology, Taichung Veterans General Hospital Introduction: Adalimumab (Humira, Abbot) is a recombinant monoclonal antibody that binds to human tumor necrosis factor (TNF-alpha) thereby interfering with endogenous TNF-alpha activity. Increased TNF-alpha levels have been associated with preeclampsia, miscarriage and infertility in both animal models and humans. TNF-alpha can activate uterine NK cells to attack trophoblast directly or induce trophoblast apoptosis through TNF-alpha produced by activated uterine NK cells. Increased trophoblast debris production can cause macrophages to secrete excessive T helper 1 cytokines which lead to excessive inflammation and thereafter miscarriage. Although there is interest in the use of TNF inhibitors to prevent pregnancy loss in patients at risk, only 2 relevant cases have been reported. Herein we reported a successful pregnancy after decreasing the elevated uterine CD57+ NK cells by adalimumab therapy in a patient with a previously unexplained miscarriage and rheumatoid arthritis in remission status. Case report: A 32 year-old Taiwanese woman presented in 2006 with rheumatoid arthritis in remission status and a recent unexplained miscarriage at 9 th gestational week. She received uterine curettage in July, 2006 because of fetal demise and the decidual tissue was sent for immunohistochemistry study, which disclosed marked increase of CD57+ NK cells (28.2/high power field (HPF). Increased percentage of CD3-CD16+ CD56+ NK cells (29%) in peripheral blood mononuclear cells was also noted. She received four doses of adalimumab injection and then another endometrial biopsy was performed on cycle day 26 in Jan. 2007. The number of CD57+ NK cells dropped significantly (1.3/HPF). The percentage of CD3-CD16+ CD56+ NK cells in PBMC also decreased to 11.9%. She got pregnant spontaneously in Feb, 2007. She is now at 24 thgestational week in stable condition. 博元婦產科發表：子宮殺手細胞過多，經 Humir a治療，病人自然懷孕 http://www.flickr.com/photos/41541241@N08/8254735242/in/photostream 自體細胞殺胎 國內見首例,創下全球第三例 上述案例彰化博元婦產科院長蔡鋒博在台灣生殖醫學會會中發表，而據醫學文獻記載，過去國外曾發生兩例自然殺手細胞殺死胚胎的案例，國內這案例應是全球第三例。自體細胞殺胎 國內見首例 自然殺手細胞多 導致流產,彰化博元婦產科院長蔡鋒博將其子宮內膜切片及胚胎組織送往美國進行免疫特殊染色後，發現子宮內帶有許多自然殺手細胞 博元婦產科發表：子宮殺手細胞過多，經 Humir a治療，病人自然懷孕個案 cd57 humidr 子宮殺手細胞 子宮過多殺手細胞，使胚胎無法存活流產，以 Humira 減少〝殺手〞(細胞)，病人成功懷孕　TSRM 2007 Humira CD57 NK CD56 自體細胞殺胎 國內見首例,創下全球第三例 上述案例彰化博元婦產科院長蔡鋒博在台灣生殖醫學會會中發表，而據醫學文獻記載，過去國外曾發生兩例自然殺手細胞殺死胚胎的案例，國內這案例應是全球第三例。自體細胞殺胎 國內見首例 自然殺手細胞多 導致流產,彰化博元婦產科院長蔡鋒博將其子宮內膜切片及胚胎組織送往美國進行免疫特殊染色後，發現子宮內帶有許多自然殺手細胞 妳大概有聽過「職業殺手」，就是專門殺人的，當做職業的，這個你 一定聽過， 但是妳一定沒有聽過，「自然殺手」細胞（ NK 細胞，Natural Killer Cell ）, 以下我簡稱殺手細胞，如果女人子宮裡面有過多的〝殺手〞細胞， 可能與不孕，流產，習慣性流產有關，我這樣比喻好了： 假如台灣2千3 百萬人口，我打個比方：大約需2 萬3 千名警察，就可以維持治安，使老百姓安居樂業，因為這些警察可以去逮捕壞人，但是如果台灣警察有 23萬人，甚至2 百30 萬人，整條街都是警察，那就不太妙了，也許他會侵犯民宅也說不定 ………。 自體細胞殺胎 國內見首例 自然殺手細胞多 導致流產,彰化博元婦產科院長蔡鋒博將其子宮內膜切片及胚胎組織送往美國進行免疫特殊染色後，發現子宮內帶有許多自然殺手細胞。