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Rheumatology Advance Access originally published online on September 5, 2007
Rheumatology 2007 46(10):1517-1519; doi:10.1093/rheumatology/kem219
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

EDITORIALS

Recurrent spontaneous abortions in antiphospholipid syndrome: natural killer cells—an additional mechanism in a multi factorial process

H. J. A. Carp and Y. Shoenfeld1,*

Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer & Tel Aviv University, Israel and 1Department of Internal Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University.

Correspondence to: Y. Shoenfeld, MD FRCP, Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, 52621, Israel. E-mail: shoenfel@post.tau.ac.il

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In this issue, Perricone et al. have shown that patients with antiphospholipid syndrome (APS) and recurrent spontaneous abortions (RSA) have higher levels of natural killer (NK) cells than those with APS and no RSA. NK cells have long been suspected to cause RSA since Aoki's original report [1] showing that increased numbers of NK cells in the peripheral blood of women with RSA predict the likelihood of another miscarriage. NK cells are the only lymphocytes found in the endometrium in pregnancy, and are able to induce apoptosis in the trophoblast if cytokine activated. There have even been attempts to reduce NK cell levels with intravenous immunoglobulin (IVIg) [2] or immunization with paternal leucocytes (PLI) [3], to prevent subsequent miscarriages. There are two questions: what are the roles of NK cells, and whether NK cells explain part of . . . [Full Text of this Article]


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