A comprehensive Bayesian analysis assessing the effectiveness of lymphocyte immunotherapy for recurrent spontaneous abortion

Rongzhou Chen , Haohan Xu , Yujia Hou , Hanghang Liu , Zheng Zheng , Shaohua Ma

Life Medicine ›› 2023, Vol. 2 ›› Issue (6) : 7

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Life Medicine ›› 2023, Vol. 2 ›› Issue (6) : 7 DOI: 10.1093/lifemedi/lnad049
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A comprehensive Bayesian analysis assessing the effectiveness of lymphocyte immunotherapy for recurrent spontaneous abortion

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Abstract

Recurrent spontaneous abortion (RSA) affects 2%–5% of couples worldwide and remains a subject of debate regarding the effectiveness of lymphocyte immunotherapy (LIT) due to limited retrospective studies. We conducted a comprehensive Bayesian analysis to assess the impact of LIT on RSA. Using data from the Shenzhen Maternity and Child Healthcare Hospital (2001–2020, n = 2316), a Bayesian generalized linear model with predictive projection feature selection was employed. Our analysis revealed a significant improvement in live birth rates for RSA patients undergoing LIT. Notably, LIT had a greater impact compared to the other 85 factors considered. To mitigate research bias, we conducted a Bayesian meta-analysis combining our dataset with 19 previously reported studies (1985–2021, n = 4246). Additionally, we developed an empirical model high-lighting the four key factors, which are the LIT result, age, paternal blood type, and anticardiolipin antibody. Younger age (19–27), paternal blood type B, and a positive anticardiolipin antibody (IgM) were associated with better therapeutic outcomes in LIT for RSA. These findings aid clinicians in identifying suitable candidates for LIT and improving treatment outcomes.

Keywords

recurrent spontaneous abortion / lymphocyte immunotherapy / Bayesian analysis / Bayesian meta-analysis

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Rongzhou Chen, Haohan Xu, Yujia Hou, Hanghang Liu, Zheng Zheng, Shaohua Ma. A comprehensive Bayesian analysis assessing the effectiveness of lymphocyte immunotherapy for recurrent spontaneous abortion. Life Medicine, 2023, 2(6): 7 DOI:10.1093/lifemedi/lnad049

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References

[1]

Dimitriadis E, Menkhorst E, Saito S, et al. Recurrent pregnancy loss. Nat Rev Dis Primers 2020;6:1–19.

[2]

Rai R, Regan L. Recurrent miscarriage. Lancet 2006;368:601–11.

[3]

Practice Committee of the American Society for Reproductive Medicine. Evaluation and treatment of recurrent pregnancy loss: a committee opinion. Fertil Steril 2012;98:1103–11.

[4]

Sacha, , Krieg, , Lynn, , Westphal . Immune function and recurrent pregnancy loss. Semin Reprod Med 2015;33:305–12.

[5]

Howard Carp. Immunotherapy for recurrent pregnancy loss. Best Pract Res Clin Obstet Gynaecol 2019;60:77–86.

[6]

Mowbray JF, Liddell H, Underwood JL, et al. Controlled trial of treatment of recurrent spontaneous abortion by immunisation with paternal cells. Lancet 1985;325:941–3.

[7]

Coulam CB, Clark DA, Collins J, et al. Worldwide collaborative observational study and meta-analysis on allogenic leukocyte immunotherapy for recurrent spontaneous abortion. Am J Reprod Immunol 2013;32:55–72.

[8]

Francisco PD, Tan-Lim CSC, Agcaoili-De Jesus MSL. Efficacy of lymphocyte immunotherapy in the treatment of recurrent pregnancy loss from alloimmunity: a systematic review and meta-analysis. Am J Reprod Immunol 2022;88:e13605.

[9]

Liu Z, Xu H, Kang X, et al. Allogenic lymphocyte immunotherapy for unexplained recurrent spontaneous abortion: a meta-analysis. Am J Reproduct Immunol 2016;76:443–53.

[10]

Pan X, Jiang J, Ma Q, et al. Outbreak of HIV infection linked to nosocomial transmission, China, 2016–2017. Emerg Infect Dis 2018;24:2141.

[11]

Ticconi C, Pietropolli A, Simone ND, et al. Endometrial immune dysfunction in recurrent pregnancy loss. Int J Mol Sci 2019;20:5332.

[12]

Ford HB, Schust DJ. Recurrent pregnancy loss: etiology, diagnosis, and therapy. Rev Obstet Gynecol 2009;2:76–83.

[13]

Carp H. Immunotherapy for recurrent pregnancy loss. Best Pract Res Clin Obstetr Gynaecol 2019;60:77–86.

[14]

Dey DK, Ghosh SK, Mallick BK. Generalized Linear Models: A Bayesian Perspective. CRC Press, 2000.

[15]

Faraway JJ. Extending the Linear Model with R: Generalized Linear, Mixed Effects and Nonparametric Regression Models, 2006.

[16]

West BT. Bayesian analysis of between-group differences in variance components in hierarchical generalized linear models. JSM Proceedings, Survey Research Methods Section. Alexandria, VA: American Statistical Association, 1828, 1842.

[17]

Kruschke JK. Bayesian data analysis. Wiley Interdiscip Rev Cognit Sci 2010;1:658–76.

[18]

Kruschke, J. Doing Bayesian Data Analysis: A Tutorial with R, JAGS, and Stan, ELSEVIER, 2014.

[19]

Kruschke JK. Bayesian analysis reporting guidelines. Nat Hum Behav 2021;5:1282–91.

[20]

Brooks S, Gelman A, Jones G, Meng X-L. Handbook of Markov Chain Monte Carlo. CRC Press, 2011.

[21]

Gelman A, Carlin JB, Stern HS, Rubin DB. Bayesian Data Analysis. Chapman and Hall/CRC, 1995.

[22]

Hastings WK. Monte Carlo sampling methods using Markov chains and their applications. Biometrika, 1970;57:97–109.

[23]

Piironen J, Paasiniemi M, Vehtari A. Projective inference in high- dimensional problems: prediction and feature selection. Electron J Stat 2020;14:2155–97.

[24]

Vehtari A, Gelman A, Gabry J. Practical Bayesian model evaluation using leave-one-out cross-validation and WAIC. Stat Comput 2017;27:1413–32.

[25]

Williams DR, Rast P, Bürkner P-C. Bayesian meta-analysis with weakly informative prior distributions, PsyArXiv 2018.

[26]

Cline AM, Kutteh WH. Is there a role of autoimmunity in implantation failure after in-vitro fertilization? Curr Opin Obstet Gynecol 2009;21:291–5.

[27]

Hořejší J, Martinek J, Nováková D, et al. Autoimmune antiovarian antibodies and their impact on the success of an IVF/ET program. Ann N Y Acad Sci 2000;900:351–6.

[28]

Magnus MC, Wilcox AJ, Morken N-H, et al. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. Bmj 2019;364:l869.

[29]

Cavalcante MB, Cavalcante CTMB, Sarno M, et al. Antinuclear antibodies and recurrent miscarriage: systematic review and meta-analysis. Am J Reprod Immunol 2020;83:e13215.

[30]

Li Y, Li X, Luo S. Effect of Recurrent Spontaneous Abortion on Pregnancy Outcomes in Sequent Successful Pregnancy Patients. Journal of Guangzhou University of Traditional Chinese Medicine 2015, 979–83.

[31]

Ruiz-Irastorza G, Crowther M, Branch W, et al. Antiphospholipid syndrome. Lancet 2010;376:1498–509.

[32]

Vinatier D, Dufour P, Cosson M, et al. Antiphospholipid syndrome and recurrent miscarriages. Eur J Obstetr Gynecol Reproduct Biol 2001;96:37–50.

[33]

Abdullahi ZG, Abdul MA, Aminu SM, et al. Antiphospholipid antibodies among pregnant women with recurrent fetal wastage in a tertiary hospital in Northern Nigeria. Ann Afr Med 2016;15:133–7.

[34]

Kiernan D. Natural resources biometrics (online book). 2021; Chapter 6.1, stats.libretexts.org/@go/page/2904.

[35]

Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions, Wiley Online Library 2008.

[36]

Team, R. C. R: A language and environment for statistical computing. MSOR Connections 2014;1:275–86.

[37]

Deeks JJ, Higgins JP. Statistical algorithms in review manager 5. Statistical Methods Group of The Cochrane Collaboration 2010;1:1–11.

[38]

Muth C, Oravecz Z, Gabry J. User-friendly Bayesian regression modeling: a tutorial with rstanarm and shinystan. Quant Methods Psychol 2018;14:99–119.

[39]

Jewson, J. RStan: Efficient MCMC in R. 2017, dokumen.tips/documents/rstan-efficient-mcmc-in-r-university-of-warwick-generated-quantities-optional.html?page=20

[40]

Cui Y, Zhong X, Ban Q, et al. Study of immunotherapy with lymphocytes in women with recurrent spontaneous abortion. Modern Prev Med 2011;38:1626–7.

[41]

Hong L, Huaixiu W, Jing W. The lymphocyte injects and treats the habitual abortion that the immune factor causes. Med Mag Shanxi 2003;32:308–9.

[42]

Mowbray J, Liddell H, Underwood JL, et al. Controlled trial of treatment of recurrent spontaneous abortion by immunisation with paternal cells. Lancet 1985;325:941–3.

[43]

Lin S, Yan S, Shan E. Analysis the efficacy of immunotherapy with lymphocytes for recurrent spontaneous abortion. Jilin Med 2012;33:1822–3.

[44]

Pandey MK, Agrawal S. 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. Int Immunopharmacol 2004;4:289–98.

[45]

Chen J-L, Yang J-M, Huang Y-Z, et al. Clinical observation of lymphocyte active immunotherapy in 380 patients with unexplained recurrent spontaneous abortion. Int Immunopharmacol 2016;40:347–50.

[46]

Liu S, Gu X, Weng R. Clinical effect of lymphocyte immunotherapy on patients with unexplained recurrent spontaneous abortion. Immun Inflammation Dis 2021;9:1272–8.

[47]

Carp H et al. Allogenic leukocyte immunization after five or more miscarriages Recurrent Miscarriage Immunotherapy Trialists Group. Hum Reprod 1997;12:250–5.

[48]

Illeni MT, Marelli G, Parazzini F, et al. Immunology: immunotherapy and recurrent abortion: a randomized clinical trial. Hum Reprod 1994;9:1247–9.

[49]

Sarno M, Cavalcante MB, Niag M, et al. Gestational and perinatal outcomes in recurrent miscarriages couples treated with lymphocyte immunotherapy. Eur J Obstetr Gynecol Reproduct Biol 2019;3:100036.

[50]

Aiwu W, Mingzhu L, Runzhi W. Preventive treatment of unexplained recurrent spontaneous abortion and effect on pregnancy outcome by lymphocytes immunotherapy. China J Chin Med 2013;28:876–8.

[51]

Bin T, Kaishu H, Wenquan Z. Analysis of lymphocytes immunotherapy for recurrent spontaneous abortion. Chin Med Treat Works 2013;21:171–2.

[52]

Ho HN, Gill TJ, Hsieh HJ, et al. Immunotherapy for recurrent spontaneous abortions in a Chinese population. Am J Reproduct Immunol 1991;25:10–5.

[53]

Group RMIT. Worldwide collaborative observational study and meta-analysis on allogenic leukocyte immunotherapy for recurrent spontaneous abortion 1. Am J Reprod Immunol 1994;32:55–72.

[54]

Gatenby PA, Cameron K, Simes RJ, et al. Treatment of recurrent spontaneous abortion by immunization with paternal lymphocytes: results of a controlled trial. Am J Reproduct Immunol 1993;29:88–94.

[55]

Daya S, Gunby J; Group RMIT. The effectiveness of allogeneic leukocyte immunization in unexplained primary recurrent spontaneous abortion. Am J Reprod Immunol 1994;32:294–302.

[56]

Clark DA, Daya S. Trials and tribulation in the treatment of recurrent spontaneous abortion. Am J Reproduct Immunol 1991;25:18–24.

[57]

Cauchi M, Lim D, Young D, et al. Treatment of recurrent aborters by immunization with paternal cells—controlled trial. Am J Reprod Immunol 1991;25:16–7.

[58]

Christiansen OB, Mathiesen O, Husth M, et al. Placebo-controlled trial of active immunization with third party leukocytes in recurrent miscarriage. Acta Obstet Gynecol Scand 1994;73:261–8.

[59]

Bandyopadhyay AR, Chatterjee D, Chatterjee M, et al. Maternal fetal interaction in the ABO system: a comparative analysis of healthy mother and couples with spontaneous abortion in Bengalee population. Am J Human Biol 2011;23:76–9.

[60]

Guzzo RA, Jackson SE, Katzell RA. Meta-analysis analysis. Res Organ Behav 1987;9:407–42.

[61]

Sutton AJ, Abrams KR. Bayesian methods in meta-analysis and evidence synthesis. Stat Methods Med Res 2001;10:277–303.

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