AUTOIMMUNE ASPECTS OF PREMATURE OVARIAN FAILURE

  • Helena Meden Vrtovec Ginekološka klinika Univerzitetni klinični center Ljubljana Šlajmerjeva 3 1000 Ljubljana
  • Alenka Levičnik Ginekološka klinika Univerzitetni klinični center Ljubljana Šlajmerjeva 3 1000 Ljubljana
  • Alojz Ihan Inštitut za mikrobiologijo Medicinska fakulteta Univerza v Ljubljani Korytkova 2 1000 Ljubljana
  • Alenka Vizjak Inštitut za patologijo Medicinska fakulteta Univerza v Ljubljani Korytkova 2 1000 Ljubljana
Keywords: premature ovarian failure, antiovarian antibodies, antithyroid antibodies, T-lymphocytes abnormalitie

Abstract

Background. The prevalence of premature ovarian failure (POF) of 1 % has important psychosocial consequences and impact on general health. Besides known etiology (genetic, chromosomal, infections, iatrogenic) autoimmunity can be the pathologic mechanism for POF.

Material and methods. Eleven women with POF, with excluded other reasons for the disease except autoimmunity were included in this study. The control group consisted of 13 healthy normo-ovulatory women. In both groups targeted family and personal history was taken and determinations of: FSH, LH, TSH, prolactin, antimüllerian hormone (AMH), inhibin B, thyroid antibodies TG and TPO. At the cellular level periferal blood T-lymphocytes were analyzed by flow cytometry, on humoral level ovarian antibodies were detected with indirect immunofluorescence on human ovary sections. Quick ACTH test was performed in study group only.

Results. In 9 patients POF was associated with another autoimmune disease. Six patients of the study group (55 %) presented very elevated thyroid autoantibodies TG and TPO, in the control group the levels of both autoantibodies were within normal range. Hormonal analyses in the study group exhibited the values of hypergonadotropic hypogonadism and consequently low levels of inhibin B and AMH. Lymphocyte subset in study group namely CD4+, CD19+ and CD8+ was significantly higher, while natural killer cells and regulatory T cells were significantly lower then in the control. group. In 4 patients (36 %) antiovarian autoantibodies were detected. Results of the quick ACTH test in the study group were normal.

Conslusions. POF is frequently associated with autoimmune disorders. The presence of antithyroid and antiovarian antibodies together with abnormalities of the cellular immunity can potentionally represent an autoimmune mechanism of POF. The question of immunomodulatory therapy in selected patients with POF is open.

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Published
2018-02-14
How to Cite
1.
Meden Vrtovec H, Levičnik A, Ihan A, Vizjak A. AUTOIMMUNE ASPECTS OF PREMATURE OVARIAN FAILURE. ZdravVestn [Internet]. 14Feb.2018 [cited 15Sep.2019];78. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2755
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Original article

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