NK & Cytokines

any time now

7 Posts
Reply Posted on: Jul 11, 2012 at 7:30pm
My wife posted a query a couple of days ago, but it appears not to have gone through. Hoping you get this one.

My wife's NK Assay test show borderline high results:
50:1 = 10.8 (RIA)

However, both of her TH1/TH2 cytokine ratios are quite low:
TNFa:IL10 = 12.4 (below normal range)
IFNg:IL10 = 6.1 (lower end of normal range)

Her TNFa (quantiative) was also tested and is 5.5 pg/ml (normal). This result suggests that her IL10 is VERY HIGH (approx 68 per my math).

How is it possible that someone's NK is high (or somewhat high), but their pro-inflammatory cytokines are low while their anti-inflammatory cytokines are high? Everything we've read says that high NK activity is coupled with high TH1 cytokines. My wife's results simply don't make sense - at least not to us.

Can you provide a brief explanation to help make sense of it?

Many thanks for your help. And for this forum.

S

Dr. Braverman

2024 Posts
RE: NK & Cytokines Posted on: Jul 12, 2012 at 10:14am
It is not ucnommon to have a low inflammatory "ratio" while TNF is normal and as you said IL10 is high. This usually suggest and implantion "vessel" development issue and not an immune rejection issue. NKa values that are borderline are of no value and just ignore them.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

any time now

7 Posts
Reply RE: NK & Cytokines Posted on: Jul 12, 2012 at 3:01pm
Thank you for your response. Sounds like this vessel development issue you mentioned is a physical problem in her body or uterus?

Could it have to do with a blood clotting or coagulation defect/mutation (such as MTHFR)?

Do you deal with this vessel development issue or will we need to see another type of specialist?

Thanks for your help.

Dr. Braverman

2024 Posts
RE: NK & Cytokines Posted on: Jul 12, 2012 at 3:10pm
I deal with all issues related to implantation failure, no this is not an MTFHR problem , just a cytokine issue but instead of inflammatory it may be the opposite issue , not enough inflammation during implantation to generate blood vessel development.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

any time now

7 Posts
Reply RE: NK & Cytokines Posted on: Jul 12, 2012 at 9:17pm
Got it. Her issue is not enough inflammation rather than too much inflammation, preventing implantation. This makes perfect sense because my wife's hcg pregnancy tests have been close to zero after all our IVFs -- including our donor egg IVF. The strange thing is that we have a son together, conceived naturally. She did bleed quite a bit during the pregnancy. Perhaps the bleeding was a part of this problem?

I understand that you use Neupogen. However, we've read that Neupogen can actually lower cytokines (pro-inflammatory) even further. Is this correct? We'd rather not use Neupogen is there's a chance it could make the situation worse.

Is there anything else you use to help with lack of inflammation in the uterus?

S

Dr. Braverman

2024 Posts
RE: NK & Cytokines Posted on: Jul 12, 2012 at 9:39pm
The change in cytokines is not always evident with neupogen although the trend is downward. The need for inflammation is only at the time of implantation so that you can have "aniogenisis" or blood vessel development. It seems that uNK cells are critical for this role and neupogen helps to recruit them into the uterine cavity both the SQ route and even the uterine wash would be beneficial in your case. HCG wash may work as well.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.