RECIPROCAL ALTERATION IN CIRCULATING TJ6-PREGNANCY PREDICTS SUCCESS OR MISCARRIAGE( CD19+ AND TJ6+ CD56+ LEUKOCYTES IN EARLY)

PROBLEM: TJ6 is a cytokine whose membrane form is regularly expressed on the B lymphocytes of women during pregnancy. In a previous study we have shown that pregnancies that end in a spontaneous abortion are ch aracterized by an increase in natural killer (NK) cells and that NK ce lls in these pregnancies also expressed TJ6, whereas NK cells from pre gnancies that terminate normally neither increase in number nor do the y express significant amounts of the cytokine. METHODS: To evaluate th e ability of TJ6 to predict pregnancy outcome, 61 blood samples from p regnant women were studied. Blood samples were drawn between 5 and 12 weeks of gestation and analyzed for lymphocyte expression of TJ6 using Cytoron Absolute flow cytometry and two-color fluorescence. The perce ntage of CD19+ (B) cells and CD56+ (NK) cells that expressed TJ6 was c alculated, and this percentage was correlated with subsequent pregnanc y outcome classified as successful (viable birth) or unsuccessful (abo rtion, stillbirth). TJ6 CD19 and TJ6 CD56 was determined in 32 blood s amples from women with successful pregnancy outcomes acid 29 samples f rom women with unsuccessful pregnancy outcome. RESULTS: The mean TJ6 C D19 expression for successful pregnancies was 10.6% and for unsuccessf ul pregnancies was 5.1% (P < 0.03). The mean TJ6 CD56+ percentage of c irculating cells that express TJ6 expression for successful pregnancie s was 3.3% and for unsuccessful pregnancies was 10.4% (P = 0.02). All unsuccessful pregnancies had less than 90% of circulating CD19 cells e xpress TJ6 and/or greater than 50% of circulating CD56 cells express T J6. Use of the expression of TJ6 on CD19 and CD56 cells during the fir st trimester predicts viable pregnancy with a sensitivity of 100%, spe cificity of 100%, positive predictive value of 100%, and negative pred ictive value of 100%. CONCLUSIONS: The work now being reported validat es the hypothesis that expression of TJ6 on NK cells obtained from pre gnant women predicts the outcome of pregnancy, In addition we show tha t this prognosticator can be reliably demonstrated early in the first trimester.