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Natural killer cells and reproductive success
Author(s) -
Sacks Gavin,
Finkelstein Emma
Publication year - 2021
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.13291
Subject(s) - immune system , human leukocyte antigen , reproductive immunology , immunology , natural killer cell , flow cytometry , antibody , biology , medicine , bioinformatics , antigen , reproductive technology , cytotoxic t cell , pregnancy , in vitro , genetics , lactation , biochemistry
Natural killer (NK) cell assessment has been attempted since the 1990s and, apart from antibody testing, is probably the commonest immune test available to clinicians. It is clear that simple enumeration of uterine NK cells by immunohistochemistry is inadequate, although better methodology such as flow cytometry may prove to be more beneficial in the future. Blood testing is an appealing noninvasive test that may be a marker for immune dysfunction, rather than a guide to uterine numbers per se. It is currently performed in women with repeated reproductive failure and should be done using tests of activation. Patients value investigation and clinicians should prefer it to blind empirical immune therapy in repeated reproductive failure cases. But, in addition to blood NK testing, a fundamental new NK genetic test (the KIR/HLA‐C interaction) is likely to provide an even more effective diagnostic tool. Insights from KIR/HLA‐C analysis imply that new immune therapy trials will need to take KIR/HLA‐C results into account.