It has been proposed that many factors have been implicated in the pathogenesis of unexplained recurrent spontaneous miscarriage (URSM). The objective of this study was to evaluate the levels of some antioxidants, tumor necrosis factor-α (TNF-α), luteinizing (LH) and follicle-stimulating hormone (FSH) in URSM. Serum levels of superoxide dismutase (SOD), catalase (CAT), LH, FSH as well as TNF-α in serum and the expression of TNF-α positive cells in placental tissues, were assayed in women suffering from unexplained first trimester miscarriage. Two groups were included, the first was represented by 16 women with URSM (number of abortions: 3–5) and the second one included 24 women with URSM (number of abortions > 5). The control groups included 20 women within their first trimester of pregnancy and 20 non pregnant healthy females within their follicular phase. The obtained results showed a highly significant decrease in serum levels of SOD and CAT, in the URSM groups compared to control groups (p< 0.05 for each comparison). Higher serum levels of TNF-α were detected in URSM groups compared to control groups (p< 0.05 for each comparison). A significant increase in serum levels of LH was encountered between URSM groups compared to control groups; on the other hand the mean levels of FSH expressed no significant changes among URSM groups as compared to first trimester pregnancies control group. A positive correlation was noticed between serum levels of TNF-α and the levels of LH (p< 0.05). We conclude that antioxidant enzymes (CAT, SOD), TNF-α, LH and FSH may play a major role in the pathogenesis of URSM. Much more work is required before the mechanisms, which lead to RSM, can be fully understood.

中文翻译：

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不明原因复发性自然流产中 TNF-α 和抗氧化酶的血清水平以及胎盘 TNF-α 表达。

有人提出，许多因素与不明原因复发性自然流产 (URSM) 的发病机制有关。本研究的目的是评估 URSM 中某些抗氧化剂、肿瘤坏死因子-α (TNF-α)、促黄体生成素 (LH) 和促卵泡激素 (FSH) 的水平。在患有不明原因妊娠早期流产的妇女中测定血清中超氧化物歧化酶 (SOD)、过氧化氢酶 (CAT)、LH、FSH 和 TNF-α 的血清水平以及胎盘组织中 TNF-α 阳性细胞的表达。包括两组，第一组由 16 名患有 URSM 的女性（流产次数：3-5）代表，第二组包括 24 名患有 URSM 的女性（流产次数 > 5）。对照组包括 20 名处于妊娠头三个月的女性和 20 名处于卵泡期的非妊娠健康女性。获得的结果显示，与对照组相比，URSM 组中 SOD 和 CAT 的血清水平显着降低（每次比较 p < 0.05）。与对照组相比，在 URSM 组中检测到更高的 TNF-α 血清水平（每次比较 p < 0.05）。与对照组相比，URSM 组之间的血清 LH 水平显着增加；另一方面，与早孕对照组相比，URSM 组的 FSH 平均水平没有显着变化。发现血清 TNF-α 水平与 LH 水平呈正相关（p < 0.05）。我们得出结论，抗氧化酶（CAT、SOD）、TNF-α、LH 和 FSH 可能在 URSM 的发病机制中起主要作用。在完全理解导致 RSM 的机制之前，还需要做更多的工作。