Recurrent pregnancy loss (RPL) is the most common manifestation of anti-phospholipid syndrome (APS), and activated CD4+ T cells are involved in its pathogenesis. Treatment with low-molecular weight heparin (LMWH) and aspirin combination improves pregnancy outcome, however, its mechanism of action is unclear. We investigated the effect of this therapy on Th1/Th2 cells in 89 patients with APS-RPL. The results showed that serum cytokine levels, T cell phenotypes, and transcription factors' gene expression levels representing Th1 responses were higher, whereas those representing Th2 responses were lower in patients with APS-RPL at the time of early pregnancy. This Th1-bias was reversed in patients who had live birth after receiving the combination therapy at the time of delivery. Patients with miscarriages continued to exhibit Th1-bias. In conclusion, these data support a role of Th1-bias in the pathogenesis of APS-RPL and suggest restoring T-cell phenotype as a new immunomodulatory mechanism of LMWH/aspirin combination.

中文翻译：

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肝素和阿司匹林联合治疗可恢复患有抗磷脂综合征相关的反复性流产的孕妇的T细胞表型。

复发性流产（RPL）是抗磷脂综合征（APS）的最常见表现，活化的CD4 + T细胞参与其发病机理。低分子肝素（LMWH）和阿司匹林联合治疗可改善妊娠结局，但其作用机理尚不清楚。我们调查了这种疗法对89例APS-RPL患者Th1 / Th2细胞的影响。结果表明，在妊娠早期，APS-RPL患者的血清细胞因子水平，T细胞表型和转录因子的基因表达水平代表Th1反应较高，而代表Th2反应的基因表达水平较低。在分娩时接受联合治疗后活产的患者，这种Th1-bias逆转了。流产患者继续表现出Th1偏倚。