Speci\u00e1ln\u00ed imunogenetick\u00e9 vy\u0161et\u0159en\u00ed pom\u00e1h\u00e1 ur\u010dit p\u0159\u00ed\u010dinu opakovan\u00fdch potrat\u016f a z\u00e1rove\u0148 zvy\u0161uje \u00fasp\u011b\u0161nost IVF terapie s darovan\u00fdmi vaj\u00ed\u010dky.<\/p>\n
Opakovan\u00e9 potraty v ran\u00e9 f\u00e1zi t\u011bhotenstv\u00ed a probl\u00e9my s dono\u0161en\u00edm plodu m\u00edvaj\u00ed r\u016fzn\u00e9 p\u0159\u00ed\u010diny. Jednou z nich m\u016f\u017ee b\u00fdt nekompatibilita mezi imunitn\u00edm syst\u00e9mem d\u011blohy matky a genotypem embrya, kterou je mo\u017en\u00e9 identifikovat jen speci\u00e1ln\u00edm vy\u0161et\u0159en\u00edm. Na z\u00e1klad\u011b jeho v\u00fdsledk\u016f dok\u00e1\u017eou odborn\u00edci vyhodnotit, jak\u00e1 m\u016f\u017ee b\u00fdt imunologick\u00e1 reakce matky na embryo. Pr\u00e1v\u011b ta je toti\u017e jedn\u00edm z kl\u00ed\u010dov\u00fdch faktor\u016f, kter\u00e9 rozhoduj\u00ed o \u00fasp\u011bchu uhn\u00edzd\u011bn\u00ed embrya i jeho dal\u0161\u00edho v\u00fdvoje. P\u0159\u00edpadn\u00e1 intolerance genotypu embrya m\u016f\u017ee m\u00edt za n\u00e1sledek z\u00e1va\u017en\u00e9 komplikace b\u011bhem t\u011bhotenstv\u00ed \u010dasto vedouc\u00ed k potratu i. Vy\u0161et\u0159en\u00ed s n\u00e1zvem HLA+ nab\u00edz\u00ed v \u010cesk\u00e9 republice zat\u00edm jen jedin\u00e1 klinika asistovan\u00e9 reprodukce \u2013 IVF CUBE v Praze. Metoda je ur\u010dena p\u0159edev\u0161\u00edm p\u00e1r\u016fm, jim\u017e nad\u011bje na d\u00edt\u011b u\u017e v minulosti zma\u0159ily opakovan\u00e9 potraty. <\/strong><\/p>\n <\/p>\n O \u00fasp\u011bchu t\u011bhotenstv\u00ed m\u016f\u017ee rozhodnout imunogenetika<\/strong><\/p>\n Ka\u017ed\u00fd \u010dlov\u011bk je v z\u00e1vislosti na sv\u00e9m genotypu nositelem specifick\u00e9 kombinace antigen\u016f HLA-C, kter\u00e9 mohou v\u00fdznamn\u011b ovlivnit reproduk\u010dn\u00ed proces. Z\u00e1rove\u0148 je nositelem unik\u00e1tn\u00ed sady tzv. KIR receptor\u016f, kter\u00e9 p\u0159edstavuj\u00ed jeden z kl\u00ed\u010dov\u00fdch prvk\u016f na\u0161\u00ed vrozen\u00e9 imunity. Tyto receptory sehr\u00e1vaj\u00ed d\u016fle\u017eitou roli nejen p\u0159i b\u011b\u017en\u00fdch imunitn\u00edch reakc\u00edch t\u011bla, nap\u0159\u00edklad na infekci, ale i p\u0159i transplantaci darovan\u00fdch org\u00e1n\u016f nebo i embry\u00ed, kdy na nich z\u00e1vis\u00ed, zda je t\u011blo p\u0159ijme. \u201eLidsk\u00fd imunitn\u00ed syst\u00e9m je p\u0159ipraven\u00fd eliminovat cokoliv, co rozpozn\u00e1 jako ciz\u00ed. To se m\u016f\u017ee st\u00e1t i b\u011bhem t\u011bhotenstv\u00ed, kdy imunitn\u00ed syst\u00e9m matky reaguje s embryem, kter\u00e9 m\u00e1 krom\u011b mate\u0159sk\u00fdch antigen\u016f i antigeny od otce. \u201c<\/em>vysv\u011btluje MUDr. Hana Vi\u0161\u0148ov\u00e1, vedouc\u00ed l\u00e9ka\u0159ka kliniky IVF CUBE<\/strong>, a pokra\u010duje: \u201eO toleranci, respektive intoleranci matky v\u016f\u010di kombinaci antigen\u016f HLA-C u embrya rozhoduj\u00ed jej\u00ed imunitn\u00ed bu\u0148ky a jejich KIR receptory zodpov\u011bdn\u00e9 za p\u0159irozenou imunitu v d\u011bloze matky. I na m\u00ed\u0159e jejich kompatibility z\u00e1vis\u00ed \u00fasp\u011b\u0161n\u00fd pr\u016fb\u011bh t\u011bhotenstv\u00ed.\u201c<\/em><\/p>\n <\/p>\n Nekompatibilita ohro\u017euje plod i matku<\/strong><\/p>\n Rozs\u00e1hl\u00e9 v\u00fdzkumn\u00e9 studie potvrzuj\u00ed, \u017ee v p\u0159\u00edpad\u011b p\u00e1r\u016f, jejich\u017e snaha o d\u00edt\u011b skon\u010dila opakovan\u00fdmi potraty, m\u016f\u017ee b\u00fdt jedn\u00edm z d\u016fvod\u016f pr\u00e1v\u011b imunologick\u00e1 intolerance d\u011blohy v\u016f\u010di embryu. To znamen\u00e1, \u017ee i kdy\u017e jsou oba partne\u0159i zdrav\u00ed a plodn\u00ed, jejich imunologick\u00e1 nekompatibilita m\u016f\u017ee v kone\u010dn\u00e9m d\u016fsledku v\u00e9st ke spont\u00e1nn\u00edm potrat\u016fm. Odpov\u011b\u010f p\u0159i hled\u00e1n\u00ed p\u0159\u00ed\u010din opakovan\u00fdch probl\u00e9m\u016f s dono\u0161en\u00edm plodu m\u016f\u017ee poskytnout i vy\u0161et\u0159en\u00ed HLA+, kter\u00e9 umo\u017e\u0148uje posoudit kompatibilitu mezi KIR receptory v d\u011bloze a antigeny HLA-C embrya. \u201eN\u011bkter\u00e9 KIR receptory v d\u011bloze matky mohou vykazovat vysokou m\u00edru intolerance v\u016f\u010di ur\u010dit\u00fdm subtyp\u016fm antigen\u016f HLA-C. A to a\u017e do takov\u00e9 m\u00edry, \u017ee \u017eena sice ot\u011bhotn\u00ed, ale opakovan\u011b p\u0159ijde o plod. Dal\u0161\u00edm velmi v\u00e1\u017en\u00fdm d\u016fsledkem takov\u00e9to nekompatibility b\u00fdv\u00e1 i preeklampsie, kter\u00e1 m\u016f\u017ee fat\u00e1ln\u011b ohrozit v\u00fdvoj a \u017eivot plodu i samotn\u00e9 matky,\u201c<\/em> vysv\u011btluje MUDr. Vi\u0161\u0148ov\u00e1. <\/p>\n <\/p>\n Pro koho je vy\u0161et\u0159en\u00ed HLA+ vhodn\u00e9<\/strong><\/p>\n Vy\u0161et\u0159en\u00ed HLA+ zp\u0159\u00edstupnila sv\u00fdm pacient\u016fm klinika IVF CUBE jako prvn\u00ed a zat\u00edm jedin\u00e1 v \u010cesk\u00e9 republice. Nejde p\u0159itom o \u017e\u00e1dnou experiment\u00e1ln\u00ed metodu, v zahrani\u010d\u00ed se s \u00fasp\u011bchem pou\u017e\u00edv\u00e1 u\u017e n\u011bkolik let. Vy\u0161et\u0159en\u00ed b\u00fdv\u00e1 indikov\u00e1no p\u0159edev\u0161\u00edm p\u00e1r\u016fm, kter\u00e9 v minulosti po\u010daly d\u00edt\u011b p\u0159irozenou cestou nebo podstoupily IVF terapii s vlastn\u00edmi \u010di darovan\u00fdmi vaj\u00ed\u010dky, ale t\u011bhotenstv\u00ed opakovan\u011b skon\u010dila spont\u00e1nn\u00edm potratem plodu. Test HLA+ tak m\u016f\u017ee tak\u00e9 odhalit p\u0159\u00ed\u010dinu probl\u00e9m\u016f s dono\u0161en\u00edm plodu. \u201ePokud se prok\u00e1\u017ee, \u017ee KIR receptory d\u011blohy vykazuj\u00ed vysokou m\u00edru intolerance v\u016f\u010di kombinaci antigen\u016f HLA-C, kter\u00e9 by embryo z\u00edskalo z vlastn\u00edho vaj\u00ed\u010dka a spermie partnera, m\u016f\u017ee b\u00fdt p\u00e1ru doporu\u010dena IVF terapie s s vyu\u017eit\u00edm darovac\u00edho programu<\/em>. V takov\u00e9m p\u0159\u00edpad\u011b n\u00e1m vy\u0161et\u0159en\u00ed HLA+ z\u00e1rove\u0148 umo\u017en\u00ed vybrat d\u00e1rkyni, kter\u00e1 bude z hlediska kombinace antigen\u016f HLA-C nejv\u00edce kompatibiln\u00ed s KIR receptory d\u011blohy pacientky. T\u00edm v\u00fdznamn\u011b zv\u00fd\u0161\u00edme \u0161anci na \u00fasp\u011bch IVF terapie a t\u011bhotenstv\u00ed,\u201c<\/em> dod\u00e1v\u00e1 MUDr. Vi\u0161\u0148ov\u00e1. <\/em><\/p>\n Vy\u0161et\u0159en\u00ed HLA+ se realizuje ze vzorku krve p\u00e1ru. Pokud jde o IVF terapii s darovan\u00fdmi bu\u0148kami, vy\u0161et\u0159\u00ed se i krev potenci\u00e1ln\u00ed d\u00e1rkyn\u011b\/d\u00e1rce. Metoda v sou\u010dasnosti nen\u00ed hrazena ze zdravotn\u00edho poji\u0161t\u011bn\u00ed.<\/p>\n —<\/p>\n Vysv\u011btlivky:<\/strong><\/p>\n HLA-C<\/strong> (Human Leucocyte Antigen-C)<\/strong> \u2013 rozs\u00e1hl\u00fd komplex gen\u016f, kter\u00e9 determinuj\u00ed povrchov\u00e9 molekuly (antigeny) um\u00edst\u011bn\u00e9 v plazmatick\u00e9 membr\u00e1n\u011b bun\u011bk. Je hlavn\u00edm histokompatibiln\u00edm syst\u00e9mem, kter\u00fd je prim\u00e1rn\u011b zodpov\u011bdn\u00fd za rozezn\u00e1v\u00e1n\u00ed vlastn\u00edho od cizorod\u00e9ho.<\/p>\n KIR (Killer Immunoglobulin Receptors)<\/strong> \u2013 transmembr\u00e1nov\u00e9 glykoproteiny vyskytuj\u00edc\u00ed se na povrchu lidsk\u00fdch NK (Natural Killer Cell) bun\u011bk imunitn\u00edho syst\u00e9mu. Tyto receptory interaguj\u00ed s MHC I. molekulami nach\u00e1zej\u00edc\u00edmi se na povrchu v\u011bt\u0161iny typ\u016f t\u011blov\u00fdch bun\u011bk a reguluj\u00ed tak cytotoxick\u00e9 funkce NK bun\u011bk. KIR receptory jsou schopn\u00e9 rozli\u0161ovat zdrav\u00e9 bu\u0148ky nap\u0159. od n\u00e1dorov\u00fdch \u010di virem infikovan\u00fdch bun\u011bk.<\/p>\nSt\u00e1hnout tiskovou zpr\u00e1vu<\/a>\nngg_shortcode_0_placeholder\n","protected":false},"excerpt":{"rendered":" Speci\u00e1ln\u00ed imunogenetick\u00e9 vy\u0161et\u0159en\u00ed pom\u00e1h\u00e1 ur\u010dit p\u0159\u00ed\u010dinu opakovan\u00fdch potrat\u016f a z\u00e1rove\u0148 zvy\u0161uje \u00fasp\u011b\u0161nost IVF terapie s darovan\u00fdmi vaj\u00ed\u010dky. Opakovan\u00e9 potraty v ran\u00e9 f\u00e1zi t\u011bhotenstv\u00ed a probl\u00e9my s dono\u0161en\u00edm plodu m\u00edvaj\u00ed r\u016fzn\u00e9 p\u0159\u00ed\u010diny. Jednou z nich m\u016f\u017ee b\u00fdt nekompatibilita mezi imunitn\u00edm syst\u00e9mem d\u011blohy matky a genotypem embrya, kterou je mo\u017en\u00e9 identifikovat jen speci\u00e1ln\u00edm vy\u0161et\u0159en\u00edm. Na z\u00e1klad\u011b jeho v\u00fdsledk\u016f dok\u00e1\u017eou odborn\u00edci vyhodnotit, jak\u00e1 m\u016f\u017ee b\u00fdt […]<\/p>\n","protected":false},"author":3,"featured_media":22506,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[131],"tags":[],"_links":{"self":[{"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/posts\/22478"}],"collection":[{"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/comments?post=22478"}],"version-history":[{"count":3,"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/posts\/22478\/revisions"}],"predecessor-version":[{"id":22489,"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/posts\/22478\/revisions\/22489"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/media\/22506"}],"wp:attachment":[{"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/media?parent=22478"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/categories?post=22478"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.phoenixcom.cz\/press\/wp-json\/wp\/v2\/tags?post=22478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}