Dr Shahata, Natural Killer Cells and a ray of hope

On Tuesday this week I googled “miscarriage clinic London”. The first result that came up was a miscarriage clinic run by Dr. Shahata. I was interested in the fact that he tests for Natural Killer Cells. I have had a series of blood tests to try and find out why I’ve miscarried 3 times and all the tests have come back normal. I haven’t yet, however, had the NKC test. A friend of mine who is pregnant and due in May had several miscarriages before she joined a trial in Liverpool where they test for and treat excess NKCs.  Here is a little info from Dr. Shahata’s website about NKCs:

There is a special class of NK cells (CD16-, CD56+) in the placenta that promotes fetus survival. Opposing is another group of NK cells (CD16+, CD56+), if active are toxic to the placenta and hence may cause a miscarriage. The same cells secrete tumor necrosis factor (TNF) which can destroy the placenta.

• Implantation of embryos into the mother’s womb is a complex process involving several factors including the local systemic immune responses. Pregnancy may fail when these events are not well synchronized.

• Therapy aimed at calming these immune activating factors should, theoretically at least, encourage fetal viability.

• CD69 is a functional triggering molecule on activated NK cells and is one of the earliest cell surface activation markers expressed and is capable of inducing toxicity.

• CD94 is an inhibitory marker of NK cell function. In 1999, a study demonstrated that NK cell toxicity could be blocked by the CD94 inhibitory receptor. Previous studies have shown that imbalances in CD69 and CD94 expression could result in infertility of unknown aetiology or recurrent miscarriage.

• The NK cell is the most abundant immune cell infiltrating the womb implantation site. In a previous study, an elevated percentage of peripheral blood NK cells were associated with recurrent failed IVF-ET treatment cycles. Another study showed that increased peripheral blood NK cell toxicity was associated with an increased rate of recurrent failed implantation after IVF-ET treatment. More recent studies have confirmed elevated NK cell CD69 expression as being associated with recurrent miscarriage and infertility of unknown aetiology. Finally, a recent small non-randomised study has also suggested elevated NK cell CD69 expression may be related to failed implantation of the embryo.

Quite by coincicence, yesterday and today this story was widely published: http://news.bbc.co.uk/1/hi/england/sussex/8522575.stm.  A woman suffered 18 miscarriages, but has now become a mother for the first time after being treated by Dr. Shahata.  It is a story of hope for all of us who have suffered miscarriages.  More so for those of us who have thus far been told that there seems to be no obvious medical reason for the miscarriages.  One of the frustrating things in this whole process is knowing that there is something wrong, but the doctors saying that they can’t find what it is.

There are, as always in the medical profession, different schools of thought on the NKCs and steroid treatment.  My husband has looked in to it online and there are some specialists out there who say there is no proof that this treatment is safe or works.  For me though, its a ray of hope and one which I intend to hold on to.  There has been so much grief and dispair in our lives over the last year, not to mention frustration at there being no answers,  that hope really is the only thing we have to cling on to.  So I hope that Dr. Shahata and his pioneering treatment is the answer for us and others like us out there.

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