Mesenchymal stem cells for recurrent miscarriage.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

BACKGROUND: Recurrent pregnancy loss (RPL), affecting 1–5% of couples, is frequently driven by immunological dysregulation, including excessive natural killer (NK) cell cytotoxicity, reduced regulatory T cell (Treg) function, Th1/Th17 dominance, and inflammatory cytokine imbalance at the maternal-fetal interface. These abnormalities disrupt immune tolerance to the semi-allogeneic fetus, leading to implantation failure or early miscarriage. Current interventions (e.g. low-dose aspirin/heparin for antiphospholipid syndrome, intravenous immunoglobulin, or corticosteroids) show variable efficacy and limitations, particularly in unexplained cases. Mesenchymal stem cells (MSCs), with proven immunomodulatory, anti-inflammatory, and tissue-repair properties, have gained regulatory approval for severe immune dysregulation conditions like steroid-refractory graft-versus-host disease (GVHD), which shares pathophysiological parallels with immune-mediated RPL, including NK hyperactivity and deficient Treg tolerance. MAIN BODY: MSCs from sources such as bone marrow, adipose tissue, or umbilical cord exert context-dependent effects, secreting anti-inflammatory factors (e.g. IL-10, TGF-β), suppressing pro-inflammatory cytokines, inhibiting cytotoxic NK activity, and promoting Treg expansion and function to restore immune homeostasis. Preclinical studies in abortion-prone mouse models (e.g. CBA

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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