{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:10:06Z","timestamp":1775707806968,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2007,7,27]],"date-time":"2007-07-27T00:00:00Z","timestamp":1185494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2007,10]]},"abstract":"<jats:sec><jats:title>Problem<\/jats:title><jats:p>Elevated Th1\/Th2 cytokine producing CD3<jats:sup>+<\/jats:sup>\/CD4<jats:sup>+<\/jats:sup> cell ratios were reported in women with a history of recurrent spontaneous abortion (RSA) and multiple implantation failures. We report, significantly elevated Th1\/Th2 cell ratios were noticed in a pregnant woman with twin pregnancies complicated with one fetal demise, who had a history of RSA, secondary Sj\u00f6gren\u2019s syndrome (SS), and rheumatoid arthritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of study<\/jats:title><jats:p>Case report.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Peripheral blood Th1\/Th2 cell ratios were significantly elevated 3\u2003weeks prior to a fetal demise of twin pregnancies at 20\u2003week gestation. Two weeks after fetal demise, the ratio of intracellular tumor necrosis factor\u2010\u03b1\/interleukin\u201010 producing CD3<jats:sup>+<\/jats:sup>\/CD4<jats:sup>+<\/jats:sup> cells in peripheral blood was further increased to three times higher than prior ratio. Elevated Th1\/Th2 ratio was down regulated after increasing dose of IVIg treatment. The patient gave birth to a male baby weighing 2650\u2003g at 36\u2003weeks gestation. No serious complications were found in the patient or the baby.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Systemic inflammatory immune response pre\u2010exists prior to a fetal demise and the degree of inflammatory immune response got worse with a presence of fetal demise in utero. We infer that the placenta is not an immunological barrier to maternal Th1\/Th2 immune responses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1600-0897.2007.00506.x","type":"journal-article","created":{"date-parts":[[2007,7,27]],"date-time":"2007-07-27T13:08:38Z","timestamp":1185541718000},"page":"325-329","source":"Crossref","is-referenced-by-count":18,"title":["Elevated Th1\/Th2 Cell Ratios in a Pregnant Woman with a History of RSA, Secondary Sj\u00f6gren\u2019s Syndrome and Rheumatoid Arthritis Complicated with One Fetal Demise of Twin Pregnancy"],"prefix":"10.1111","volume":"58","author":[{"given":"Joanne","family":"Kwak\u2010Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung\u2010Ki","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Gilman\u2010Sachs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,7,27]]},"reference":[{"key":"e_1_2_4_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.53.9.569"},{"key":"e_1_2_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/26.5.324"},{"key":"e_1_2_4_4_2","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/S0025-6196(11)62408-7","article-title":"Incidence of physician\u2010diagnosed primary Sjogren syndrome in residents of Olmsted County, Minnesota","volume":"76","author":"Pillemer 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