Dr. Gilman-Sachs received her B.S. in 1962 from the University of Illinois at Urbana, M.S. in 1964 from the University of Illinois at Urbana, and her Ph.D. in Microbiology and Immunology in 1983 from the University of Illinois at Chicago, School of Health Sciences. She came to Rosalind Franklin University of Medicine and Science in 1985 and is Director of the Flow Cytometry Laboratory and Associate Director of the Clinical Immunology Laboratory. She is ABMLI Board Certified in Clinical Immunology.
Fifty percent of all recurrent spontaneous abortions (RSA) are unexplained and probably immune-related. My research involves the evaluation of pre- and post-immunization parameters in women who have received treatment to prevent RSA. One of the parameters studied in the past year is the ratio of TH1 vs TH2 cytokines. A successful pregnancy is supported by TH2 rather than TH1 cytokines at the maternal-fetal interface. Women with histories of recurrent spontaneous abortions may have a reversed ratio. Therefore, in this study the ratio of TH1/TH2 intracellular cytokines has been determined in women with two or more successful pregnancies and compared to women with histories of recurrent spontaneous abortions. These immune parameters are determined using peripheral blood lymphocytes and gating on CD4 and CD8 lymphocytes. The study indicates that there is indeed a difference between these two groups of women. The next set of experiments will be aimed at determining what treatments can reverse these ratios in RSA patients and allow a successful pregnancy to continue in women. Also, the ratios may be useful in monitoring and treating women with pregnancy loss.
Pregnancy loss is multifactorial and many immune related aspects are involved in it. Other factors being studied are activation markers on lymphocytes such as CD69 or CD25, natural killer cell (CD56+) cytokines, the relationship between KIR receptor genes of the female and HLA-C genes of the father in successful pregnancy, and last but not least the relationship between polymorphisms of cytokine promoters and pregnancy loss. By investigating the roles of these factors in successful or unsuccessful pregnancies, better treatment options may be utilized in women with recurrent spontaneous abortions.
Kwong C, Gilman-Sachs A, Beaman K. Tumor-associated a2 vacuolar ATPase acts as a key mediator of cancer-related inflammation by inducing pro-tumorigenic properties in monocytes. J Immunol. 1;186(3): 2011
Kim NY, Cho HJ, Kim HY, Yang KM, Ahn HK, Thornton S, Park JC, Beaman K, Gilman-Sachs A,
Kwak-Kim J. Thyroid Autoimmunity and its Association with Cellular and Humoral Immunity in Women with Reproductive Failures. Am J Reprod Immunol. 65:78-87, 2011
Lee S, Kim J, Jang B, Hur S, Jung U, Kil K, Na B, Lee M, Choi Y, Fukui A, Gilman-Sachs A
, Kwak-Kim JY. Fluctuation of peripheral blood T, B, and NK cells during a menstrual cycle of normal healthy women. J Immunol
. 2010 Jul 1;185(1):756-62. Epub 2010 Jun 7.
Fukui A, Kwak-Kim J, Ntrivalas E, Gilman-Sachs A and Beaman K. Intracellular cytokine expression of peripheral blood NK cell subsets in women with recurrent spontaneous abortions and implantation failures. Fertil Steril. 89(1):157-65,2008.
Kwak-Kim, J. and Gilman-Sachs, A. Clinical implication of natural killer cells and reproduction. Am. J. Reproductive Immunology, 59:388-400, 2008.
Kwak-Kim J, Lee SK, Gilman-Sachs A. Elevated Th1/Th2 cell ratios in a pregnant woman with a history of RSA, secondary Sjögren's syndrome and rheumatoid arthritis complicated with one fetal demise of twin pregnancy. Am J Reprod Immunol. 2007 Oct;58(4):325-9.
Ntrivalas E, Derks R, Gilman-Sachs A, Kwak-Kim J, Levine R, Beaman K. Novel role for the N-terminus domain of the a2 isoform of vacuolar ATPase in interleukin-1beta production. Hum Immunol. 2007 Jun;68(6):469-77.
Fukui A, Ntrivalas E, Gilman-Sachs A, Kwak-Kim J, Lee SK, Levine R, Beaman K. Expression of natural cytotoxicity receptors and a2V-ATPase on peripheral blood NK cell subsets in women with recurrent spontaneous abortions and implantation failures. Am J Reprod Immunol. 2006 Nov-Dec;56(5-6):312-20
Ntrivalas, E., J. Kwak-Kim, K. Beaman, H. Mantouvalos, and A. Gilman-Sachs. "An invitro coculture model to study cytokine profiles of natural killer cells during maternal immune cell-trophoblast interactions," J. Soc. Gynecol Investig., 13(3):196-202, 2006.
Ntrivalas EI, Bowser CR, Kwak-Kim J, Beaman KD, Gilman-Sachs A. Expression of killer immunoglobulin-like receptors on peripheral blood NK cell subsets of women with recurrent spontaneous abortions or implantation failures. Am J Reprod Immunol. 2005 May;53(5):215-21.
Kwak-Kim, J.Y., A. Gilman-Sachs and C.E. Kim. "T helper 1 and 2 immune responses in relationship to pregnancy, nonpregnancy, recurrent spontaneous abortions and infertility of repeated implantation failures," Chem. Immunol. Allergy, 88:64-79, 2005.