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Biomedicines
Special Issues
Immunology in Recurrent Pregnancy Loss, Preeclampsia and Infertility
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Immunology in Recurrent Pregnancy Loss, Preeclampsia and Infertility

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Immunology and Immunotherapy".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 1501

Editor

Dr. Jenny Valentina Garmendia

E-Mail Website
Guest Editor
Institute of Molecular and Translational Medicine, Faculty of Medicine, Palacký University, 77900 Olomouc, Czech Republic
Interests: immunology of pregnancy; tumor immunologic mechanisms; translational medicine

Special Issue Information

Dear Colleagues,

Pregnancy is an allograft that requires special tolerant mechanisms to preserve fetal vitality. When these mechanisms fail, what ensues is recurrent pregnancy loss, recurrent implantation failure in in vitro fertilization, and, in rare occasions, infertility. The mother’s immune system plays an important role during this tolerogenic state. In this Special Issue, we will showcase studies on the immunology of normal pregnancy, recurrent pregnancy loss, infertility, and preeclampsia, as well as autoimmune and infection diseases in gestation.

Dr. Jenny Valentina Garmendia
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • immunology of pregnancy
  • recurrent pregnancy loss
  • infertility
  • preeclampsia
  • autoimmunity

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Published Papers (3 papers)

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Research

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11 pages, 557 KB  
Article
Non-Criteria Antiphospholipid Antibodies in Women with Recurrent Pregnancy Loss
by Madina Khalmirzaeva, Gulfiruz Urazbayeva, Almagul Kurmanova, Nagima Mamedalieva, Gaukhar Kurmanova, Damilya Salimbayeva, Ainur Veliyeva, Gaini Anartayeva, Zhanar Kypshakbayeva, Shugyla Amirtayeva and Altynay Nurmakova
Biomedicines 2026, 14(6), 1177; https://doi.org/10.3390/biomedicines14061177 - 22 May 2026
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Abstract
Background: Recurrent pregnancy loss (RPL) remains etiologically unexplained in 40–50% of cases following standard diagnostic workup. Non-criteria antiphospholipid antibodies (non-criteria aPL) are increasingly considered potential markers of seronegative obstetric antiphospholipid syndrome (APS); however, their diagnostic value in this clinical setting requires further [...] Read more.
Background: Recurrent pregnancy loss (RPL) remains etiologically unexplained in 40–50% of cases following standard diagnostic workup. Non-criteria antiphospholipid antibodies (non-criteria aPL) are increasingly considered potential markers of seronegative obstetric antiphospholipid syndrome (APS); however, their diagnostic value in this clinical setting requires further investigation. Objective: To assess the diagnostic value of non-criteria aPL in women with RPL and to construct an exploratory immunological scoring model for diagnostic stratification. Methods: Antiphospholipid antibody detection was performed using a single-measurement semi-quantitative line immunoblot assay (Anti-Phospholipid 10 Dot, Generic Assays, Germany). Statistical analysis included χ2, Fisher’s exact test, Mann–Whitney U test, binary logistic regression, and ROC analysis. Results: Statistically significant associations with RPL were observed for anti-prothrombin antibodies (OR = 11.1; 95% CI 1.8–68.0; p = 0.022 [Haldane–Anscombe correction]), anti-annexin V (OR = 4.28; 95% CI 1.18–15.6; p = 0.023), and anti-β2GP I (OR = 3.31; 95% CI 1.18–9.28; p = 0.019). The exploratory composite immunological score demonstrated moderate discriminatory performance (AUC = 0.701; 95% CI 0.588–0.814; p = 0.005). The overall logistic regression model was statistically significant (χ2 = 8.564; p = 0.036), although none of the individual predictors retained independent significance, indicating a contribution of cumulative immunological burden rather than any single marker. Conclusions: In this single-center cross-sectional study, non-criteria aPL were frequently detected in women with RPL and were statistically associated with the condition. The findings should be interpreted as hypothesis-generating only, given the cross-sectional design, single-measurement immunoblot, small control group, and absence of external validation. Confirmation in larger prospective multicenter cohorts using ELISA-based assays with the internationally recommended 12-week repeat measurement is required before any clinical implementation. Full article
(This article belongs to the Special Issue Immunology in Recurrent Pregnancy Loss, Preeclampsia and Infertility)
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12 pages, 1188 KB  
Article
Systemic Immune-Inflammation Index and Clinical Predictors of Atypical PRES in Eclampsia: Higher Blood Pressure and Inflammatory Burden Drive Multi-Regional Involvement
by Mehmet İncebıyık and Adalet Göçmen
Biomedicines 2026, 14(4), 862; https://doi.org/10.3390/biomedicines14040862 - 9 Apr 2026
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Abstract
Objective: To identify clinical and neuroimaging predictors of atypical Posterior Reversible Encephalopathy Syndrome (PRES) in eclampsia and evaluate the role of multi-regional cerebral involvement (neuroimaging burden). Methods: This retrospective cohort study included 266 patients with eclampsia and radiologically confirmed PRES (2018–2025). [...] Read more.
Objective: To identify clinical and neuroimaging predictors of atypical Posterior Reversible Encephalopathy Syndrome (PRES) in eclampsia and evaluate the role of multi-regional cerebral involvement (neuroimaging burden). Methods: This retrospective cohort study included 266 patients with eclampsia and radiologically confirmed PRES (2018–2025). Patients were classified as typical (n = 234, 88.0%) or atypical (n = 32, 12.0%). A two-stage multivariable logistic regression was performed to identify independent predictors, sequentially incorporating clinical and neuroimaging variables. Results: Peak systolic blood pressure was significantly higher in atypical vs. typical groups (191.6 ± 20.4 vs. 172.4 ± 18.5 mmHg, p < 0.001). Furthermore, atypical cases exhibited a significantly higher systemic inflammatory burden, characterized by markedly elevated Systemic Immune-Inflammation Index (SII) and CRP levels (p < 0.001). Atypical cases exhibited a markedly greater neuroimaging burden, with a higher mean number of involved brain regions (4.4 ± 1.2 vs. 2.1 ± 0.6, p < 0.001). In Model 1 (clinical variables only), systolic blood pressure was a strong predictor of atypicality (OR: 1.24 per 10 mmHg increase, 95% CI: 1.12–1.38, p < 0.001). After incorporating neuroimaging features in Model 2, the total number of involved brain regions emerged as the strongest independent predictor (OR: 2.08, 95% CI: 1.52–2.85, p < 0.001), while the independent effect of blood pressure was attenuated. Conclusions: Atypical PRES in eclampsia reflects extensive, high-burden cerebral vasogenic edema rather than a distinct radiological subtype. While hypertension initiates the process, the total regional burden determines the atypical signature. This burden-focused perspective improves risk stratification and diagnostic vigilance in high-risk obstetrics. Full article
(This article belongs to the Special Issue Immunology in Recurrent Pregnancy Loss, Preeclampsia and Infertility)
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8 pages, 195 KB  
Viewpoint
Autoimmune Disorders and Thrombophilia in Pathologic Pregnancies: Management Throughout the Full Gestation
by Rui Gao and Lang Qin
Biomedicines 2026, 14(5), 1143; https://doi.org/10.3390/biomedicines14051143 - 18 May 2026
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Abstract
Pathologic pregnancies including recurrent pregnancy loss, stillbirth, early-onset pre-eclampsia and early-onset fetal growth restriction form a continuous spectrum throughout gestation and have attracted wide attention. Autoimmune disorders and associated acquired thrombophilia are key etiological factors. However, because of the complicated associations between various [...] Read more.
Pathologic pregnancies including recurrent pregnancy loss, stillbirth, early-onset pre-eclampsia and early-onset fetal growth restriction form a continuous spectrum throughout gestation and have attracted wide attention. Autoimmune disorders and associated acquired thrombophilia are key etiological factors. However, because of the complicated associations between various clinical manifestations, laboratory examinations and treatments, the management of pathologic pregnancies with autoimmune disorders and associated acquired thrombophilia are difficult. This viewpoint article presents a comprehensive full gestation management strategy emphasizing early identification and multidisciplinary management to improve pregnancy outcomes in these patients. Future research should focus on novel biomarkers, therapeutic methods and crosstalk mechanisms between autoimmune disorders and thrombophilia to optimize clinical strategies. Full article
(This article belongs to the Special Issue Immunology in Recurrent Pregnancy Loss, Preeclampsia and Infertility)
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