In our group of patients, there was a small AFC or these structures were no longer seen on ultrasound, which agrees with the data in the literature (61). Conclusion Clinical and biological characteristics of women without known causes of disease suggest a possibility of autoimmune pathogenesis. stimulating hormone and low levels of inhibin B and anti-Mllerian hormone were observed. In 16 (80%) patients, POI was associated in their personal and familial history with another autoimmune disease. Fifty percent of patients presented highly elevated antithyroid antibodies. The lymphocyte subset, especially B cells, was significantly higher (p=0.014), and peripheral regulatory lymphocytes CD25+ high were significantly lower (p=0.015) in the study group than in the control group. PF-00446687 Anti- ovarian antibodies were detected in 20% of patients with POI. Conclusion: We presume that the presence of anti-ovarian antibodies together with abnormalities of cellular immunity may in some cases potentially represent the involvement of an autoimmune mechanism in idiopathic POI. strong class=”kwd-title” Keywords: Autoantibody, Thyroid Stimulating Antibody, Cell Immunity, Premature Ovarian Insufficiency, T-Lymphocyte Introduction Premature ovarian insufficiency (POI) is characterized by hypergonadotropic amenorrhea due to cessation of ovarian function before the age of 40 years. The diagnosis is based on amenorrhea before the age of 40 associated with follicle stimulating Rabbit Polyclonal to NOTCH2 (Cleaved-Val1697) hormone (FSH) levels 40 IU/l, detected on two occasions at least one month apart (1). POI causes female infertility, while is a significant psychosocial burden and a risk to womens health. It occurs in 1% of women, of whom 10-28% have primary and 4-18% secondary amenorrhea (2, 3). Although there are multiple etiologies of POI (genetic, chromosomal, infectious, and iatrogenic causes), the etiology cannot be identified in most patients and this PF-00446687 is referred to as idiopathic POI; up to 30% of idiopathic cases may have an autoimmune cause (4). The most convincing evidence coming from the commonly observed association of POI with other autoimmune disorders (5, 6) are demonstration of anti-ovarian antibodies (AOA, 7, 8) and histological findings of ovarian tissue from affected women. Roughly, one third of POI patients have AOA and/or antithyroid antibodies in their serum (1, 9). Various organ-specific and systemic autoimmune diseases cause autoimmune ovarian insufficiency in up to 30% of women with POI (4). According to PF-00446687 the literature, 2-10% of POI cases are known to be associated with adrenal autoimmunity (10). One of the first signs that autoimmunity may be responsible for ovarian function failure came from the observation that ovarian failure may precede the onset of Addisons PF-00446687 disease by 8-14 years (11). Autoimmune Addisons disease seldom develops in isolation, whereas several other endocrine glands and organs are generally affected, leading to an autoimmune polyglandular syndrome (APGS, 12). Two main forms of APGS can be clinically discerned, APGS types 1 and 2. APGS type 1 is characterized by an association of mucocutaneous candidiasis, hypoparathyroidism and Addisons disease. In about 60% of cases, there is also PF-00446687 an association with ovarian insufficiency. Blizzard et al. (13) and Irvine et al. (14) found that POI commonly presents with adrenal cytoplasmic antibodies, called steroid cell antibodies (SCA); they react with cytoplasmic antigens of other steroid-producing cells present in the ovary, testis and placenta. Alteration of lymphocytes and their specific subsets, as well as T-cell mediated injury are likely to play an important role in the pathogenesis of autoimmune oophoritis. Surface markers of peripheral blood mononuclear cells (PBMC) have been shown to be deranged in early autoimmune phases and to be persisted through the disease, even after targeted disruption (15). The presence of pathogenic factors might accelerate the process of apoptosis and atresia of ovarian follicles during the fetal and post-natal period (16). This interpretation is based on the dogma that the number of ovarian follicles at birth is final and that there is no possibility of regeneration or renewal of reserve follicles in adulthood (17). Experimental work on animals suggests a possibility of renewal of the follicle reserve from proliferative germinal ovarian cells even.