What is a cd56 level? I was told that my NKC levels should have been as low as 2-3 and mine was up around the 10/11 mark. It seems a concern that your FS would change his mind?? This is my first cycle diagnosed with NKC - will be using the Colorado protocol
I have just been taking the pill for a month, start taking nasal spray tomorrow and stop pill on Thursday. On 15th going in for a blood test, then on 17th I start,y injections. On this day, which is an extra due to NKC I also start taking dexamethasone tablets. Additional medication is also the Intralipid I'm going in for on the 25th, clexane injections, other tablets and also patches.
I'm finding myself in this boat too sadly.. After 5 embies all perfect embies being transferred none have stuck!
I went on predisolone and had an intralipid transfusion before transfer but still nothing..
So now the doc is ordering more bloods to see what's going on..
So I'll join this boat girls! X
Hi, just blowing through, but have a little bit of CD56-related info, and also a question for those doing intralipid.
I did IVFA Bondi protocol (prednisolone and clexane) for NK cells. My bloods (done by the Sacks research group) came back OK, but my biopsy was high for NK. I didn't actually pay much attention to the details of the results because by that point we just wanted to throw everything we could that might possibly help at each cycle (got UTD on 8th stim cycle).
Maybe about 30 years ago the field of immunology decided to stop giving the newly discovered proteins on the surface of cells confusing names, that might differ from lab to lab, and just started numbering them at 1. So whatever local in-house name you might use, CD3 was CD3 (a protein closely associated with the T cell receptor) across the whole world.
CD56 is found on NK cells and some brain cells. It's "word name" is NCAM, which stands for neural cell adhesion molecule, i.e. the protein might help the cells remain in contact with (adhere to) some specific other cells for a little while.
The main way it's used diagnostically and in research is to say that if you find a white blood cell with CD56 on it then it is an NK cell, although a few other white blood cells can also wear CD56 at times.
Now, for my question arising from intralipid infusions. NKT cells (not NK cells) have a little bit of NK cell appearance, like CD56, and a little bit of T cell appearance, like CD3. NKT cells have been proposed to be a rare variety or relative of T cell that respond to lipids, whereas most "normal" T cells respond to protein. Does the effectiveness of intralipid mean that NKT cells are actually involved, and not (or not only) regular NK cells?
Last edited by felicita; 06-05-2012 at 16:02.
Thanks Felicita, you explain that well, is it something I should be worried about then? For them to say I don't have NK cells but have this cd56 thing preset?
What does the predisolone do? How did you feel with the Intralipid fusion?
I didn't pay enough attention (none really) to how the results were reported to be able to say if you ought to be worried or not.
The simple (but slightly inaccurate) answer is that if CD56 is 11 then NK must be 11.
But perhaps they saw that some of the CD56 was on the other few cells that sometimes have it. I don't know enough about the testing to know how many markers they look for at once. (CD4 T cells, not NK cells, was my research area.) Perhaps it's best to ask your Dr, "If CD56 is a marker for NK cells, why is the interpretation of my NK result different to my CD56 result."
To properly interpret the results yourself you'd need to know a heap more about how they did the test, like if they did Fc-gamma blocking on the prepared sample before labelling for CD56 or anything else, or did they use Fab fragments instead, and also the units associated with that number 10 or 11, eg. is it % (of what), or # per area of slide, or x1 million per something or other, or whatever else. I don't know what methods pathologists actually use for this test.
My FS was also in two minds about treating me for NK since my results were equivocal. I figure that since other immune system components, not just NK, might contribute to implantation failure then better to treat. Treatment is pretty much the same for nearly all immune issues (immunosuppression + anticoagulant). I didn't escape using prednisolone without side effects, the worst for me (and for DH) was I get angry and short-tempered on it. My Ob warns that 25 mg prednisolone can interfere with growth of the membranes, but my protocol only went as high as 20 mg anyway, and yay I'm weaned off it now.
Perhaps your FS hopes that if your results are borderline for the test used that you can avoid side effects by gambling that treatment is unnecessary.
Thanks for your good wishes, but I got my BFP on stim#8 (in Jan). Twins are due in October.
I wrote an introduction to NK cells for someone a while back in another thread. Might be useful for you, might not.
n.b. In that post I never talked about CD56 or other CD markers on the surface of cells. Where it says CD21 it refers to menstrual cycle day number 21. ((The protein marker called CD21 ("word name" = CR2, for complement receptor number 2) is found on B cells, so not at all relevant for an NK discussion.))
I've think I've got a post or three floating around somewhere (probs somewhere in that same Sydney girls thread) talking more about prednisolone.
Prednisolone is an immunosuppressant. It makes it a little more difficult for cells to divide, so stops an immune response getting a good run-up at things.
Short term effects: weakened immune system (you want this), short temper (for me), central obesity (I didn't get this, fat body and face), increased peeing (adrenal glands go on holiday), insomnia (try taking tablets in the morning), dreams are more vivid, my ectopic heart beats ("skipped beats") were more common (probably due to electrolyte changes resulting from adrenal holiday), I noticed increased hair fall. Don't forget to get and read the leaflet from your pharmacist.
Long term side effects include thinning skin/hair, poorer wound healing, i.e. things associated with cell division - which is also how too high a dose can interfere with growth of baby's membranes as I mentioned in reply above to moomechanic. But for IVF you don't really need to be on it for very long, just a few months.
With regards to the adrenal glands going on holiday, you can't just stop taking prednisolone suddenly. You need to wean off slowly or you stand a good chance of throwing your electrolyte balance dangerously out of whack. My instructions were to drop the dosage by 5 mg each week, until you reach 0. My adrenals return to normal (i.e. I can sleep through the night without needing to get up to pee) after about 4 days on 10 mg.
My NKT question might be one for the FS to answer, but I don't have access to an NK FS so figured I'd ask you girls instead.
Last edited by felicita; 06-05-2012 at 20:52.
We transferred 2 every time til the last time when the other didn't defrost well.. Sorry to hear your little ones didn't stick either.. This road doesn't get any easier does it?
The predisolone is a steroid that is suppose to suppress any baddies in your body. Also was on augmentin 5 days pre transfer to kill any infection., then 3 days before trans I had the transfusion, it didn't hurt at all, uncomfy at first but fine! Just sat in hosp for 6 hours relaxing.. But still it didn't work.. It looks like milk!
Will you be trying it next?
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