Wang M, Zhang P, Yu S, et al. - In order to gain clarity on the mechanism of action whereby treatment with low-molecular weight heparin (LMWH) and aspirin combination improves pregnancy outcome in recurrent pregnancy loss (RPL) secondary to anti-phospholipid syndrome (APS), researchers examined 89 patients with APS-RPL in whom the influence of this therapy on Th1/Th2 cells was investigated. Findings revealed that patients with APS-RPL exhibited higher serum cytokine levels, T cell phenotypes, and transcription factors' gene expression levels representing Th1 responses at the time of early pregnancy, but those expressing Th2 responses were lower. Reversal of this Th1-bias was evident in those who had live birth following taking the combination therapy at the time of delivery. Th1-bias was continuously seen in patients with miscarriages. Overall, Th1-bias is implicated in APS-RPL pathogenesis and a novel immunomodulatory mechanism of LMWH/aspirin combination could be restoring T-cell phenotype.