Koelman C A, Coumans A B, Nijman H W, Doxiadis I I, Dekker G A, Claas F H
Department of Immunohematology and Blood Bank, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands.
J Reprod Immunol. 2000 Mar;46(2):155-66. doi: 10.1016/s0165-0378(99)00062-5.
The involvement of immune mechanisms in the aetiology of preeclampsia is often suggested. Normal pregnancy is thought to be associated with a state of tolerance to the foreign antigens of the fetus, whereas in preeclamptic women this immunological tolerance might be hampered. The present study shows that oral sex and swallowing sperm is correlated with a diminished occurrence of preeclampsia which fits in the existing idea that a paternal factor is involved in the occurrence of preeclampsia. Because pregnancy has many similarities with transplantation, we hypothesize that induction of allogeneic tolerance to the paternal HLA molecules of the fetus may be crucial. Recent data suggest that exposure, and especially oral exposure to soluble HLA (sHLA) or HLA derived peptides can lead to transplantation tolerance. Similarly, sHLA antigens, that are present in the seminal plasma, might cause tolerance in the mother to paternal antigens. In order to test whether this indeed may be the case, we investigated whether sHLA antigens are present in seminal plasma. Using a specific ELISA we detected sHLA class I molecules in seminal plasma. The level varied between individuals and was related to the level in plasma. Further studies showed that these sHLA class I molecules included classical HLA class I alleles, such as sHLA-A2, -B7, -B51, -B35 and sHLA-A9. Preliminary data show lower levels of sHLA in seminal plasma in the preeclampsia group, although not significantly different from the control group. An extension of the present study is necessary to verify this hypothesis.
子痫前期病因中免疫机制的参与常被提及。正常妊娠被认为与对胎儿外来抗原的耐受状态相关，而子痫前期女性的这种免疫耐受可能受到阻碍。本研究表明口交和吞咽精液与子痫前期发生率降低相关，这与子痫前期发生涉及父系因素的现有观点相符。由于妊娠与移植有许多相似之处，我们推测诱导对胎儿父系HLA分子的同种异体耐受可能至关重要。最近的数据表明，接触，尤其是口服可溶性HLA（sHLA）或HLA衍生肽可导致移植耐受。同样，精浆中存在的sHLA抗原可能使母亲对父系抗原产生耐受。为了检验是否确实如此，我们研究了精浆中是否存在sHLA抗原。使用特异性ELISA，我们在精浆中检测到了sHLA I类分子。其水平因人而异，且与血浆中的水平相关。进一步研究表明，这些sHLA I类分子包括经典的HLA I类等位基因，如sHLA - A2、- B7、- B51、- B35和sHLA - A9。初步数据显示，子痫前期组精浆中sHLA水平较低，尽管与对照组无显著差异。有必要扩展本研究以验证这一假设。
