Varla-Leftherioti M, Keramitsoglou T, Spyropoulou-Vlachou M, Papadimitropoulos M, Kontopoulou-Antonopoulou V, Tsekoura C, Sankarkumar U, Paparistidis N, Ghosh K, Pawar A, Vrani V, Daniilidis M, Parapanissiou E, Diler A S, Carin M, Stavropoulos-Giokas C
Immunobiology Department, RSA Clinic, Helena Venizelou Maternity Hospital, Athens, Greece.
Tissue Antigens. 2007 Apr;69 Suppl 1:297-303. doi: 10.1111/j.1399-0039.2006.00782.x.
The aim of the study was to investigate whether human leukocyte antigen (HLA) allele sharing between partners or the maternal killer immunoglobulin-like receptor (KIR) repertoire is associated with recurrent spontaneous abortion (RSA) and repeated implantation failure after in vitro fertilization (IVF)/embryo transfer. From a total population of 158 RSA couples, 40 couples with repeated implantation failures (IVF) and 81 control couples, reported by five different laboratories, analysis was performed for (a) HLA sharing in 50 RSA, 31 IVF and 31 control couples, (b) DQA10505 sharing/homozygosity among partners in 108 RSA, 40 IVF and 36 control couples, and (c) the women's KIR repertoire in 46 RSA, 26 IVF and 36 control wives. RSA couples were divided into alloimmune aborter (RSAallo) and autoimmune aborter (RSAauto). The results oppose to the suggestion that increased HLA sharing per se or a limited maternal KIR repertoire predisposes to RSA or IVF failure. However, the observation of a slightly higher percentage of DQA10505 sharing in the RSAauto and the IVF group needs further investigation. The ratio of inhibitory to activating KIR (actKIR) was slightly lower in RSAallo and IVF women (1.9 vs 2.6 in controls), while in a high percentage of these women, the standard receptors of the KIR A haplotype were combined with actKIR/s of the haplotype B (66.6% and 45.4% vs 20% and 15.3% in RSAauto and control groups). This may suggest a possible involvement of actKIRs in embryo implantation and the maintenance of pregnancy and also requires further investigation.
本研究的目的是调查伴侣之间的人类白细胞抗原（HLA）等位基因共享或母体杀伤细胞免疫球蛋白样受体（KIR）库是否与复发性自然流产（RSA）以及体外受精（IVF）/胚胎移植后的反复植入失败有关。来自五个不同实验室报告的总共158对RSA夫妇、40对反复植入失败（IVF）的夫妇和81对对照夫妇，对以下方面进行了分析：（a）50对RSA夫妇、31对IVF夫妇和31对对照夫妇中的HLA共享情况；（b）108对RSA夫妇、40对IVF夫妇和36对对照夫妇中伴侣之间的DQA10505共享/纯合性；（c）46名RSA女性、26名IVF女性和36名对照女性的KIR库。RSA夫妇被分为同种免疫流产者（RSAallo）和自身免疫流产者（RSAauto）。结果与以下观点相反，即HLA共享增加本身或母体KIR库有限易导致RSA或IVF失败。然而，在RSAauto组和IVF组中观察到DQA10505共享百分比略高，这需要进一步研究。RSAallo组和IVF组女性中抑制性KIR与激活性KIR（actKIR）的比例略低（对照组为1.9比2.6），而在这些女性中，高比例的KIR A单倍型标准受体与B单倍型的actKIR组合（RSAauto组和对照组分别为66.6%和45.4%，而RSAauto组和对照组分别为20%和15.3%）。这可能表明actKIRs可能参与胚胎植入和维持妊娠，这也需要进一步研究。
