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复发性流产夫妇间HLA - DRB1共享对白细胞治疗后妊娠结局的影响。

The effect of HLA-DRB1 sharing between the couples with recurrent pregnancy loss on the pregnancy outcome after leukocyte therapy.

作者信息

Gharesi-Fard Behrouz, Askarinejad-Behbahani Rahil, Behdin Shabnam

机构信息

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, e-mail:

出版信息

Iran J Immunol. 2014 Mar;11(1):13-20.

Abstract

BACKGROUND

Miscarriage is a common phenomenon complicating more than half of pregnancies. Recurrent Pregnancy Loss (RPL) is defined as three or more pregnancies lost before the twentieth week of gestation. It is believed that abnormality in maternal immune reaction to fetus and sharing of HLA antigens might be associated with RPL.

OBJECTIVE

To investigate the effect of HLA-DRB1 sharing between the couples with recurrent pregnancy loss on the pregnancy outcome after leukocyte therapy.

METHODS

Sixty primary RPL women who were immunized and followed after therapy (30 successful and 30 unsuccessful) and their husbands formed the cases of this study. In addition, one hundred healthy women were considered as the controls. HLA-DRB1 genotypes of all the cases and controls were checked by PCR-SSP method.

RESULTS

HLA typing indicated that the prevalence of HLA-DRB1 sharing (defined as at least one allele sharing) between the couples with unsuccessful outcomes was significantly higher compared to those with successful outcomes (63.3% vs. 23.3%, p<0.004). Moreover, HLA DRB1*07:01 allelic group was significantly more frequent in the patients with unsuccessful outcome compared to the controls (18.3% vs. 8%, p<0.04).

CONCLUSION

Our results confirmed the role of HLA sharing in RPL and revealed that HLA-DRB1 typing may be a valuable prognostic factor for the leukocyte therapy outcome.

摘要

背景

流产是一种常见现象,使超过半数的妊娠复杂化。复发性流产(RPL)定义为妊娠20周前发生三次或三次以上流产。据信,母体对胎儿的免疫反应异常以及人类白细胞抗原(HLA)抗原的共享可能与复发性流产有关。

目的

探讨复发性流产夫妇间HLA-DRB1共享对白细胞治疗后妊娠结局的影响。

方法

60例接受免疫治疗并随访的原发性复发性流产女性(30例成功,30例失败)及其丈夫构成本研究的病例组。此外,100名健康女性作为对照组。采用聚合酶链反应-序列特异性引物(PCR-SSP)法检测所有病例组和对照组的HLA-DRB1基因型。

结果

HLA分型显示,流产未成功夫妇间HLA-DRB1共享(定义为至少一个等位基因共享)的发生率显著高于流产成功夫妇(63.3%对23.3%,p<0.004)。此外,与对照组相比,流产未成功患者中HLA DRB1*07:01等位基因组的频率显著更高(18.3%对8%,p<0.04)。

结论

我们的结果证实了HLA共享在复发性流产中的作用,并表明HLA-DRB1分型可能是白细胞治疗结局的一个有价值的预后因素。

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