Smith J B, Cowchock F S, Hankinson B, Iftekhar A
Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107.
Arthritis Rheum. 1989 Dec;32(12):1572-6. doi: 10.1002/anr.1780321211.
The incidence of pregnancy loss is higher in patients with various autoimmune diseases than in the general population. The causes of recurrent spontaneous abortions (RSA) are unknown; however, the presence of antinuclear antibodies and other antibodies in some women with RSA who are otherwise healthy suggests the possibility of underlying autoimmune disease. Because autoimmune diseases are often associated with an increased incidence of certain histocompatibility antigens, we examined the occurrence of specific HLA antigens in patients who had been treated for RSA. We found HLA-DR5 to be significantly overrepresented in the patients with RSA who aborted again after treatment with paternal mononuclear cell immunotherapy, compared with the incidence of this phenotype in a control population. Neither antinuclear antibodies nor antilymphocyte antibodies segregated with DR5. However, DR5+ patients who developed antilymphocyte antibodies after immunotherapy were more likely than all other treated patients to experience subsequent abortion (P less than 0.01). Our findings suggest the possibility of an underlying autoimmune disease in these women.
各种自身免疫性疾病患者的妊娠丢失发生率高于普通人群。复发性自然流产（RSA）的病因尚不清楚；然而，一些RSA女性在其他方面健康的情况下存在抗核抗体和其他抗体，提示可能存在潜在的自身免疫性疾病。由于自身免疫性疾病常与某些组织相容性抗原的发生率增加有关，我们检查了接受RSA治疗的患者中特定HLA抗原的出现情况。我们发现，与对照人群中该表型的发生率相比，在用父本单核细胞免疫疗法治疗后再次流产的RSA患者中，HLA - DR5的比例显著过高。抗核抗体和抗淋巴细胞抗体均未与DR5分离。然而，免疫治疗后产生抗淋巴细胞抗体的DR5 +患者比所有其他接受治疗的患者更有可能随后发生流产（P小于0.01）。我们的研究结果提示这些女性可能存在潜在的自身免疫性疾病。
