父系 HLA-C 是不明原因复发性流产的危险因素。
Paternal HLA-C is a risk factor in unexplained recurrent miscarriage.
机构信息
Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, Leiden, The Netherlands.
出版信息
Am J Reprod Immunol. 2018 Feb;79(2). doi: 10.1111/aji.12797. Epub 2017 Dec 4.
PROBLEM
HLA-C is the only classical HLA-I antigen expressed on trophoblast. We hypothesized that the alloimmune response to paternal HLA-C plays a role in unexplained recurrent miscarriage.
METHOD OF STUDY
In a case-control design, we included 100 women with at least three unexplained consecutive miscarriages along with their partners and children. For the first control group, we included 90 women with an uneventful singleton pregnancy without pregnancy complications in their history along with their children. The second control group consisted of 425 families. HLA-C07 and HLA-C17 frequencies, which are the most immunogenic HLA-C antigens, along with HLA-C mismatches, and the presence of specific HLA antibodies in the mother were determined.
RESULTS
HLA-C and HLA-C07 mismatches were significantly increased in couples with recurrent miscarriage compared to control subjects (P = .016, P = .008, respectively). The incidence of child-specific HLA-C07/HLA-C*17 antibodies was increased in women with recurrent miscarriage (P = .007).
CONCLUSION
The results show that HLA-C incompatibility between couples is significantly associated with unexplained recurrent miscarriage.
问题
HLA-C 是滋养层细胞上唯一表达的经典 HLA-I 抗原。我们假设对父系 HLA-C 的同种免疫反应在不明原因的复发性流产中起作用。
方法
在病例对照设计中，我们纳入了 100 名至少连续发生三次不明原因流产的妇女及其伴侣和子女。对于第一个对照组，我们纳入了 90 名无妊娠并发症的单胎妊娠且无妊娠并发症史的妇女及其子女。第二个对照组包括 425 个家庭。确定了最具免疫原性的 HLA-C07 和 HLA-C17 抗原以及 HLA-C 错配的频率，以及母亲体内是否存在特定的 HLA 抗体。
结果
与对照组相比，复发性流产夫妇的 HLA-C 和 HLA-C07 错配明显增加（P=.016，P=.008）。复发性流产妇女中存在针对儿童特异性 HLA-C07/HLA-C*17 抗体的发生率增加（P=.007）。
结论
结果表明，夫妇之间 HLA-C 不匹配与不明原因的复发性流产显著相关。
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