Gerencer M, Singer Z, Pfeifer S, Tomasković M, Humar I, Mezulić V, Kuvacić I, Zepić L, Kastelan A
Tissue Typing Center, KBC Rebro, University Hospital, Zagreb, Yugoslavia.
Tissue Antigens. 1988 Sep;32(3):130-8. doi: 10.1111/j.1399-0039.1988.tb01648.x.
Total of 356 women with various types of pregnancy disorders as well as their husbands were classified in four groups regarding the type of the disorder as follows: 1. Recurrent spontaneous abortions (RSA) of unknown etiology (N = 105) and RSA - primary aborters only (N = 84); 2. Blighted ovum (N = 80); 3. Rh immunization in pregnancy (N = 90); 4. ABO immunization in pregnancy (N = 47). Two groups of couples were used as controls: 1. Couples randomly taken from forensic medicine cases of paternity evaluation (N = 104); 2. Couples having two or more children with HLA immunization in pregnancy (N = 78). The couples from all groups were typed for red blood group antigens of ABO, Rhesus, MNSs, Kell, Duffy, Lewis, Kidd and P systems and also for HLA antigens. Significantly higher frequency of antigen HLA-A9 was found in women with RSA (corr. p = 0.0003) and in women with pregnancy disorders caused by Rh immunization (corr. p = 0.0136). In couples with RSA the degree of HLA compatibility was significant (p = 0.0048) and the reactivity of spouses in MLR was significantly decreased (p = 0.0001). Significantly, more low responders in MLR were also found among the women with RSA as compared to the controls (p = 0.0217). Two possible pathologic mechanisms may explain the association between HLA antigens and RSA: 1. immunological defects which are linked to HLA-D/DR region causing malfunction of immunosuppressive mechanisms during pregnancy; 2. endocrinological defect which is linked to HLA region as 21-OH hydroxylase deficiency gene.
共有356名患有各种妊娠疾病的女性及其丈夫，根据疾病类型分为四组，具体如下：1. 病因不明的复发性自然流产（RSA）（N = 105）以及仅为初次流产的RSA（N = 84）；2. 空孕囊（N = 80）；3. 孕期Rh免疫（N = 90）；4. 孕期ABO免疫（N = 47）。两组夫妇作为对照：1. 从法医亲子鉴定案例中随机抽取的夫妇（N = 104）；2. 有两个或更多孩子且孕期发生HLA免疫的夫妇（N = 78）。对所有组的夫妇进行ABO、Rh、MNSs、Kell、Duffy、Lewis、Kidd和P系统的红细胞血型抗原分型，以及HLA抗原分型。在患有RSA的女性（校正p = 0.0003）和由Rh免疫引起妊娠疾病的女性中（校正p = 0.0136），发现抗原HLA-A9的频率显著更高。在患有RSA的夫妇中，HLA相容性程度显著（p = 0.0048），且配偶在混合淋巴细胞反应（MLR）中的反应性显著降低（p = 0.0001）。与对照组相比，在患有RSA的女性中，MLR中低反应者也显著更多（p = 0.0217）。两种可能的病理机制可以解释HLA抗原与RSA之间的关联：1. 与HLA-D/DR区域相关的免疫缺陷，导致孕期免疫抑制机制功能异常；2. 与HLA区域相关的内分泌缺陷，如21-羟化酶缺乏基因。
