Ober C, Elias S, O'Brien E, Kostyu D D, Hauck W W, Bombard A
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago.
Am J Reprod Immunol Microbiol. 1988 Dec;18(4):111-5. doi: 10.1111/j.1600-0897.1988.tb00245.x.
Antigenic differences between mother and fetus (i.e., blood group incompatibilities) were traditionally considered deleterious for viviparous reproduction. Recently, evidence has accumulated suggesting that maternal response to paternally derived fetal antigens, paradoxically, may facilitate maintenance of pregnancy. Thus, fetuses whose paternally derived antigens do not differ from maternal antigens (i.e., histocompatible pregnancies) may be at a selective disadvantage during pregnancy. Parents sharing histocompatibility antigens (i.e., HLA) may produce compatible fetuses and show overall reduced fertility. Indeed, increased HLA sharing has been reported in some couples experiencing repetitive spontaneous abortion. However, the effects of HLA sharing in couples not selected because of previous pregnancy losses have not been assessed. To elucidate the reproductive effects of maternal-fetal histocompatibility, we initiated prospective population-based studies of parental HLA sharing and reproductive outcome in the Hutterites, a population isolate that lives communally and proscribes contraception. The relationship between HLA-A, -B, and -DR sharing and reproductive outcome was examined in 111 Hutterite couples. Intervals from marriage to each birth were no longer among couples sharing antigens; differences were significant at the second birth and remained significant through the sixth birth (P less than .05). When the effects of sharing at individual loci were examined, HLA-DR was the only individual locus that was a significant predictor of birth interval length (P = .025). Completed family sizes were 6.5 and 9.0 among couples sharing and not sharing HLA-DR, respectively (P = .082, 2-tailed). However, recognized fetal loss rates did not differ among couples sharing and not sharing antigens.(ABSTRACT TRUNCATED AT 250 WORDS)
传统上认为，母亲与胎儿之间的抗原差异（即血型不相容）对胎生繁殖有害。最近，越来越多的证据表明，母亲对父源胎儿抗原的反应，矛盾的是，可能有助于维持妊娠。因此，其父源抗原与母亲抗原无差异的胎儿（即组织相容性妊娠）在妊娠期间可能处于选择性劣势。共享组织相容性抗原（即人类白细胞抗原）的父母可能会生出相容性胎儿，且总体生育力降低。事实上，一些经历反复自然流产的夫妇中报告了人类白细胞抗原共享增加的情况。然而，尚未评估在未因既往妊娠丢失而被挑选的夫妇中人类白细胞抗原共享的影响。为了阐明母胎组织相容性对生殖的影响，我们在哈特人（一个群居且禁止避孕的群体）中开展了基于人群的父母人类白细胞抗原共享与生殖结局的前瞻性研究。在111对哈特人夫妇中研究了人类白细胞抗原-A、-B和-DR共享与生殖结局之间的关系。抗原共享夫妇的每次生育间隔时间并无延长；在第二次生育时差异显著，并一直持续到第六次生育（P小于0.05）。当研究各个位点共享的影响时，人类白细胞抗原-DR是唯一显著预测生育间隔长度的单个位点（P = 0.025）。共享和不共享人类白细胞抗原-DR的夫妇的完整家庭规模分别为6.5和9.0（双侧P = 0.082）。然而，抗原共享和不共享的夫妇之间已确认的胎儿丢失率并无差异。（摘要截选至250词）
