Department of Obstetrics and Gynecology, University of Yamanashi, 1110 Shimokawahigashi, Chuo City, Yamanashi Prefecture 409-3898, Japan; Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 12-chome, Maeda, Teine-ku, Sapporo-shi 006-8555, Japan.
Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 12-chome, Maeda, Teine-ku, Sapporo-shi 006-8555, Japan.
J Reprod Immunol. 2023 Aug;158:103955. doi: 10.1016/j.jri.2023.103955. Epub 2023 May 18.
To evaluate whether anti-β2-Glycoprotein I/HLA-DR (anti-β2GPI/HLA-DR) antibody is associated with pathophysiology of infertility, 224 women with infertility were enrolled from July 2020 to December 2021 in this prospective study. The serum levels of anti-β2GPI/HLA-DR antibody (normal < 73.3 U) were determined in 224 women with infertility. Backgrounds, causes and clinical factors were compared between women with and without anti-β2GPI/HLA-DR antibody. Forty (17.9 %) of the 224 women tested positive for anti-β2GPI/HLA-DR antibody. The prevalence of endometriosis was higher in women with anti-β2GPI/HLA-DR antibody than in women without the antibody (32.5 %, 13/40 vs. 17.4 %, 32/184; P = 0.048). Logistic regression analyses revealed that, among clinical factors and diseases, endometriosis was associated with anti-β2GPI/HLA-DR antibody positivity in infertile women (adjusted-odds ratio [OR] 3.01, 95 % confidence interval [CI] 1.30-6.99; P = 0.010). Twenty-three (15.5 %) of 148 women who underwent assisted reproductive technology (ART) tested positive for anti-β2GPI/HLA-DR antibody. The prevalence of recurrent implantation failure (RIF) defined as three or more implantation failures following in vitro fertilization and embryo transfers was higher in women with ART who tested positive for the antibody (43.5 %, 10/23) than in women with ART who tested negative (20.8 %, 26/125; P = 0.032). Logistic regression analyses revealed that RIF was associated with anti-β2GPI/HLA-DR antibody positivity in women with ART (adjusted-OR 2.92, 95 % CI 1.05-8.11; P = 0.040). Anti-β2GPI/HLA-DR antibody may be associated with the pathophysiology of infertility, endometriosis and RIF; and can be a potential therapeutic target in infertility.
为了评估抗β2-糖蛋白 I/HLA-DR（抗β2GPI/HLA-DR）抗体是否与不孕的病理生理学有关，本前瞻性研究纳入了 2020 年 7 月至 2021 年 12 月期间的 224 名不孕女性。测定了 224 名不孕女性的血清抗β2GPI/HLA-DR 抗体水平（正常<73.3U）。比较了有和无抗β2GPI/HLA-DR 抗体的女性的背景、病因和临床因素。224 名女性中，有 40 名（17.9%）抗β2GPI/HLA-DR 抗体阳性。抗β2GPI/HLA-DR 抗体阳性的女性中子宫内膜异位症的患病率高于抗体阴性的女性（32.5%，13/40 vs. 17.4%，32/184；P=0.048）。Logistic 回归分析显示，在临床因素和疾病中，子宫内膜异位症与不孕女性抗β2GPI/HLA-DR 抗体阳性相关（调整后比值比[OR]3.01，95%置信区间[CI]1.30-6.99；P=0.010）。在接受辅助生殖技术（ART）的 148 名女性中，有 23 名（15.5%）抗β2GPI/HLA-DR 抗体阳性。抗β2GPI/HLA-DR 抗体阳性的 ART 女性中，复发性着床失败（RIF）的患病率（定义为体外受精和胚胎移植后三次或更多次着床失败）高于抗体阴性的 ART 女性（43.5%，10/23 vs. 20.8%，26/125；P=0.032）。Logistic 回归分析显示，ART 女性的 RIF 与抗β2GPI/HLA-DR 抗体阳性相关（调整后比值比[OR]2.92，95%置信区间[CI]1.05-8.11；P=0.040）。抗β2GPI/HLA-DR 抗体可能与不孕的病理生理学、子宫内膜异位症和 RIF 有关，并且可能成为不孕的潜在治疗靶点。
