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人类白细胞抗原-G 和 -F 与复发性流产和着床失败的关联:系统评价和荟萃分析。

Association of human leukocyte antigen-G and -F with recurrent miscarriage and implantation failure: A systematic review and meta-analysis.

机构信息

Clinical medical school, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Gynecology Department, Hospital of Chengdu University of TCM, Chengdu, China.

出版信息

Am J Reprod Immunol. 2023 Dec;90(6):e13792. doi: 10.1111/aji.13792.

Abstract

PROBLEM

The immune system plays an essential role in embryonic implantation and pregnancy, but the molecular details remain controversial. In the past four decades, human leukocyte antigen (HLA)-G and -F have garnered significant attention.

METHOD OF STUDY

MEDLINE, EMBASE, Web of Science, and the Cochrane Trials Registry were searched from their inception dates until December 2022. Studies were selected following PRISMA guidelines. Meta-analyses were used to assess the relationship of soluble HLA-G (sHLA-G) and HLA-G 3'-untranslated region polymorphisms with recurrent miscarriage (RM) and recurrent implantation failure (RIF). Narrative synthesis was conducted to determine the association of RM with other single nucleotide polymorphisms (SNPs) and HLA-G protein in tissues and of RIF with HLA-F. Risk-of-bias was assessed using ROBINS-I. Publication bias was assessed using Egger's and Begg's tests.

RESULTS

Finally, 42 articles were eligible for inclusion in the systematic review (32 in the meta-analysis; 13 in narrative synthesis). We found a significant association between the 14-bp ins/del HLA-G polymorphism and RM risk, but no definitive association with RIF risk. Women with RM had lower blood concentrations of sHLA-G during pregnancy and non-pregnancy than did controls. For women in the RIF group, no significant difference was found.

CONCLUSION

HLA-G protein and gene expression levels may be closely related to RM. The relevance of HLA-G to RIF is still being determined. A narrative synthesis of current studies has shown that HLA-F is likely associated with RIF.

摘要

问题

免疫系统在胚胎着床和妊娠中起着至关重要的作用,但分子细节仍存在争议。在过去的四十年中,人类白细胞抗原(HLA)-G 和 -F 引起了广泛关注。

方法

从其创建日期到 2022 年 12 月,我们在 MEDLINE、EMBASE、Web of Science 和 Cochrane 临床试验注册中心进行了搜索。根据 PRISMA 指南选择研究。我们使用荟萃分析来评估可溶性 HLA-G(sHLA-G)和 HLA-G 3'-非翻译区多态性与复发性流产(RM)和复发性着床失败(RIF)的关系。我们进行了叙述性综合分析,以确定 RM 与其他单核苷酸多态性(SNPs)和组织中的 HLA-G 蛋白的关系,以及 RIF 与 HLA-F 的关系。使用 ROBINS-I 评估风险偏差。使用 Egger 和 Begg 检验评估发表偏倚。

结果

最终,有 42 篇文章符合系统评价的纳入标准(32 篇进行荟萃分析;13 篇进行叙述性综合分析)。我们发现 14-bp ins/del HLA-G 多态性与 RM 风险之间存在显著关联,但与 RIF 风险无明确关联。RM 患者在妊娠和非妊娠期间的血液 sHLA-G 浓度低于对照组。对于 RIF 组的女性,未发现显著差异。

结论

HLA-G 蛋白和基因表达水平可能与 RM 密切相关。HLA-G 与 RIF 的相关性仍在确定中。对当前研究的叙述性综合分析表明,HLA-F 可能与 RIF 相关。

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