Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology and Reproductology, Mendeleevskaya Line 3, 199034 St. Petersburg, Russia.
Int J Mol Sci. 2023 Dec 17;24(24):17572. doi: 10.3390/ijms242417572.
Pregnancy loss is the most frequent complication of a pregnancy which is devastating for affected families and poses a significant challenge for the health care system. Genetic factors are known to play an important role in the etiology of pregnancy loss; however, despite advances in diagnostics, the causes remain unexplained in more than 30% of cases. In this review, we aggregated the results of the decade-long studies into the genetic risk factors of pregnancy loss (including miscarriage, termination for fetal abnormality, and recurrent pregnancy loss) in euploid pregnancies, focusing on the spectrum of point mutations associated with these conditions. We reviewed the evolution of molecular genetics methods used for the genetic research into causes of pregnancy loss, and collected information about 270 individual genetic variants in 196 unique genes reported as genetic cause of pregnancy loss. Among these, variants in 18 genes have been reported by multiple studies, and two or more variants were reported as causing pregnancy loss for 57 genes. Further analysis of the properties of all known pregnancy loss genes showed that they correspond to broadly expressed, highly evolutionary conserved genes involved in crucial cell differentiation and developmental processes and related signaling pathways. Given the features of known genes, we made an effort to construct a list of candidate genes, variants in which may be expected to contribute to pregnancy loss. We believe that our results may be useful for prediction of pregnancy loss risk in couples, as well as for further investigation and revealing genetic etiology of pregnancy loss.
妊娠丢失是妊娠最常见的并发症,对受影响的家庭来说是毁灭性的,对医疗保健系统构成了重大挑战。遗传因素在妊娠丢失的病因学中起着重要作用;然而,尽管诊断技术有所进步,但在超过 30%的病例中,其病因仍未得到解释。在这篇综述中,我们汇总了十年来研究的结果,总结了非整倍体妊娠(包括自然流产、胎儿异常终止妊娠和复发性妊娠丢失)中遗传风险因素,重点研究了与这些情况相关的点突变谱。我们回顾了用于研究妊娠丢失原因的分子遗传学方法的演变,并收集了 196 个独特基因中 270 个个体遗传变异的信息,这些基因被报道为妊娠丢失的遗传原因。其中,18 个基因中的变异已被多项研究报道,有 57 个基因的两个或更多变异被报道为导致妊娠丢失。对所有已知妊娠丢失基因的特性进行进一步分析表明,它们对应于广泛表达、高度进化保守的基因,涉及关键的细胞分化和发育过程以及相关的信号通路。鉴于已知基因的特征,我们努力构建了候选基因列表,这些基因的变异可能导致妊娠丢失。我们相信,我们的研究结果可能有助于预测夫妇的妊娠丢失风险,以及进一步研究和揭示妊娠丢失的遗传病因。