The fetus as an allograft: evidence for protective antibodies to HLA-linked paternal antigens.

Non-cytotoxic antibodies to paternal B lymphocytes were detected in sera from 11 of 11 multiparous women and from 11 of 16 normal primigravidae during the first trimester of pregnancy. These antibodies were not, however, detected in sera from 9 of 10 women of comparable gestation at the time of spontaneous abortion. By means of a rosette inhibition assay, the difference in antibody activity between the primigravidae (mean 37.9 +/- 19%, median 36.5%) and the women subject to spontaneous abortion (mean 7.3 +/- 11.6%, median 0%) was statistically significant. This antibody activity was not directed to the known HLA specificities (HLA--A, B, C, or DR), but linkage to the HLA gene complex was suggested by family studies. These results provide evidence for an HLA-linked antigen system not defined by conventional tissue-typing techniques. Fetomaternal disparity at this antigenic site may be important for successful pregnancy.