Kishore R, Agarwal S, Halder A, Das V, Shukla B R, Agarwal S S
Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Obstet Gynaecol Res. 1996 Apr;22(2):177-83. doi: 10.1111/j.1447-0756.1996.tb00962.x.
To study the prevalence of HLA sharing between spouses and its correlation with presence of antipaternal cytotoxic antibody (APCA) and mixed lymphocyte reaction (MLR) blocking factors in recurrent spontaneous aborters (RSA).
Study was carried out at Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, from 1988-1992. Hundred couples with 3 or more consecutive recurrent spontaneous abortions and equal number of age, parity and ethinically matched normal controls were selected for studying HLA, APCA and MLR blocking factors. Meta-analysis was performed using standard formula and significance was tested by Chi-square analysis.
Significant HLA sharing was observed in couples with RSA at A and DR loci compared to normal controls (p < 0.001). Twenty-seven point eight percent of couples with RSA were positive for APCA compared to 49% of controls (p < 0.01). MLR blocking factors were detected in 26% couples with RSA compared to 78% in controls (p < 0.001). An inverse correlation between HLA sharing and APCA and MLR positivity was demonstrated.
The study supports that greater HLA sharing between spouses, associated with lack of an appropriate immune response to them could be responsible for RSA.
研究复发性自然流产患者（RSA）配偶间人类白细胞抗原（HLA）共享情况及其与抗父细胞毒性抗体（APCA）和混合淋巴细胞反应（MLR）阻断因子存在情况的相关性。
1988年至1992年在勒克瑙的桑贾伊·甘地医学科学研究生学院（SGPGI）开展研究。选择100对有3次或更多次连续复发性自然流产的夫妇以及年龄、胎次和种族匹配的同等数量正常对照，以研究HLA、APCA和MLR阻断因子。采用标准公式进行荟萃分析，并通过卡方分析检验显著性。
与正常对照相比，RSA夫妇在A和DR位点观察到显著的HLA共享（p < 0.001）。RSA夫妇中27.8%的APCA呈阳性，而对照组为49%（p < 0.01）。在RSA夫妇中检测到MLR阻断因子的占26%，而对照组为78%（p < 0.001）。证实HLA共享与APCA及MLR阳性之间呈负相关。
该研究支持配偶间更大程度的HLA共享，以及对其缺乏适当的免疫反应可能是RSA的原因。
