Document Detail


The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth.
MedLine Citation:
PMID:  20605049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anti-paternal HLA-antibodies are considered a harmless phenomenon during most pregnancies, whereas their role in recurrent miscarriage (RM) patients is disputed. In contrast to primary RM, patients with secondary RM have carried a fetus to term pregnancy prior to a series of miscarriages, which increases the chance that allogeneic fetal cells appear in the maternal circulation. This study investigates the frequency of HLA-antibodies in secondary RM, primary RM patients and parous controls and analyzes whether the presence of HLA-antibodies in early pregnancy is associated with pregnancy outcome. Sera from women with secondary RM (n=56), primary RM (n=13) and parous controls (n=24) were tested for HLA-antibodies using an ELISA assay and complement dependent cytotoxicity. Samples were taken at gestational week 4-5 in 62 (90%) of the patients. HLA-antibodies were significantly more frequent in secondary RM patients with a boy prior to the miscarriages (62%) compared to secondary RM patients with a firstborn girl (29%, p=0.03), primary RM patients (23%, p=0.02) and parous controls (25%, p=0.005). Forty-one percent of HLA-antibody positive pregnant RM patients had a live birth compared to 76% of HLA-antibody negative RM patients, p=0.006 (adjusted OR: 0.22 (0.07-0.68), p=0.008). In conclusion, HLA-antibodies are significantly more frequent in secondary RM patients with a firstborn boy than in other RM patients and controls. The presence of these antibodies in early pregnancy is associated with a reduced chance of a live birth. Further exploring this association may increase our understanding of maternal acceptance of the fetal allograft.
Authors:
Henriette Svarre Nielsen; Marian D Witvliet; Rudi Steffensen; Geert W Haasnoot; Els Goulmy; Ole Bjarne Christiansen; Frans Claas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of reproductive immunology     Volume:  87     ISSN:  1872-7603     ISO Abbreviation:  J. Reprod. Immunol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-05-20     Revised Date:  2011-09-16    
Medline Journal Info:
Nlm Unique ID:  8001906     Medline TA:  J Reprod Immunol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  67-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
The Fertility Clinic, University Hospital Copenhagen, Rigshospitalet, Fertility Clinic 4071, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. henriette.svarre.nielsen@rh.regionh.dk
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / genetics,  immunology*
Adult
Antibody Specificity
Cytotoxicity Tests, Immunologic
Enzyme-Linked Immunospot Assay
Female
HLA Antigens / immunology*
Histocompatibility Testing
Histocompatibility, Maternal-Fetal*
Humans
Immune Tolerance
Isoantibodies / blood*,  immunology
Live Birth
Odds Ratio
Pregnancy / immunology*
Pregnancy Outcome
Sex Characteristics
Young Adult
Chemical
Reg. No./Substance:
0/HLA Antigens; 0/Isoantibodies
Comments/Corrections
Erratum In:
J Reprod Immunol. 2011 May;89(2):216

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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