The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth
| Autor: | Henriette Svarre Nielsen, Rudi Steffensen, Geert W. Haasnoot, Ole Bjarne Christiansen, Els Goulmy, Frans H.J. Claas, Marian D. Witvliet |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Abortion Habitual Enzyme-Linked Immunospot Assay medicine.medical_specialty Immunology Abortion Histocompatibility Maternal-Fetal Recurrent miscarriage HLA-antibodies Pregnancy outcome cytotoxic t-cells lymphocytotoxic antibodies protective antibodies spontaneous-abortions firstborn boy fetal dna pregnancy women antigen fetus Young Adult Antibody Specificity HLA Antigens Isoantibodies Pregnancy Recurrent miscarriage Immune Tolerance Odds Ratio medicine Humans Immunology and Allergy Young adult Gynecology Sex Characteristics Fetus business.industry Histocompatibility Testing Pregnancy Outcome Obstetrics and Gynecology Odds ratio Cytotoxicity Tests Immunologic medicine.disease Reproductive Medicine Gestation Female business Live birth Live Birth |
| Zdroj: | Journal of Reproductive Immunology, 87(1-2), 67-73 Nielsen, H S, Witvliet, M D, Steffensen, R, Haasnoot, G W, Goulmy, E, Christiansen, O B & Claas, F 2010, ' The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth ', Journal of Reproductive Immunology, vol. 87, no. 1-2, pp. 67-73 . https://doi.org/10.1016/j.jri.2010.05.006 |
| ISSN: | 0165-0378 |
| Popis: | 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. (C) 2010 Elsevier Ireland Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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