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KMID : 0350519920450041335
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Journal of Catholic Medical College
1992 Volume.45 No. 4 p.1335 ~ p.1347
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Major-Histocompatiblity in Couples with Recurrent Pregnancy Loss
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Abstract
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The survival or loss of the fetus as an allograft remains a significant immunological problem.
Although chromosomal abnormality has been known as a major cause of spontaneous abortion, immunologic factor has recently been reported as an another important cause of recurrent pregnancy loss(RPL).
Many studies have supported the correlation between HLA antigens and RPL, but other studies could not confirm this finding. The purpose of this-study is to clarify these conflicting facts and determine the new criteria of immunotherapy in couples
with
RPL possibly due to immunologic causes. To clarify the relationship between HLA antigens and RPL, the incidence of frequency, homozygosity, the degree of disparity and the incidence of sharing in HLA alleles from 25 couples experiencing RPL were
compared with those of 51 randomized fertile couples as a control group.
Tissue typing was performed using a standard microlymphocytotoxicity test for HLA class I(A, B & C) and a new method of two step polymerase chain reaction(PCR) of DNA samples followed by gel electrophoresis for HLA class II(DRB1, DQA1, DQB1 &
DPB1).
@ES The results were as follows:
@EN 1. In HLA class I, there was an evidence of increased incidences of Cw3, A2, Cw1 and A24 in RPL group, And compared with the control group, there were significantly high incidences of B17, B61, Cw1 and Cw3 in RPL group.
2. In HLA class II there was an evidence of increased incidences of DQB1*01, DQB1*03, DQA1*03, DPB1*02, DPB1*05, DQA1*01, DRB1*04 and DRB1*06 in RPL group, And compared with the control group, there were significantly high incidences of DRB1*08,
DQA1*06 and DPB1*13 in RPL group.
3. There were significantly high incidences of homozygosity at the DRB1 and DPB1 loci in RPL group compared with the control group. On the other hand, there were significantly low incidences at the B locus in RPL group.
4. By contrast, the degrees of disparity were significantly decreased at the DRB1 and DPB1 loci but significantly increased at the B locus in RPL group compared with the control group.
5. The incidence of the HLA sharing at the individual locus was only significantly increased at the C locus in RPL groupcompared with the control group. But there was observed to be increased their incidences at the remaining loci in RPL group.
6. The incidence of couples with HLA alleles shared four or more was significantly increased in RPL group compared with the control group. And incidence of couples with HLA alleles shared five or more was also significantly increased in RPL
group.
But
the incidence of couples with HLA alleles shared three or more was not significantly different between two groups.
The findings of the study suggest that it seems to be relatively close association between RPL and HLA, especially HLA class II rather than HLA class I, and that immunotherapy could be considered in couples with HLA alleles shared four or more.
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KEYWORD
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