Maternal HLA Panel-Reactive Antibodies in Early Gestation Positively Correlate with Chronic Chorioamnionitis: Evidence in Support of the Chronic Nature of Maternal Anti-fetal Rejection
link https://doi.org/10.1111/j.1600-0897.2011.01066.xaccount_box Lee, JoonHoaccount_box Romero, Robertoaccount_box Xu, Yiaccount_box Kim, Jung Sunaccount_box Park, Ji Youngaccount_box Pedro Kusanovic, Juanaccount_box Chaiworapongsa, Tinnakornaccount_box Hassan, Sonia S.account_box Kim, Chong Jai
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| Autor | Lee, JoonHo Romero, Roberto Xu, Yi Kim, Jung Sun Park, Ji Young Pedro Kusanovic, Juan Chaiworapongsa, Tinnakorn Hassan, Sonia S. Kim, Chong Jai |
| Título | Maternal HLA Panel-Reactive Antibodies in Early Gestation Positively Correlate with Chronic Chorioamnionitis: Evidence in Support of the Chronic Nature of Maternal Anti-fetal Rejection |
| Revista | AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY |
| ISSN | 1046-7408 |
| ISSN electrónico | 1600-0897 |
| Volumen | 66 |
| Número de publicación | 6 |
| Página inicio | 510 |
| Página final | 526 |
| Fecha de publicación | 2011 |
| Resumen | Problem Maternal tolerance of the fetus is essential for viviparity, yet anti-fetal rejection occurs in several pregnancy complications. Chronic chorioamnionitis is a feature of anti-fetal cellular rejection. There is a robust association between chronic chorioamnionitis and maternal seropositivity for antihuman leukocyte antigen (HLA) panel-reactive antibodies (PRA) at the time of delivery. This longitudinal study was performed to assess maternal HLA PRA status in early gestation and the temporal evolution of maternal HLA PRA in the context of chronic chorioamnionitis and, thereby, to determine whether HLA PRA during the course of pregnancy is useful for the detection of anti-fetal rejection. Method of study Maternal sera obtained before 16 weeks of gestation and at delivery were analyzed for HLA PRA in cases with (N = 100) and without (N = 150) chronic chorioamnionitis. Results IgG (but not IgM) HLA class I and II PRA positivity at delivery was higher in cases with chronic chorioamnionitis than in those without chronic chorioamnionitis. IgG HLA class I PRA positivity before 16 weeks of gestation was higher in cases with chronic chorioamnionitis than in those without (30.3 versus 13.3%; P = 0.001). Positive conversion (negative HLA PRA before 16 weeks of gestation but positive at delivery) of IgG HLA class I and II PRA was significantly associated with chronic chorioamnionitis. Fetal HLA class I antigen-specific antibodies were confirmed in 12 of 16 mothers tested who were sensitized to HLA class I antigens before 16 weeks of gestation. Conclusion Positive maternal HLA PRA before 16 weeks of gestation and the temporal evolution of maternal HLA PRA are associated with the presence of chronic chorioamnionitis at the time of delivery. Maternal IgG HLA PRA has the potential to be a monitoring tool of anti-fetal rejection. Furthermore, the findings herein indicate that subsets of fetuses are exposed to alloimmune HLA antibodies for months, especially in cases with chronic chorioamnionitis. |
| Derechos | acceso restringido |
| Agencia financiadora | Perinatology Research Branch, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT |
| DOI | 10.1111/j.1600-0897.2011.01066.x |
| Editorial | WILEY |
| Enlace | |
| Id de publicación en Pubmed | MEDLINE:21951517 |
| Id de publicación en WoS | WOS:000296896300009 |
| Paginación | 17 páginas |
| Palabra clave | Human leukocyte antigen panel-reactive antibody pregnancy preterm birth NEONATAL ALLOIMMUNE THROMBOCYTOPENIA REGULATORY T-CELLS IMMUNOGLOBULIN-G ANTIBODIES INFLAMMATORY RESPONSE UNKNOWN ETIOLOGY ALLOGRAFT PATHOLOGY RECURRENT ABORTION IMMUNE TOLERANCE PRETERM BIRTH FETAL |
| Tema ODS | 05 Gender Equality 03 Good Health and Well-being |
| Tema ODS español | 05 Igualdad de género 03 Salud y bienestar |
| Tipo de documento | artículo |