Evidence for superantigen involvement in preeclampsia.
OBJECTIVE
Preeclampsia is the leading cause of maternal morbidity and premature fetal delivery in the United States, most likely involving the immune system in disease genesis. In this report, we tested the hypothesis that a superantigen phenomenon is an important factor in the pathogenesis of the disease.


METHODS
A semi-quantitative polymerase chain reaction (PCR) was used to assess T-cell receptor (TCR) beta chain variable (Vbeta) regions as an indicator of T-cell expansion in both peripheral blood and basal plate of preeclamptic patients. All the subjects were also molecularly typed to identify their HLA-class II alleles.


RESULTS
In peripheral blood of the majority of the patients, there was a high abundance of the Vbeta4 gene family, which was not observed in the control group. Polyclonality of this Vbeta gene family was confirmed by analysis of the Valpha chain and the complementary determining region 3 (CDR3). The majority of patients carried the Human Leukocyte Antigens (HLA)-DRB1*13 allele.


CONCLUSIONS
We present evidence for the existence of a superantigen-like effect in at least a subset of patients with preeclampsia.
Luppi
P
P
Department of Pediatrics, Rangos Research Center, Children's Hospital of Pittsburgh, PA 15213, USA.
McKnight
C
C
Mathie
T
T
Faas
S
S
Rudert
W A
WA
Stewart-Akers
A M
AM
Trucco
M
M
DeLoia
J A
JA
D000483:Alleles; D004730:Endothelium, Vascular / Q000276:immunology; D005260:Female; D015332:Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D005802:Genes, MHC Class II; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006684:HLA-DR Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains; D006801:Humans; D008213:Lymphocyte Activation; D010920:Placenta / Q000276:immunology; D011225:Pre-Eclampsia / Q000235:genetics / Q000276:immunology*; D011247:Pregnancy; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018089:Superantigens / Q000276:immunology*; D016176:T-Lymphocyte Subsets / Q000276:immunology*
D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D018089:Superantigens