The presence of gestational diabetes is associated with increased detection of anti-HLA-class II antibodies in the maternal circulation.
OBJECTIVE
Gestational diabetes (GD) may be associated with temporarily reduced immune tolerance toward alloantigens for the time of pregnancy. The aim of this study was to assess anti-HLA-class I and -II antibodies as markers for an aberrant immunostimulation in women with GD.


METHODS
The percentage of anti-HLA-class I and -II antibodies was estimated in women with GD, normal term delivery and fetal distress, which was confirmed by demonstrating low cord blood pH for this patient group. These antibodies may cross the placental barrier and cause interleukin-6 (IL-6) release from fetal monocytes by cross-linking monocytes with antibody-loaded cells. Therefore we estimated the percentage of IL-6-positive monocytes in the fetal circulation of these three patient groups.


RESULTS
We found a significantly increased percentage of anti-HLA-class II in the circulation of women with GD. In comparison with women with normal term delivery, a significantly increased percentage of IL-6-positive monocytes was detected for women with GD and for women with fetal distress. Significantly decreased cord blood pH were detected for neonates born in the presence of fetal distress but not for neonates born in the presence of GD.


CONCLUSIONS
Our results suggest that GD is associated with an increased humoral immune response against HLA-class II antigens.
Steinborn
Andrea
A
Department of Obstetrics and Gynecology, University of Heidelberg, Germany.
Saran
Gaby
G
Schneider
Andreas
A
Fersis
Nicos
N
Sohn
Christof
C
Schmitt
Edgar
E
D016640:Diabetes, Gestational / Q000276:immunology*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000166:cytology; D005316:Fetal Distress / Q000150:complications; D000949:Histocompatibility Antigens Class II / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007518:Isoantibodies / Q000097:blood*; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000378:metabolism*; D008954:Models, Biological; D011247:Pregnancy / Q000276:immunology*
D000949:Histocompatibility Antigens Class II; D007518:Isoantibodies