title: Human leukocyte antigen may predict outcome of primary recurrent spontaneous abortion treated with paternal lymphocyte alloimmunization therapy.
abstract: OBJECTIVE
  Recurrent spontaneous abortion (RSA) is defined by at least three consecutive abortions in otherwise healthy couples. Paternal lymphocyte alloimmunization therapy (PLAT) is an effective therapy for RSA in some cases, but there are no predictive markers about the effectiveness of PLAT.
  
  
  METHODS
  Forty-two consecutive cases with primary RSA treated by PLAT and 23 controls were the subjects. Polymorphisms of human leukocyte antigen (HLA)-E, HLA-G, HLA-A, HLA-B, HLA-C and HLA-DRB1 were investigated by sequenced based typing. Promoter polymorphism and a 14 bp ins/del polymorphism in exon 8 were also investigated for HLA-G.
  
  
  RESULTS
  Thirty-eight RSA wives became pregnant within 1 year after PLAT. Among them, 27 obtained babies (succeeded PLAT cases), while 11 again aborted with no detectable chromosomal abnormalities in the aborted fetuses (aborted PLAT cases). The frequencies of HLA-G*010401, A*2402, B*5201, and DRB1*1502 were significantly increased in the aborted cases than those in the succeeded cases or controls. Of note, HLA-G*010401 was found in all aborted cases whereas it was found in 51.9% of succeeded cases (odds ratio = 21.4, P = 0.006, P(c) = 0.03), and the presence of HLA-G*010401 could predict the abortion after PLAT with sensitivity and specificity of 100% and 48.1%, respectively.
  
  
  CONCLUSIONS
  Human leukocyte antigen testing may be useful for predicting effectiveness of PLAT in RSA.
authors.affiliation: Kano Medical Cooperation Clinic, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kano
authors.forename: Takahide
authors.initials: T
authors.lastname: Mori
authors.forename: Masako
authors.initials: M
authors.lastname: Furudono
authors.forename: Hironobu
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Watanabe
authors.forename: Eri
authors.initials: E
authors.lastname: Kikkawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Warita
authors.forename: Makoto
authors.initials: M
authors.lastname: Onizuka
authors.forename: Megumi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Maeda
authors.forename: Taeko
authors.initials: T
authors.lastname: Naruse
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Inoko
authors.forename: Akinori
authors.initials: A
authors.lastname: Kimura
mesh_terms: D000026:Abortion, Habitual / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics*; D015234:HLA-A Antigens / Q000235:genetics; D015235:HLA-B Antigens / Q000235:genetics; D015236:HLA-C Antigens / Q000235:genetics; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D059951:HLA-G Antigens; D006239:Haplotypes; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D006801:Humans; D050498:Live Birth; D017710:Lymphocyte Transfusion; D018579:Patient Selection; D011110:Polymorphism, Genetic; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D015236:HLA-C Antigens; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I