title: Soluble human leukocyte antigen-G isoforms in maternal plasma in early and late pregnancy.
abstract: OBJECTIVE
  Human Leukocyte Antigen (HLA)-G is a class Ib gene located in the human major histocompatibility complex (MHC). Several lines of investigation indicate that the HLA-G molecule is involved in the maternal acceptance of the semi-allogenic fetus during pregnancy and in the development of tolerance. Expression of soluble HLA-G (sHLA-G) is positively correlated with successful in vitro fertilization (IVF) treatments, and aberrant expression of HLA-G in certain complications of pregnancy, such as pre-eclampsia and spontaneous abortion, has been reported. The main purpose of this study was to investigate the levels of different soluble HLA-G isoforms in maternal plasma in early and late pregnancy.
  
  
  METHODS
  Soluble HLA-G (sHLA-G) can be detected in maternal blood, and in this study, two different isoforms of sHLA-G, namely sHLA-G1 generated by shedding of membrane-bound HLA-G1 and HLA-G generated by specific HLA-G transcripts, have been investigated early [median of 16.4 weeks of gestation (GW)] and late (median: 38.9 GW) in pregnancy in an original cohort of 580 pregnant Caucasian women.
  
  
  RESULTS
  Lower concentrations of sHLA-G1 were found late in pregnancy (>32 GW) in a group of women with severe pre-eclampsia compared with controls with uncomplicated pregnancies (P = 0.029, P(C) = 0.09; Mann-Whitney; Logistic regression analysis: P = 0.024, OR = 0.920, 95% CI: 0.855-0.989). However, this was not the case with HLA-G5, and significantly more of the cases with severe pre-eclampsia had detectable plasma HLA-G5 compared with that of the control group (P = 0.013, P(C) = 0.04; Mann-Whitney). Similar findings were not observed in women with gestational hypertension or existing hypertension continuing into pregnancy. Furthermore, there was a trend toward lower maternal plasma sHLA-G1 in a group of women with premature birth (<37 GW) compared with that of the control group (P = 0.028, P(C) = 0.17; Mann-Whitney). On the contrary, HLA-G5 was lower in the control group compared with that in the premature group (P = 0.004, P(C) = 0.02; Mann-Whitney).
  
  
  CONCLUSIONS
  This study shows in line with other published studies that a high, detectable soluble HLA-G concentration in maternal plasma or serum is not mandatory for a successful pregnancy. However, complications during pregnancy, such as (severe) pre-eclampsia, spontaneous abortion, IUGR, and premature birth, are associated with a low or undetectable level of soluble HLA-G in the maternal blood circulation. Also, this study indicates that sHLA-G1 is the interesting soluble HLA-G isoform in pre-eclampsia, and that low or undetectable levels of HLA-G5 at the end of pregnancy seem to be associated with an uncomplicated normal pregnancy, whereas in severe pre-eclampsia and possibly other pregnancy complications, such as preterm birth and IUGR, the level of HLA-G5 is higher.
authors.affiliation: Department of Experimental and Diagnostic Medicine, Section of Medical Genetics, University of Ferrara, Ferrara, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Rizzo
authors.forename: Anita Sylvest
authors.initials: AS
authors.lastname: Andersen
authors.forename: Michael Rud
authors.initials: MR
authors.lastname: Lassen
authors.forename: Helle Christina
authors.initials: HC
authors.lastname: Sørensen
authors.forename: Thomas
authors.initials: T
authors.lastname: Bergholt
authors.forename: Margit Hørup
authors.initials: MH
authors.lastname: Larsen
authors.forename: Loredana
authors.initials: L
authors.lastname: Melchiorri
authors.forename: Marina
authors.initials: M
authors.lastname: Stignani
authors.forename: Olavio R
authors.initials: OR
authors.lastname: Baricordi
authors.forename: Thomas Vauvert F
authors.initials: TV
authors.lastname: Hviid
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005786:Gene Expression Regulation; D005865:Gestational Age; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D007108:Immune Tolerance; D011225:Pre-Eclampsia / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D047928:Premature Birth / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D013997:Time Factors
chemical_list: D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I