title: The A6936G polymorphism of the endothelial protein C receptor gene is associated with the risk of unexplained foetal loss in Mediterranean European couples.
abstract: The endothelial protein C receptor (EPCR) is expressed by trophoblast cells. Mid-gestation pregnancy loss is described in animals with a haemochorial placenta lacking EPCR. The A6936G allele of the EPCR gene (PROCR) may be associated with lower EPCR densities on trophoblasts, but data are lacking for its effect on the risk of pregnancy loss in humans. A 1:2 case-control study on unexplained pregnancy loss was nested in the NOHA First cohort: 3,218 case couples and 6,436 control couples were studied for PROCR A6936G, coagulation factor V gene (F5) G1691A and coagulation factor II gene (F2) G20210A polymorphisms. Ethnicity and time of pregnancy loss defined through biometry-based gestational ages (embryonic loss < 10(th) week > or = foetal loss) were analysed. The PROCR A6936G allele, in mothers and fathers, was associated only with foetal loss in both Europeans and non-Europeans. Increasing probability levels of carrying a homozygous child were increasingly associated with the risk of foetal demise. The F5 G1691A and F2 G20210A alleles, only in mothers, were only and independently associated with foetal loss in Europeans. In our population, the PROCR A6936G allele describes women, but also men and thus couples, at risk for first unexplained foetal loss. This risk is independent of the foetal loss risk conferred to our local Mediterranean European women by the F5 G1691A and F2 G20210A alleles. Data confirm that the relationship between thrombophilias and pregnancy loss varies according to ethnicity and loss type.
authors.affiliation: Haematology Laboratory, University Hospital, Nîmes, France.
authors.forename: Eva
authors.initials: E
authors.lastname: Cochery-Nouvellon
authors.forename: Céline
authors.initials: C
authors.lastname: Chauleur
authors.forename: Christophe
authors.initials: C
authors.lastname: Demattei
authors.forename: Eric
authors.initials: E
authors.lastname: Mercier
authors.forename: Pascale
authors.initials: P
authors.lastname: Fabbro-Peray
authors.forename: Pierre
authors.initials: P
authors.lastname: Marès
authors.forename: Patrick
authors.initials: P
authors.lastname: Mismetti
authors.forename: Géraldine
authors.initials: G
authors.lastname: Lissalde-Lavigne
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gris
mesh_terms: D015703:Antigens, CD / Q000235:genetics* / Q000276:immunology / Q000378:metabolism; D001777:Blood Coagulation / Q000235:genetics; D016022:Case-Control Studies; D020964:Embryo Loss / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology; D000074283:Endothelial Protein C Receptor; D004727:Endothelium / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D005060:Europe; D005191:Family Characteristics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008522:Mediterranean Sea; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011956:Receptors, Cell Surface / Q000235:genetics* / Q000276:immunology / Q000378:metabolism; D014327:Trophoblasts / Q000276:immunology / Q000378:metabolism* / Q000473:pathology
chemical_list: D015703:Antigens, CD; D000074283:Endothelial Protein C Receptor; C478370:PROCR protein, human; D011956:Receptors, Cell Surface