title: Association of plasminogen activator inhibitor-1 and angiotensin converting enzyme polymorphisms with recurrent pregnancy loss in Iranian women.
abstract: BACKGROUND
  Recurrent pregnancy loss (RPL) defined by two or more failed pregnancies before 20 weeks of gestation. Several factors play a role in RPL including thrombophilic conditions which can be influenced by gene polymorphisms. Plasminogen activator inhibitor-1 (PAI-1) and angiotensin converting enzyme (ACE) genes are closely related to fibrinolytic process, embryonic development and pregnancy success.
  
  
  OBJECTIVE
  The aim of this study was to investigate the relationship between RPL and common polymorphisms in ACE and PAI-1 genes.
  
  
  METHODS
  In this case control study, 100 women with recurrent abortions (at least two) were selected as cases and 100 healthy women with two or more normal term deliveries without a history of abortion as controls. Total genomic DNA was isolated from blood leukocytes. The status of the PAI-1 4G/5G and ACE (D/I) polymorphism was determined by PCR-RFLP.
  
  
  RESULTS
  Homozygosity for PAI-1 4G polymorphism was seen in 17 cases (17%), and 5 controls (5%) (p=0.006) so patients with homozygote 4G mutation were significantly more prone to RPL in contrast to control group (OR: 4.63, % 95 CI: 1.55-13.84). In addition, 7 patients (7 %), and no one from the control group, were homozygote (I/I) for ACE polymorphism (p=0.034), suggesting no significant associations between ACE D allele or DD genotype and RPL.
  
  
  CONCLUSIONS
  Considering these results, because 4G/4G polymorphism for PAI-1 gene could be a thrombophilic variant leading to abortion, analysis of this mutation and other susceptibility factors are recommended in patients with RPL.
authors.affiliation: Department of Biology, Guilan University, Rasht, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Shakarami
authors.affiliation: Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. ; Tehran Medical Genetics Laboratory, Tehran, Iran.
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Akbari
authors.affiliation: Department of Biology, Varamin Pishva Branch, Islamic Azad University, Varamin Pishva, Iran.
authors.forename: Shohreh
authors.initials: S
authors.lastname: Zare Karizi
keywords: Angiotensin converting enzyme; Plasminogen activator inhibitor-1; Spontaneous abortion; Thrombophilia