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Hiby SE, Apps R, Sharkey AM, Farrell LE, Gardner L, Mulder A, Claas FH, Walker JJ, Redman CC, Morgan L, Tower C, Regan L, Moore GE, Carrington M, Moffett A. Maternal activating KIRs protect against human reproductive failure mediated by fetal HLA-C2. J Clin Invest 2010; 120:4102-10. [PMID: 20972337 PMCID: PMC2964995 DOI: 10.1172/jci43998] [Citation(s) in RCA: 358] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 08/25/2010] [Indexed: 11/17/2022] Open
Abstract
Many common disorders of pregnancy are attributed to insufficient invasion of the uterine lining by trophoblast, fetal cells that are the major cell type of the placenta. Interactions between fetal trophoblast and maternal uterine NK (uNK) cells--specifically interactions between HLA-C molecules expressed by the fetal trophoblast cells and killer Ig-like receptors (KIRs) on the maternal uNK cells--influence placentation in human pregnancy. Consistent with this, pregnancies are at increased risk of preeclampsia in mothers homozygous for KIR haplotype A (KIR AA). In this study, we have demonstrated that trophoblast expresses both paternally and maternally inherited HLA-C surface proteins and that maternal KIR AA frequencies are increased in affected pregnancies only when the fetus has more group 2 HLA-C genes (C2) than the mother. These data raise the possibility that there is a deleterious allogeneic effect stemming from paternal C2. We found that this effect also occurred in other pregnancy disorders (fetal growth restriction and recurrent miscarriage), indicating a role early in gestation for these receptor/ligand pairs in the pathogenesis of reproductive failure. Notably, pregnancy disorders were less frequent in mothers that possessed the telomeric end of the KIR B haplotype, which contains activating KIR2DS1. In addition, uNK cells expressed KIR2DS1, which bound specifically to C2+ trophoblast cells. These findings highlight the complexity and central importance of specific combinations of activating KIR and HLA-C in maternal-fetal immune interactions that determine reproductive success.
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Affiliation(s)
- Susan E. Hiby
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Richard Apps
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Andrew M. Sharkey
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Lydia E. Farrell
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Lucy Gardner
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Arend Mulder
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Frans H. Claas
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - James J. Walker
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Christopher C. Redman
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Linda Morgan
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Clare Tower
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Lesley Regan
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Gudrun E. Moore
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Mary Carrington
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Ashley Moffett
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
Centre for Trophoblast Research, Cambridge, United Kingdom.
Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick, NCI-Frederick, Frederick, Maryland, USA.
Ragon Institute of MGH, MIT, and Harvard, Boston, Massachusetts, USA.
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Perinatal Research Group, Leeds Institute of Molecular Medicine, University of Leeds, St. James University Hospital, Leeds, United Kingdom.
Genetics of Pre-eclampsia (GOPEC) consortium (
http://www.gopec.org).
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
Department of Clinical Chemistry, Institute of Genetics, University of Nottingham, Nottingham, United Kingdom.
Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester, United Kingdom.
Department of Obstetrics and Gynaecology, St. Mary’s Hospital Medical School, London, United Kingdom.
Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, United Kingdom
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