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Vincze M, Sikovanyecz J, Molnár A, Földesi I, Surányi A, Várbíró S, Németh G, Sikovanyecz J, Kozinszky Z. Predictive Capabilities of Human Leukocyte Antigen-G and Galectin-13 Levels in the Amniotic Fluid and Maternal Blood for the Pregnancy Outcome. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:85. [PMID: 38256346 PMCID: PMC10820789 DOI: 10.3390/medicina60010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Increasing evidence points to the significant role of the angiogenic factor levels in screening for pregnancy outcome. To examine the potential relationship between concentrations of placental protein 13 (PP13) and soluble human leukocyte antigen-G (sHLA-G) in maternal serum and amniotic fluid at 16-23 weeks of gestation and the sonographic features of pregnancy as well as pregnancy outcome. Materials and Methods: PP13 and sHLA-G in serum and amniotic fluid, fetal biometrical data, and placental volume and perfusion indices were determined in 71 euploid, singleton pregnancies. Results: The serum sHLA-G level exhibits a negative correlation with the serum PP13 level (r = -0.186, p < 0.001) and a positive correlation with the sHLA-G level in amniotic fluid (r = 0.662, p < 0.001). A significant correlation was found between serum sHLA-G level and placental volume (r = 0.142, p < 0.05) and between amniotic sHLA-G level and placental perfusion (r = -0.450, p < 0.001). A low amniotic PP13 level significantly predicted the birth weight (r = -0.102, p < 0.05), the duration of pregnancy (r = -0.155, p < 0.05), and the fetal abdominal circumference (r = -0.098, p < 0.05). Conclusions: PP13 assayed in amniotic fluid might be a potential marker of fetal growth, and sHLA-G can be an adjunct modality reflecting placental sonographic parameters.
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Affiliation(s)
- Márió Vincze
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - András Molnár
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Imre Földesi
- Department of Laboratory Medicine, University of Szeged, H-6720 Szeged, Hungary;
| | - Andrea Surányi
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Gábor Németh
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - János Sikovanyecz
- Department of Obstetrics and Gynecology, University of Szeged, H-6725 Szeged, Hungary; (M.V.); (J.S.J.); (A.M.); (A.S.); (S.V.); (G.N.); (J.S.)
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynecology, Danderyd Hospital, 182 88 Stockholm, Sweden
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Han N, Xia W, Zhu C, Zhang X, Wang F, Yin Z, Zeng Q. Association of human leukocyte antigen-G and -F with recurrent miscarriage and implantation failure: A systematic review and meta-analysis. Am J Reprod Immunol 2023; 90:e13792. [PMID: 38009058 DOI: 10.1111/aji.13792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/21/2023] [Accepted: 10/14/2023] [Indexed: 11/28/2023] Open
Abstract
PROBLEM The immune system plays an essential role in embryonic implantation and pregnancy, but the molecular details remain controversial. In the past four decades, human leukocyte antigen (HLA)-G and -F have garnered significant attention. METHOD OF STUDY MEDLINE, EMBASE, Web of Science, and the Cochrane Trials Registry were searched from their inception dates until December 2022. Studies were selected following PRISMA guidelines. Meta-analyses were used to assess the relationship of soluble HLA-G (sHLA-G) and HLA-G 3'-untranslated region polymorphisms with recurrent miscarriage (RM) and recurrent implantation failure (RIF). Narrative synthesis was conducted to determine the association of RM with other single nucleotide polymorphisms (SNPs) and HLA-G protein in tissues and of RIF with HLA-F. Risk-of-bias was assessed using ROBINS-I. Publication bias was assessed using Egger's and Begg's tests. RESULTS Finally, 42 articles were eligible for inclusion in the systematic review (32 in the meta-analysis; 13 in narrative synthesis). We found a significant association between the 14-bp ins/del HLA-G polymorphism and RM risk, but no definitive association with RIF risk. Women with RM had lower blood concentrations of sHLA-G during pregnancy and non-pregnancy than did controls. For women in the RIF group, no significant difference was found. CONCLUSION HLA-G protein and gene expression levels may be closely related to RM. The relevance of HLA-G to RIF is still being determined. A narrative synthesis of current studies has shown that HLA-F is likely associated with RIF.
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Affiliation(s)
- Nana Han
- Clinical medical school, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wanting Xia
- Gynecology Department, Hospital of Chengdu University of TCM, Chengdu, China
| | - Can Zhu
- Clinical medical school, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuan Zhang
- Clinical medical school, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fan Wang
- Clinical medical school, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhixing Yin
- Clinical medical school, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian Zeng
- Gynecology Department, Hospital of Chengdu University of TCM, Chengdu, China
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Jahan P, Bhuwalka R, Begum M, Madduru D, Ahmad A, Bonu R. UP-regulated levels of sHLA-G in women with a history of RPL in mid-gestation presumably to achieve ongoing pregnancy. Am J Reprod Immunol 2023; 90:e13798. [PMID: 38009053 DOI: 10.1111/aji.13798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023] Open
Abstract
PROBLEM Recurrent Pregnancy Loss (RPL) is a disorder characterized by two or more pregnancy losses within 20th week of gestation. Globally 1-5% of the couples are affected, 50% of these cases are with unknown etiology. HLA-G, an Immuno-modulatory molecule is a non-classical MHC-1 protein, expressed abundantly on extravillous trophoblastic cells, responsible for spiral artery remodeling, maintaining maternal immune tolerance and fetal growth by adjusting pro and anti-inflammatory milieu during different gestational phases. METHOD OF STUDY In the present case-control study CD4+HLA-G+ tTreg cells were enumerated by flow cytometry and estimation of the circulating levels of sHLA-G in the blood samples of 300 mid-gestation pregnant women with (iRPL) and without history of RPL (nRPL) by Enzyme-linked Immunosorbent assay was done. The cases included 92 primary and 58 secondary RPL cases RESULTS: A significant reduction in number of tTregs and elevated levels of circulating sHLA-G in iRPL (.03, 200.9) versus nRPL (.09, 90.32) was observed. Further, the primary cases showed higher circulating sHLA-G and no difference in relation to CD4+HLA-G+ tTregs compared to the secondary cases. Receiver operating curve (ROC) characteristics of sHLA-G (AUC = .8) was superior to CD4+HLA-G+ (AUC = .7) for iRPL patients over nRPL group. CONCLUSIONS Our results are suggestive of the over-expression of sHLA-G which may be caused due to its shedding from surface of trophoblast as a compensatory mechanism to save the on-going pregnancy. To realize the present outcome, studies are required on on-going pregnancy follow-up cases with favorable and unfavorable pregnancy outcome.
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Affiliation(s)
- Parveen Jahan
- School of Sciences (Zoology), Maulana Azad National Urdu University, Gachibowli, Hyderabad, Telangana, India
| | - Rashmi Bhuwalka
- School of Sciences (Zoology), Maulana Azad National Urdu University, Gachibowli, Hyderabad, Telangana, India
| | - Mahmooda Begum
- School of Sciences (Zoology), Maulana Azad National Urdu University, Gachibowli, Hyderabad, Telangana, India
| | - Dhatri Madduru
- Department of Biochemistry, Osmania University, Hyderabad, Telangana, India
| | - Arif Ahmad
- School of Sciences (Zoology), Maulana Azad National Urdu University, Gachibowli, Hyderabad, Telangana, India
| | - Rajeshwari Bonu
- Gynaecology and Obstetrics Department, Niloufer Hospital, Hyderabad, Telangana, India
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Barbaro G, Inversetti A, Cristodoro M, Ticconi C, Scambia G, Di Simone N. HLA-G and Recurrent Pregnancy Loss. Int J Mol Sci 2023; 24:ijms24032557. [PMID: 36768880 PMCID: PMC9917226 DOI: 10.3390/ijms24032557] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/16/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Placentation is an immunological compromise where maternal immune system cells and trophoblastic cells interact to reach an equilibrium condition. Although the cross talk between the two systems is complex and not completely understood, Human Leukocyte Antigen G (HLA-G), expressed on trophoblastic cell surfaces, seems to be one of the main molecules involved in the modulation of both local and systemic maternal immune response. The prevalence of recurrent pregnancy loss (RPL), probably underestimated, is 5% of all women who achieve pregnancy, and about 40-60% percent of RPL cases are unexplained. There is an immunological analogy between allograft rejection and miscarriage, and the purpose of this review is to describe how the HLA-G pathway alterations are involved in disrupting the immunologic balance and in increasing the risk of recurrent pregnancy loss.
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Affiliation(s)
- Greta Barbaro
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), L. go A. Gemelli 8, 00168 Roma, Italy
| | - Annalisa Inversetti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milano, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Martina Cristodoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milano, Italy
| | - Carlo Ticconi
- Dipartimento di Scienze Chirurgiche, Ginecologia e Ostetricia, Università di Torvergata, 00168 Roma, Italy
| | - Giovanni Scambia
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), L. go A. Gemelli 8, 00168 Roma, Italy
- U.O.C. di Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, L. go A. Gemelli 8, 00168 Rome, Italy
| | - Nicoletta Di Simone
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milano, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
- Correspondence:
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