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Javandoust Gharehbagh F, Soltani-Zangbar MS, Yousefzadeh Y. Immunological mechanisms in preeclampsia: A narrative review. J Reprod Immunol 2024; 164:104282. [PMID: 38901108 DOI: 10.1016/j.jri.2024.104282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/03/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
Maternal immunologic mechanisms for tolerance are essential for a successful pregnancy because they prevent maladaptive immune responses to the placenta and semi-allogeneic fetus and promote fetal growth. Preeclampsia is a major global cause of fetal mortality and morbidity. It is characterized by new-onset hypertension and proteinuria that occurs at twenty weeks of pregnancy or later. Preeclampsia is defined by a rise in cytokines that are pro-inflammatory and antiangiogenic components in the fetoplacental unit and the vascular endothelium of pregnant women, as well as an excessive and increasing stimulation of the immune system. Crucially, inflammation can result in low birth weight and inadequate placental perfusion in neonates. Preeclampsia, which is ultimately connected to inflammatory responses, can be impacted by several immunological mechanisms. Our goal in this work was to compile the most recent research on the pathoimmunology of preeclampsia, including studies on angiogenic variables and, in particular, immunological components.
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Affiliation(s)
| | - Mohammad Sadegh Soltani-Zangbar
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Bhattarai A, Shah S, Dahal K, Neupane R, Thapa S, Neupane N, Barboza JJ, Shrestha A, Sah R, Apostolopoulos V. Biomarker role of maternal soluble human leukocyte antigen G in pre-eclampsia: A meta-analysis. Immun Inflamm Dis 2024; 12:e1254. [PMID: 38639563 PMCID: PMC11027746 DOI: 10.1002/iid3.1254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/26/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Human leukocyte antigen-G (HLA-G) is a non-classical class I HLA molecule shown to regulate the immunomodulation of maternal immune cells to prevent fetal tissue destruction. Low levels of freely circulating maternal soluble HLA-G (sHLA-G) have been observed in pre-eclampsia, however, no pooled evidence exists. This meta-analysis aimed to generate pooled findings on the association of sHLA-G levels with pre-eclampsia and is the first study to perform a trimester-wise comparison of the levels of sHLA-G in preeclamptic cases and normal pregnant controls. METHODS The databases PubMed, Emba, Web of Science, and Google Scholar through May 31, 2023. Preeclamptic women were defined as cases and normal pregnancies as controls. Data on the level of sHLA-G in cases and controls was extracted and subjected to a meta-analysis using a random-effects model. The pooled effect was expressed in terms of standardized mean difference (SMD). Sensitivity analysis was performed to investigate the effect of the exclusion of each study on the pooled results. Publication bias was assessed statistically. RESULTS Nine studies with altogether 567 PE cases and 1132 normal pregnancy controls were included in the meta-analysis. The first and third trimester levels of sHLA-G in PE cases were significantly lower than that of normal pregnant controls: (SMD: -0.84 [-1.29; -0.38]; p = .003; I2 = 54%) and (SMD: -0.39 [-0.71; -0.06]; p = .02; I2 = 79%) respectively. Sensitivity analysis revealed significant fluctuations in the pooled findings when few studies were excluded, raising questions on the consistency of results among studies. CONCLUSION Although we found that first and third-trimester sHLA-G levels in pre-eclampsia are significantly lower, taking into consideration the inconsistent results from the sensitivity analysis, our findings advocate the demand for more studies with larger sample sizes to generate solid ground pooled evidence on the predictive role of sHLA-G in pre-eclampsia.
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Affiliation(s)
| | - Sangam Shah
- Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Krishna Dahal
- Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Raksha Neupane
- Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Sangharsha Thapa
- Department of NeurologyWestchester Medical CenterValhallaNew YorkUSA
| | | | | | | | - Ranjit Sah
- Department of MicrobiologyTribhuvan University Teaching Hospital, Institute of MedicineKathmanduNepal
- Department of MicrobiologyDr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil VidyapeethPuneIndia
- Department of Public Health DentistryDr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil VidyapeethPuneIndia
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Immunology and Translational ResearchVictoria UniversityMelbourneVictoriaAustralia
- Australian Institute for Musculoskeletal Science, Immunology ProgramMelbourneVictoriaAustralia
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Mukherjee I, Singh S, Karmakar A, Kashyap N, Mridha AR, Sharma JB, Luthra K, Sharma RS, Biswas S, Dhar R, Karmakar S. New immune horizons in therapeutics and diagnostic approaches to Preeclampsia. Am J Reprod Immunol 2023; 89:e13670. [PMID: 36565013 DOI: 10.1111/aji.13670] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 11/02/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022] Open
Abstract
Hypertensive disorders of pregnancy (HDP) are one of the commonest maladies, affecting 5%-10% of pregnancies worldwide. The American College of Obstetricians and Gynecologists (ACOG) identifies four categories of HDP, namely gestational hypertension (GH), Preeclampsia (PE), chronic hypertension (CH), and CH with superimposed PE. PE is a multisystem, heterogeneous disorder that encompasses 2%-8% of all pregnancy-related complications, contributing to about 9% to 26% of maternal deaths in low-income countries and 16% in high-income countries. These translate to 50 000 maternal deaths and over 500 000 fetal deaths worldwide, therefore demanding high priority in understanding clinical presentation, screening, diagnostic criteria, and effective management. PE is accompanied by uteroplacental insufficiency leading to vascular and metabolic changes, vasoconstriction, and end-organ ischemia. PE is diagnosed after 20 weeks of pregnancy in women who were previously normotensive or hypertensive. Besides shallow trophoblast invasion and inadequate remodeling of uterine arteries, dysregulation of the nonimmune system has been the focal point in PE. This results from aberrant immune system activation and imbalanced differentiation of T cells. Further, a failure of tolerance toward the semi-allogenic fetus results due to altered distribution of Tregs such as CD4+FoxP3+ or CD4+CD25+CD127(low) FoxP3+ cells, thereby creating a cytotoxic environment by suboptimal production of immunosuppressive cytokines like IL-10, IL-4, and IL-13. Also, intracellular production of complement protein C5a may result in decreased FoxP3+ regulatory T cells. With immune system dysfunction as a major driver in PE pathogenesis, it is logical that therapeutic targeting of components of the immune system with pharmacologic agents like anti-inflammatory and immune-modulating molecules are either being used or under clinical trial. Cholesterol synthesis inhibitors like Pravastatin may improve placental perfusion in PE, while Eculizumab (monoclonal antibody inhibiting C5) and small molecular inhibitor of C5a, Zilucoplan are under investigation. Monoclonal antibody against IL-17(Secukinumab) has been proposed to alter the Th imbalance in PE. Autologous Treg therapy and immune checkpoint inhibitors like anti-CTLA-4 are emerging as new candidates in immune horizons for PE management in the future.
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Affiliation(s)
- Indrani Mukherjee
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.,Amity Institute of Biotechnology (AIB), Amity University, Noida, India
| | - Sunil Singh
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Abhibrato Karmakar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Kashyap
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Asit Ranjan Mridha
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jai Bhagwan Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Luthra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Radhey Shyam Sharma
- Ex-Head and Scientist G, Indian Council of Medical Research, New Delhi, India
| | - Subhrajit Biswas
- Amity Institute of Molecular Medicine & Stem Cell Research (AIMMSCR), Amity University, Noida, India
| | - Ruby Dhar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Subhradip Karmakar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
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Wei X, Yang X. The central role of natural killer cells in preeclampsia. Front Immunol 2023; 14:1009867. [PMID: 36865565 PMCID: PMC9972679 DOI: 10.3389/fimmu.2023.1009867] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
Preeclampsia (PE) is a disease that is unique to pregnancy and affects multiple systems. It can lead to maternal and perinatal mortality. The precise etiology of PE is unclear. Patients with PE may have systemic or local immune abnormalities. A group of researchers has proposed that the immune communication between the fetus and mother is primarily moderated by natural killer (NK) cells as opposed to T cells, since NK cells are the most abundant immune cells in the uterus. This review examines the immunological roles of NK cells in the pathogenesis of PE. Our aim is to provide obstetricians with a comprehensive and updated research progress report on NK cells in PE patients. It has been reported that decidual NK (dNK) cells contribute to the process of uterine spiral artery remodeling and can modulate trophoblast invasion. Additionally, dNK cells can stimulate fetal growth and regulate delivery. It appears that the count or proportion of circulating NK cells is elevated in patients with or at risk for PE. Changes in the number or function of dNK cells may be the cause of PE. The Th1/Th2 equilibrium in PE has gradually shifted to an NK1/NK2 equilibrium based on cytokine production. An improper combination of killer cell immunoglobulin-like receptor (KIR) and human leukocyte antigen (HLA)-C may lead to insufficient activation of dNK cells, thereby causing PE. In the etiology of PE, NK cells appear to exert a central effect in both peripheral blood and the maternal-fetal interface. To maintain immune equilibrium both locally and systemically, it is necessary to take therapeutic measures directed at NK cells.
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Affiliation(s)
- Xiaoqi Wei
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China
| | - Xiuhua Yang
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China
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5
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Dunk CE, Bucher M, Zhang J, Hayder H, Geraghty DE, Lye SJ, Myatt L, Hackmon R. Human Leukocyte Antigen HLA-C, HLA-G, HLA-F and HLA-E placental profiles are altered in Early Severe Preeclampsia and Preterm Birth with Chorioamnionitis. Am J Obstet Gynecol 2022; 227:641.e1-641.e13. [PMID: 35863458 DOI: 10.1016/j.ajog.2022.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The extravillous trophoblast expresses each of the non-classical MHC class I antigens - HLA-E, F, and G and a single classical class I antigen HLA-C. We recently demonstrated dynamic expression patterns of HLA-C, G and F during early EVT invasion and placentation. OBJECTIVE In this study we investigate the hypothesis that the immune inflammatory mediated complications of pregnancy such as early preeclampsia and preterm labor, may show altered expression profiles of non-classical HLA. STUDY DESIGN Real time q-PCR, western blot and immunohistochemistry were performed on placental villous tissues and basal plate sections from term non-laboring deliveries, preterm deliveries and severe early onset preeclampsia both with and without small for gestational age neonates. RESULTS HLA-G is strongly and exclusively expressed by the EVT within the placental basal plate and its levels increase in pregnancies complicated by severe early onset PE with SGA neonates as compared to healthy term controls. HLA-C shows a similar profile in the EVT of PE pregnancies, but significantly decreases in the villous placenta. HLA-F protein levels are decreased in both EVT and villous placenta of severe early onset PE pregnancies both with and without SGA babies as compared to Term and PTB deliveries. HLA-E decreases in blood vessels in placentas from PE pregnancies as compared to Term and PTB deliveries. HLA-F and HLA-C are increased in the placenta of PTBs with chorioamnionitis as compared to idiopathic PTB. CONCLUSION Dysregulation of placental HLA expression at the maternal fetal interface may contribute to the compromised maternal tolerance in PTB with chorioamnionitis and excessive maternal systemic inflammation associated with severe early onset PE.
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Affiliation(s)
- Caroline E Dunk
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada; Department of Experimental Therapeutics, Toronto General Hospital Research Institute, University Hospital Network, Toronto, Canada
| | - Matthew Bucher
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, Oregon, USA
| | - Jianhong Zhang
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Heyam Hayder
- Department of Biology, York University, Toronto, Canada
| | | | - Stephen J Lye
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada; Fred Hutchinson Cancer Research Center, Seattle, USA; Department of Obstetrics and Gynecology and Department of Physiology, University of Toronto, Toronto, Canada
| | - Leslie Myatt
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, Oregon, USA
| | - Rinat Hackmon
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, Oregon, USA.
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6
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Aisagbonhi O, Morris GP. Human Leukocyte Antigens in Pregnancy and Preeclampsia. Front Genet 2022; 13:884275. [PMID: 35571013 PMCID: PMC9093604 DOI: 10.3389/fgene.2022.884275] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Preeclampsia is a pregnancy-induced hypertensive disorder, the pathophysiology of which includes underlying maternal cardiovascular disease, deficient spiral artery remodeling during placenta development, and inflammatory immune responses at the maternal-fetal interface. Human leukocyte antigens (HLA) are major histocompatibility complex molecules essential for the recognition of foreign antigens that is central to immune defense against pathogens and critical determinants for the immune system discriminating between self and non-self tissues, such as in transplantation. Pregnancy represents a naturally existing “transplantation”, where the maternal immune system must be immunologically tolerant to the developing fetus which is 50% allogeneic. It is then unsurprising that HLA also influence normal pregnancy and pregnancy complications including preeclampsia. Here we review the role of classical and non-classical HLA molecules in influencing normal physiologic function during pregnancy and describe the association of HLA with pathophysiology in preeclampsia.
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Dietz S, Schwarz J, Velic A, González-Menéndez I, Quintanilla-Martinez L, Casadei N, Marmé A, Poets CF, Gille C, Köstlin-Gille N. Human Leucocyte Antigen G and Murine Qa-2 Are Critical for Myeloid Derived Suppressor Cell Expansion and Activation and for Successful Pregnancy Outcome. Front Immunol 2022; 12:787468. [PMID: 35111157 PMCID: PMC8801456 DOI: 10.3389/fimmu.2021.787468] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/27/2021] [Indexed: 12/03/2022] Open
Abstract
During pregnancy, maternal immune system has to balance tightly between protection against pathogens and tolerance towards a semi-allogeneic organism. Dysfunction of this immune adaptation can lead to severe complications such as pregnancy loss, preeclampsia or fetal growth restriction. In the present study we analyzed the impact of the murine MHC class Ib molecule Qa-2 on pregnancy outcome in vivo. We demonstrate that lack of Qa-2 led to intrauterine growth restriction and increased abortion rates especially in late pregnancy accompanied by a disturbed trophoblast invasion and altered spiral artery remodeling as well as protein aggregation in trophoblast cells indicating a preeclampsia-like phenotype. Furthermore, lack of Qa-2 caused imbalanced immunological adaptation to pregnancy with altered immune cell and especially T-cell homeostasis, reduced Treg numbers and decreased accumulation and functional activation of myeloid-derived suppressor cells. Lastly, we show that application of sHLA-G reduced abortion rates in Qa-2 deficient mice by inducing MDSC. Our results highlight the importance of an interaction between HLA-G and MDSC for pregnancy success and the therapeutic potential of HLA-G for treatment of immunological pregnancy complications.
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Affiliation(s)
- Stefanie Dietz
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - Julian Schwarz
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - Ana Velic
- Interfaculty Institute for Cell Biology, Proteome Center Tuebingen (PCT), University of Tuebingen, Tübingen, Germany
| | | | | | - Nicolas Casadei
- Next Generation Sequencing (NGS) Competence Center Tuebingen (NCCT), Tuebingen, Germany; Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Alexander Marmé
- Gynecology and Obstetrics Practice, Am Lustnauer Tor, Tuebingen, Germany
| | - Christian F Poets
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany
| | - Christian Gille
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany.,Department of Neonatology, Heidelberg University Children's Hospital, Heidelberg, Germany
| | - Natascha Köstlin-Gille
- Department of Neonatology, Tuebingen University Children's Hospital, Tuebingen, Germany.,Department of Neonatology, Heidelberg University Children's Hospital, Heidelberg, Germany
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8
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Iriyama T, Sayama S, Osuga Y. Role of adenosine signaling in preeclampsia. J Obstet Gynaecol Res 2021; 48:49-57. [PMID: 34657345 DOI: 10.1111/jog.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Placenta-specific molecular basis that is responsible for the pathophysiology of preeclampsia (PE) remains to be fully understood. Adenosine, an endogenous nucleoside, is a signaling molecule that is induced under pathological conditions such as hypoxia and is involved in various diseases. Recent evidence on humans and animal models has demonstrated that enhanced placental adenosine signaling contributes to the development of PE. This review is to summarize current progress and discuss the significance of adenosine signaling in the pathophysiology of PE and future perspectives of therapeutic possibilities targeting adenosine signaling.
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Affiliation(s)
- Takayuki Iriyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Seisuke Sayama
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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9
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Tantengco OAG, Richardson L, Lee A, Kammala A, Silva MDC, Shahin H, Sheller-Miller S, Menon R. Histocompatibility Antigen, Class I, G (HLA-G)'s Role during Pregnancy and Parturition: A Systematic Review of the Literature. Life (Basel) 2021; 11:life11101061. [PMID: 34685432 PMCID: PMC8537334 DOI: 10.3390/life11101061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/18/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction: Immune homeostasis of the intrauterine cavity is vital for pregnancy maintenance. At term or preterm, fetal and maternal tissue inflammation contributes to the onset of labor. Though multiple immune-modulating molecules are known, human leukocyte antigen (HLA)-G is unique to gestational tissues and contributes to maternal–fetal immune tolerance. Several reports on HLA-G’s role exist; however, ambiguity exists regarding its functional contributions during pregnancy and parturition. To fill these knowledge gaps, a systematic review (SR) of the literature was conducted to better understand the expression, localization, function, and regulation of HLA-G during pregnancy and parturition. Methods: A SR of the literature on HLA-G expression and function reported in reproductive tissues during pregnancy, published between 1976–2020 in English, using three electronic databases (SCOPE, Medline, and ClinicalTrials.gov) was conducted. The selection of studies, data extraction, and quality assessment were performed in duplicate by two independent reviewers. Manuscripts were separated into three categories: (1) expression and localization of HLA-G, (2) regulators of HLA-G, and (3) the mechanistic roles of HAL-G. Data were extracted, analyzed, and summarized. Results: The literature search yielded 2554 citations, 117 of which were selected for full-text evaluation, and 115 were included for the final review based on our inclusion/exclusion criteria. HLA-G expression and function were mostly studied in placental tissue and/or cells and peripheral blood immune cells, while only 13% of the studies reported data on amniotic fluid/cord blood and fetal membranes. Measurements of soluble and membranous HLA-G were determined mostly by RNA-based methods and protein by immunostaining, Western blot, or flow cytometric analyses. HLA-G was reported to regulate inflammation and inhibit immune-cell-mediated cytotoxicity and trophoblast invasion. Clinically, downregulation of HLA-G is reported to be associated with poor placentation in preeclampsia and immune cell infiltration during ascending infection. Conclusions: This SR identified several reports supporting the hypothesized role of immune regulation in gestational tissues during pregnancy. A lack of rigor and reproducibility in the experimental approaches and models in several reports make it difficult to fully elucidate the mechanisms of action of HLA-G in immune tolerance during pregnancy.
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Affiliation(s)
- Ourlad Alzeus G. Tantengco
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines Manila, Manila 1101, Philippines
| | - Lauren Richardson
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
| | - Alan Lee
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
| | - Ananthkumar Kammala
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
| | - Mariana de Castro Silva
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
- Department of Pathology, Botucatu Medical School, Universidade Estadual Paulista, UNESP, Botucatu 18618-687, São Paulo, Brazil
| | - Hend Shahin
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
| | - Samantha Sheller-Miller
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
| | - Ramkumar Menon
- Division of Basic and Translational Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA; (O.A.G.T.); (L.R.); (A.L.); (A.K.); (M.d.C.S.); (H.S.); (S.S.-M.)
- Correspondence:
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10
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Kirschen GW, AlAshqar A, Miyashita-Ishiwata M, Reschke L, El Sabeh M, Borahay MA. Vascular biology of uterine fibroids: connecting fibroids and vascular disorders. Reproduction 2021; 162:R1-R18. [PMID: 34034234 DOI: 10.1530/rep-21-0087] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022]
Abstract
Fibroids are benign tumors caused by the proliferation of myometrial smooth muscle cells in the uterus that can lead to symptoms such as abdominal pain, constipation, urinary retention, and infertility. While traditionally thought of as a disease process intrinsic to the uterus, accumulating evidence suggests that fibroid growth may be linked with the systemic vasculature system, although cell-intrinsic factors are certainly of principal importance in their inception. Fibroids are associated with essential hypertension and preeclampsia, as well as atherosclerosis, for reasons that are becoming increasingly elucidated. Factors such as the renin-angiotensin-aldosterone system, estrogen, and endothelial dysfunction all likely play a role in fibroid pathogenesis. In this review, we lay out a framework for reconceptualizing fibroids as a systemic vascular disorder, and discuss how pharmaceutical agents and other interventions targeting the vasculature may aid in the novel treatment of fibroids.
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Affiliation(s)
- Gregory W Kirschen
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Abdelrahman AlAshqar
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Obstetrics and Gynecology, Kuwait University, Kuwait City, Kuwait
| | | | - Lauren Reschke
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Malak El Sabeh
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mostafa A Borahay
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
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11
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Bortolotti D, Gentili V, Santi E, Taliento C, Vitagliano A, Schiuma G, Beltrami S, Rizzo S, Lanza G, Rizzo R, Gafà R, Greco P. Late-onset intrauterine growth restriction and HHV-6 infection: A pilot study. J Med Virol 2021; 93:6317-6322. [PMID: 34138476 DOI: 10.1002/jmv.27138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022]
Abstract
Late-onset Intrauterine growth restriction (IUGR) refers to impaired growth and development of the fetus, characterized by placental morphological abnormalities that affect the fetus's supply of nutrients. Human leukocyte antigen-G (HLA-G) is physiologically expressed during pregnancy, but decreased in normal placenta during the last weeks of gestation possibly inducing childbirth. Several viruses involved in congenital infection, such as herpesviruses, exploit HLA-G expression as an immune-escape mechanism. To date, despite different congenital herpetic infections having been associated with late IUGR, no direct implication of Human herpesvirus 6 (HHV-6) infection has been reported. We evaluated HLA-G expression and HHV-6 infection in 11 placentas from late-onset IUGR newborns and 11 placentas from uncomplicated pregnancies by histopathological and immunohistochemistry analysis. We found higher levels of HLA-G expression and HHV-6 presence in IUGR placenta samples compared with control placenta samples. We report HHV-6 staining in IUGR placenta samples, characterized by high HLA-G expression. These preliminary data suggest a possible involvement of HHV-6 infection in HLA-G deregulation that might affect vessel remodeling and prevent the correct pregnancy outcome in the IUGR condition.
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Affiliation(s)
- Daria Bortolotti
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Valentina Gentili
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Erica Santi
- Department of Medical Sciences,Obstetric and Gynecological Clinic, University of Ferrara, Ferrara, Italy
| | - Cristina Taliento
- Department of Medical Sciences,Obstetric and Gynecological Clinic, University of Ferrara, Ferrara, Italy
| | - Amerigo Vitagliano
- Department of Medical Sciences,Obstetric and Gynecological Clinic, University of Ferrara, Ferrara, Italy
| | - Giovanna Schiuma
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Silvia Beltrami
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Sabrina Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Lanza
- Department of Translational and for Romagna Medicine, University of Ferrara, Ferrara, Italy
| | - Roberta Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Roberta Gafà
- Department of Translational and for Romagna Medicine, University of Ferrara, Ferrara, Italy
| | - Pantaleo Greco
- Department of Medical Sciences,Obstetric and Gynecological Clinic, University of Ferrara, Ferrara, Italy
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12
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Persson G, Stæhr CS, Klok FS, Lebech M, Hviid TVF. Evidence for a shift in placental HLA-G allelic dominance and the HLA-G isoform profile during a healthy pregnancy and pre-eclampsia. Biol Reprod 2021; 105:846-858. [PMID: 34159362 DOI: 10.1093/biolre/ioab121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 11/12/2022] Open
Abstract
Human leukocyte antigen (HLA)-G is a non-classical class Ib major expressed by placental trophoblast cells plays a central role in establishing tolerance to the semi-allogeneic fetus and in placentation. HLA-G exists in different soluble or membrane-bound isoforms. Pre-eclampsia, a major cause of fetal and maternal morbidity and mortality, has been linked to insufficient placentation and an altered immune response in pregnancy, including altered HLA-G expression. The 14 bp insertion/deletion polymorphism in the 3' untranslated region of the gene and the isoform profile may affect HLA-G expression. The aim of the current pilot study was to characterize the expression patterns of HLAG mRNA, protein and isoform profile in uncomplicated term pregnancies and in cases of pre-eclampsia. Maternal sHLA-G mRNA and protein levels was slightly reduced in pre-eclampsia. No difference was found for placental blood, and no correlation between peripheral and placental sHLA-G levels was found. We observed no association between neither fetal nor maternal HLA-G 14 bp insertion/deletion genotypes and pre-eclampsia, nor a significant difference in isoform profiles. However, in HLA-G 14 bp insertion/deletion heterozygous placental samples, we observed abundant HLA-G1 14 bp insertion allele expression in the term placentae, which is contrary to previous findings in first trimester trophoblast. Increased HLA-G1 14 bp insertion allele expression in the placenta was associated with reduced levels of placental sHLA-G and an altered isoform profile with increased relative levels of HLA-G1 and -G5 and reduced levels of HLA-G3. The results indicate that an allelic shift in heterozygous individuals could represent a novel regulatory pathway.
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Affiliation(s)
- Gry Persson
- Centre for Immune Regulation and Reproductive Immunology (CIRRI), Department of Clinical Biochemistry, The ReproHealth Research Consortium ZUH, Zealand University Hospital, and Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Christina Seefeldt Stæhr
- Centre for Immune Regulation and Reproductive Immunology (CIRRI), Department of Clinical Biochemistry, The ReproHealth Research Consortium ZUH, Zealand University Hospital, and Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Freja Syrach Klok
- Centre for Immune Regulation and Reproductive Immunology (CIRRI), Department of Clinical Biochemistry, The ReproHealth Research Consortium ZUH, Zealand University Hospital, and Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Morten Lebech
- Department of Gynaecology and Obstetrics, The ReproHealth Research Consortium ZUH, Zealand University Hospital, and Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Thomas Vauvert F Hviid
- Centre for Immune Regulation and Reproductive Immunology (CIRRI), Department of Clinical Biochemistry, The ReproHealth Research Consortium ZUH, Zealand University Hospital, and Department of Clinical Medicine, University of Copenhagen, Denmark
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13
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Johnsen GM, Fjeldstad HES, Drabbels JJM, Haasnoot GW, Eikmans M, Størvold GL, Alnaes-Katjavivi P, Jacobsen DP, Scherjon SA, Redman CWG, Claas FHJ, Staff AC. A possible role for HLA-G in development of uteroplacental acute atherosis in preeclampsia. J Reprod Immunol 2021; 144:103284. [PMID: 33578175 DOI: 10.1016/j.jri.2021.103284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/09/2020] [Accepted: 01/26/2021] [Indexed: 12/18/2022]
Abstract
HLA-G, a non-classical HLA molecule expressed by extravillous trophoblasts, plays a role in the maternal immune tolerance towards fetal cells. HLA-G expression is regulated by genetic polymorphisms in the 3' untranslated region (3'UTR). Low levels of HLA-G in the maternal circulation and placental tissue are linked to preeclampsia. Our objective was to investigate whether variants of the 3'UTR of the HLA-G gene in mother and fetus are associated with acute atherosis, a pregnancy specific arterial lesion of the decidua basalis that is prevalent in preeclampsia. Paired maternal and fetal DNA samples from 83 normotensive and 83 preeclamptic pregnancies were analyzed. We sequenced the part of the HLA-G 3'UTR containing a 14-bp insertion/deletion region and seven single nucleotide polymorphisms (SNPs). Associations with acute atherosis were tested by logistic regression. The frequency of heterozygosity for the 14-bp polymorphism (Ins/Del) and the +3142 SNP (C/G) variant in the fetus are associated with acute atherosis in preeclampsia (66.7 % vs. 39.6 %, p = 0.039, and 69.0 % vs. 43.4 %, p = 0.024). Furthermore, the fetal UTR-3 haplotype, which encompasses the 14-bp deletion and the +3142G variant, is associated with acute atherosis in preeclampsia (15 % vs. 3.8 %, p = 0.016). In conclusion, HLA-G polymorphisms in the fetus are associated with acute atherosis. We hypothesize that these polymorphisms lead to altered HLA-G expression in the decidua basalis, affecting local feto-maternal immune tolerance and development of acute atherosis.
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Affiliation(s)
- Guro M Johnsen
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway; Division of Obstetrics and Gyneacology, Oslo University Hospital, Norway; Institute for Experimental Medical Research, Oslo University Hospital, Norway.
| | - Heidi E S Fjeldstad
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway; Division of Obstetrics and Gyneacology, Oslo University Hospital, Norway
| | - Jos J M Drabbels
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Netherlands
| | - Geert W Haasnoot
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Netherlands
| | - Michael Eikmans
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Netherlands
| | - Gro L Størvold
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway; Division of Obstetrics and Gyneacology, Oslo University Hospital, Norway; Institute for Experimental Medical Research, Oslo University Hospital, Norway
| | | | - Daniel P Jacobsen
- Division of Obstetrics and Gyneacology, Oslo University Hospital, Norway
| | - Sicco A Scherjon
- Department of Obstetrics and Gynecology, University of Groningen, Netherlands
| | | | - Frans H J Claas
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Netherlands
| | - Anne Cathrine Staff
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway; Division of Obstetrics and Gyneacology, Oslo University Hospital, Norway
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14
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Jacobsen DP, Lekva T, Moe K, Fjeldstad HES, Johnsen GM, Sugulle M, Staff AC. Pregnancy and postpartum levels of circulating maternal sHLA-G in preeclampsia. J Reprod Immunol 2020; 143:103249. [PMID: 33254097 DOI: 10.1016/j.jri.2020.103249] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/14/2022]
Abstract
Preeclampsia is a leading cause of maternal and offspring mortality and morbidity, and predicts increased future cardiovascular disease risk. Placental dysfunction and immune system dysregulation are likely key pathophysiological factors. Soluble human leukocyte antigen G (sHLA-G) may dampen the specific immune response towards placental trophoblasts. Previous studies have shown low sHLA-G levels in preeclampsia, but postpartum, levels are unknown. Furthermore, the relationship between sHLA-G and sFlt-1 and PlGF, placental function markers, is unknown. We hypothesized that low maternal sHLA-G during pregnancy would be associated with placental dysfunction, including preeclampsia, gestational hypertension, and dysregulated sFlt-1 and PlGF, and that sHLA-G would remain decreased following preeclampsia. We included 316 pregnant women: 58 with early-onset preeclampsia (<34 weeks' gestation), 81 with late-onset preeclampsia (≥34 weeks' gestation), 25 with gestational hypertension, and 152 normotensive controls. Postpartum (1 or 3 years), we included 321 women: 29 with early-onset preeclampsia, 98 with late-onset preeclampsia, 57 with gestational hypertension, and 137 who were normotensive during their index pregnancies. In pregnancy, plasma sHLA-G was significantly lower both in the early- and late-onset preeclampsia groups compared to controls. In women with preeclampsia or gestational hypertension, sHLA-G was inversely correlated with serum sFlt-1. Postpartum, plasma sHLA-G levels were significantly higher in women who had had early-onset preeclampsia compared to controls. Our results support that sHLA-G may be important for placental function. Unexpectedly, sHLA-G was elevated up to 3 years after early-onset preeclampsia, suggesting an excessively activated immune system following this severe preeclampsia form, potentially contributing to future cardiovascular disease risk.
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Affiliation(s)
- Daniel P Jacobsen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway.
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital, Norway
| | - Kjartan Moe
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway; Department of Obstetrics and Gynaecology, Bærum Hospital, Vestre Viken HF, Norway
| | - Heidi E S Fjeldstad
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Guro Mørk Johnsen
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway
| | - Meryam Sugulle
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Anne Cathrine Staff
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
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15
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Fetal HLA-G mediated immune tolerance and interferon response in preeclampsia. EBioMedicine 2020; 59:102872. [PMID: 32680723 PMCID: PMC7502669 DOI: 10.1016/j.ebiom.2020.102872] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Fetal immune tolerance is crucial for pregnancy success. We studied the link between preeclampsia, a severe pregnancy disorder with uncertain pathogenesis, and fetal human leukocyte antigen G (HLA-G) and other genes regulating maternal immune responses. METHODS We assessed sex ratios and regulatory HLA-G haplotypes in population cohorts and series of preeclampsia and stillbirth. We studied placental mRNA expression of 136 genes by sequencing and HLA-G and interferon alpha (IFNα) protein expression by immunohistochemistry. FINDINGS We found underrepresentation of males in preeclamptic births, especially those delivered preterm or small for gestational age. Balancing selection at HLA-G associated with the sex ratio, stillbirth, and preeclampsia. We observed downregulation of HLA-G, its receptors, and many other tolerogenic genes, and marked upregulation of IFNA1 in preeclamptic placentas. INTERPRETATION These findings indicate that an evolutionary trade-off between immune tolerance and protection against infections at the maternal-fetal interface promotes genetic diversity in fetal HLA-G, thereby affecting survival, preeclampsia, and sex ratio. We highlight IFNA1 as a potential mediator of preeclampsia and a target for therapeutic trials. FUNDING Finnish Medical Foundation, Päivikki and Sakari Sohlberg Foundation, Karolinska Institutet Research Foundation, Scandinavia-Japan Sasakawa Foundation, Japan Eye Bank Association, Astellas Foundation for Research on Metabolic Disorders, Japan Society for the Promotion of Science, Knut and Alice Wallenberg Foundation, Swedish Research Council, Medical Society Liv och Hälsa, Sigrid Jusélius Foundation, Helsinki University Hospital and University of Helsinki, Jane and Aatos Erkko Foundation, Academy of Finland, Finska Läkaresällskapet, Novo Nordisk Foundation, Finnish Foundation for Pediatric Research, and Emil Aaltonen Foundation.
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16
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Valencia-Ortega J, Saucedo R, Peña-Cano MI, Hernández-Valencia M, Cruz-Durán JG. Immune tolerance at the maternal-placental interface in healthy pregnancy and pre-eclampsia. J Obstet Gynaecol Res 2020; 46:1067-1076. [PMID: 32428989 DOI: 10.1111/jog.14309] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/17/2020] [Accepted: 04/30/2020] [Indexed: 12/15/2022]
Abstract
AIM The objective of this review is to describe the immunological mechanisms which facilitate maternal tolerance at the maternal-placental interface, and to discuss how these mechanisms are disrupted in pre-eclampsia. METHODS A literature review was performed based on the analysis of papers available on PubMed. The most important and relevant studies regarding the immunological mechanisms which facilitate maternal tolerance in healthy pregnancy and pre-eclampsia are presented in this article. RESULTS The maternal-placental interface is the site where the immune tolerance begins and develops. Within the innate immunity, natural killer cells, macrophages and dendritic cells play a pivotal role in tolerance through regulation of inflammation. On the other hand, within the adaptive immunity, the correct increase of regulatory T cells is crucial for ensuring immune tolerance toward placental cells. Disturbances in maternal tolerance can lead to the appearance of pregnancy complications such as pre-eclampsia, which has a considerable impact on perinatal morbidity and mortality. CONCLUSION Our partial knowledge of immunological mechanisms involved in tolerance at the maternal-placental interface indicates that pre-eclampsia is characterized by alterations of this maternal immune tolerance, which could represent the origin of the disease.
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Affiliation(s)
- Jorge Valencia-Ortega
- Endocrine Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Renata Saucedo
- Endocrine Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - María I Peña-Cano
- Faculty of Chemistry, Universidad Autónoma del Estado de México, Toluca, Mexico
| | - Marcelino Hernández-Valencia
- Endocrine Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - José G Cruz-Durán
- UMAE Hospital de Gineco-Obstetricia No. 3, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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17
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Persson G, Bork JBS, Isgaard C, Larsen TG, Bordoy AM, Bengtsson MS, Hviid TVF. Cytokine stimulation of the choriocarcinoma cell line JEG-3 leads to alterations in the HLA-G expression profile. Cell Immunol 2020; 352:104110. [PMID: 32387976 DOI: 10.1016/j.cellimm.2020.104110] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/16/2020] [Accepted: 04/05/2020] [Indexed: 12/13/2022]
Abstract
The checkpoint molecule human leukocyte antigen (HLA)-G has restricted tissue expression, and plays a role in the establishment of maternal tolerance to the semi-allogenic fetus during pregnancy by expression on the trophoblast cells in the placenta. HLA-G exists in at least seven well-described mRNA isoforms, of which four are membrane-bound and three soluble. Regulation of the tissue expression of HLA-G and its isoforms is relatively unknown. Therefore, it is important to understand the regulation of HLA-G, and the HLA-G+ choriocarcinoma cell line JEG-3 is a widely used cellular model. We hypothesized that cytokines present in the microenvironment can regulate the HLA-G expression profile. In the present study, we systematically stimulated JEG-3 cells with various concentrations of IL-2, IL-4 IL-6, IL-10, IL-12, IL-15, IL-17A, TGF-β1, TNF-α and IFN-γ1b. The results suggest that IFN-γ plays a role in maintenance of HLA-G expression, while IL-10 might be involved in regulation of the isoform profile.
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Affiliation(s)
- Gry Persson
- Center for Immune Regulation and Reproductive Immunology (CIRRI), The ReproHealth Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, and the Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Julie Birgit Siig Bork
- Center for Immune Regulation and Reproductive Immunology (CIRRI), The ReproHealth Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, and the Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Cecilie Isgaard
- Center for Immune Regulation and Reproductive Immunology (CIRRI), The ReproHealth Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, and the Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Tine Graakjær Larsen
- Center for Immune Regulation and Reproductive Immunology (CIRRI), The ReproHealth Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, and the Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Anna Maria Bordoy
- Center for Immune Regulation and Reproductive Immunology (CIRRI), The ReproHealth Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, and the Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Meghan Sand Bengtsson
- Center for Immune Regulation and Reproductive Immunology (CIRRI), The ReproHealth Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, and the Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Thomas Vauvert Faurschou Hviid
- Center for Immune Regulation and Reproductive Immunology (CIRRI), The ReproHealth Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, and the Department of Clinical Medicine, University of Copenhagen, Denmark
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18
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Rambaldi MP, Weiner E, Mecacci F, Bar J, Petraglia F. Immunomodulation and preeclampsia. Best Pract Res Clin Obstet Gynaecol 2019; 60:87-96. [DOI: 10.1016/j.bpobgyn.2019.06.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/10/2019] [Accepted: 06/17/2019] [Indexed: 01/08/2023]
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19
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A role for both HLA-F and HLA-G in reproduction and during pregnancy? Hum Immunol 2019; 81:127-133. [PMID: 31558330 DOI: 10.1016/j.humimm.2019.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 01/15/2023]
Abstract
The human major histocompatibility complex includes a group of non-classical HLA class I genes, HLA-E, -F and -G. While nearly all focus since the discovery of these class Ib molecules have been on basic biochemistry and molecular biology of HLA-G and HLA-E, as well as their expression patterns, functions in immune modulation and during pregnancy, and also possible implications in a range of diseases, in infertility and pregnancy complications, HLA-F has nearly been ignored. However, recent discoveries show that HLA-F can be expressed as both open conformers binding to a number of KIRs on primarily NK cells, as well as peptide-bound HLA-F binding to ILT2 and ILT4. Furthermore, a number of reports indicate a possible involvement of HLA-F in viral infections, in cancer immunology, and in fertility and reproduction, which may initiate more interest in this rather unknown HLA class I molecule. In this short review, we focus on recent discoveries that indicate a functional role for HLA-F in reproduction and during pregnancy, and the role of HLA-F in relation to HLA-G.
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20
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Phoswa WN, Naicker T, Ramsuran V, Moodley J. Pre-eclampsia: the role of highly active antiretroviral therapy and immune markers. Inflamm Res 2018; 68:47-57. [PMID: 30276649 DOI: 10.1007/s00011-018-1190-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/26/2018] [Accepted: 09/27/2018] [Indexed: 02/06/2023] Open
Abstract
PURPOSE OF THE REVIEW This review highlights the role immune cells and markers such as natural killer (NK) cells, cytokines and human leukocyte antigen (HLA-G) play in predisposing HIV-infected women who are on HAART to develop PE, thus contributing to a better understanding and early diagnosis of PE with a subsequent reduction in maternal foetal and neonatal deaths. RECENT FINDINGS Pregnant women infected with the Human Immunodeficiency Virus (HIV) have a 25% risk of mother to child transmission. This risk, however, decreases to 2% if the women is on treatment. Highly active antiretroviral therapy (HAART) is the recommended treatment for both pregnant and non-pregnant women infected with HIV. Treatment with HAART is reported to potentiate predisposition to the development of hypertensive disorders of pregnancy such as pre-eclampsia (PE). Pre-eclampsia accounts for 7-10% of abnormal pregnancies worldwide. Studies demonstrate that pregnant women with HIV have PE at lower frequencies than uninfected women, however, the converse is observed upon HAART initiation. HIV-infected women on HAART exhibit a greater tendency to develop PE, emanating from immune reconstitution induced by HAART. There is paucity of information as to the pathogenesis of PE upon HAART initiation and there are, therefore, controversial data as to whether HAART predisposes women to a lower, equal or higher risk of PE development compared to the general population, further investigations on the impact of HIV infection and HAART on the immune response and rate of PE development in HIV infected pregnant women are urgently needed.
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Affiliation(s)
- Wendy N Phoswa
- Discipline of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Thajasvarie Naicker
- Optics and Imaging Centre, University of KwaZulu-Natal, Durban, South Africa
| | - Veron Ramsuran
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.,Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Jagidesa Moodley
- Women's Health and HIV Research Group, University of KwaZulu-Natal, Durban, South Africa
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21
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Yazdani N, Shekari Khaniani M, Bastami M, Ghasemnejad T, Afkhami F, Mansoori Derakhshan S. HLA-G regulatory variants and haplotypes with susceptibility to recurrent pregnancy loss. Int J Immunogenet 2018; 45:181-189. [DOI: 10.1111/iji.12364] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 02/05/2018] [Accepted: 03/01/2018] [Indexed: 12/01/2022]
Affiliation(s)
- N. Yazdani
- Immunology Research Center; Tabriz University of Medical Sciences; Tabriz Iran
- Department of Medical Genetic; Faculty of Medicine; Tabriz University of Medical Sciences; Tabriz Iran
| | - M. Shekari Khaniani
- Department of Medical Genetic; Faculty of Medicine; Tabriz University of Medical Sciences; Tabriz Iran
| | - M. Bastami
- Department of Medical Genetic; Faculty of Medicine; Tabriz University of Medical Sciences; Tabriz Iran
| | - T. Ghasemnejad
- Department of Medical Genetic; Faculty of Medicine; Tabriz University of Medical Sciences; Tabriz Iran
| | - F. Afkhami
- Department of Medical Genetics; Faculty of Medicine; Tarbiat Modares University; Tehran Iran
| | - S. Mansoori Derakhshan
- Immunology Research Center; Tabriz University of Medical Sciences; Tabriz Iran
- Department of Medical Genetic; Faculty of Medicine; Tabriz University of Medical Sciences; Tabriz Iran
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22
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Luo S, Pei J, Li X, Gu W. Decreased expression of JHDMID in placenta is associated with preeclampsia through HLA-G. J Hum Hypertens 2018; 32:448-454. [PMID: 29662139 DOI: 10.1038/s41371-018-0062-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/16/2017] [Accepted: 02/09/2018] [Indexed: 01/22/2023]
Abstract
The exact mechanism of preeclampsia (PE) remains unclear, accumulating researches have indicated multiple epigenetic factors relate to PE and histone methylation plays a crucial role in modifying the gene expression. So we aimed to confirm that abnormal expression of histone demethylase JHDM1D contributes to PE and lower expression of HLA-G in PE. We tested the expression of JHDM1D, H3K9me2, and H3K27me2 in the placentas of PE and normal control (NC)women who had a healthy pregnancy with Immunohistochemistry and we found that JHDM1D, H3K9me2, and H3K27me2 were all mainly expressed in the nuclei of the extra-villous trophoblasts (EVTs). JHDM1D was lower expressed in PE than in NC placentas, corresponding with the mRNA level and protein level with qTR-PCR and western blot, while H3K9me2 and H3K27me2 were higher expressed in PE. We further investigated the biological functions of JHDM1D in HTR-8/SVneo cells. We found that siJHDM1D inhibited cell growth after 24 h of the transfection and reduced the invasion, while increasing the apoptosis of HTR-8/SVneo. We then constructed the siJHDM1D stable cell line and confirmed with CHIP-qPCR that siJHDM1D inhibited the expression of HLA-G through increased the enrichment of H3K9me2 and H3K27me2 in the JHDM1D bounding region of HLA-G. Taken together, our study confirms that decreased expression of JHDM1D is associated with PE through down-regulating HLA-G and casts new light to the diagnosis and therapy of PE.
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Affiliation(s)
- Shouling Luo
- The Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Jiangnan Pei
- The Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Xiaotian Li
- The Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Weirong Gu
- The Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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23
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Lai A, Elfeky O, Rice GE, Salomon C. Optimized Specific Isolation of Placenta-Derived Exosomes from Maternal Circulation. Methods Mol Biol 2018; 1710:131-138. [PMID: 29196999 DOI: 10.1007/978-1-4939-7498-6_10] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Exosomes are small (~100 nm) vesicles that carry a wide range of molecules including proteins, RNAs, and DNA. Exosomes are secreted from a wide range of cells including placental cells. Interestingly, exosomes secreted from placental cells have been identified in maternal circulation as early as in 6 weeks of gestation, and their concentration increases with the gestational age. While there is growing interest in elucidating the role of exosomes during normal and complicated pregnancies (such as preeclampsia), progress in the field has been delayed because of the inability to isolate placental exosomes from maternal circulation. Therefore, here we describe a workflow to isolate placental exosomes from maternal circulation.
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Affiliation(s)
- Andrew Lai
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Bldg. 71/918, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia
| | - Omar Elfeky
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Bldg. 71/918, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia
| | - Gregory E Rice
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Bldg. 71/918, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia
- Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, LA, USA
| | - Carlos Salomon
- Exosome Biology Laboratory, Centre for Clinical Diagnostics, University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Bldg. 71/918, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.
- Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, LA, USA.
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepción, Concepción, Chile.
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Persson G, Melsted WN, Nilsson LL, Hviid TVF. HLA class Ib in pregnancy and pregnancy-related disorders. Immunogenetics 2017; 69:581-595. [PMID: 28699111 DOI: 10.1007/s00251-017-0988-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/18/2017] [Indexed: 12/30/2022]
Abstract
The HLA class Ib genes, HLA-E, HLA-F, and HLA-G, were discovered long after the classical HLA class Ia genes. The elucidation of their functions had a modest beginning. However, their basic functions and involvement in pathophysiology and a range of diseases are now emerging. Although results from a range of studies support the functional roles for the HLA class Ib molecules in adult life, especially HLA-G and HLA-F have most intensively been, and were also primarily, studied in relation to reproduction and pregnancy. The expression of HLA class Ib proteins at the feto-maternal interface in the placenta seems to be important for the maternal acceptance of the semi-allogenic fetus. In contrast to the functions of HLA class Ia, HLA-G possesses immune-modulatory and tolerogenic functions. Here, we review an accumulating amount of data describing the functions of HLA class Ib molecules in relation to fertility, reproduction, and pregnancy, and a possible role for these molecules in certain pregnancy complications, such as implantation failure, recurrent spontaneous abortions, and pre-eclampsia. The results from different kinds of studies point toward a role for HLA class Ib, especially HLA-G, throughout the reproductive cycle from conception to the birth weight of the child.
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Affiliation(s)
- Gry Persson
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Zealand University Hospital, 10 Sygehusvej, 4000, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Wenna Nascimento Melsted
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Zealand University Hospital, 10 Sygehusvej, 4000, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Line Lynge Nilsson
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Zealand University Hospital, 10 Sygehusvej, 4000, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Vauvert F Hviid
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Zealand University Hospital, 10 Sygehusvej, 4000, Roskilde, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Emmery J, Christiansen OB, Nilsson LL, Dahl M, Skovbo P, Møller AM, Steffensen R, Hviid TVF. Associations between fetal HLA-G genotype and birth weight and placental weight in a large cohort of pregnant women – Possible implications for HLA diversity. J Reprod Immunol 2017; 120:8-14. [DOI: 10.1016/j.jri.2017.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/09/2017] [Accepted: 02/15/2017] [Indexed: 10/20/2022]
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26
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Nilsson LL, Djurisic S, Andersen AMN, Melbye M, Bjerre D, Ferrero-Miliani L, Hackmon R, Geraghty DE, Hviid TVF. Distribution of HLA-G extended haplotypes and one HLA-E polymorphism in a large-scale study of mother-child dyads with and without severe preeclampsia and eclampsia. HLA 2016; 88:172-86. [PMID: 27596021 DOI: 10.1111/tan.12871] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/29/2016] [Accepted: 08/10/2016] [Indexed: 01/01/2023]
Abstract
The etiological pathways and pathogenesis of preeclampsia have rendered difficult to disentangle. Accumulating evidence points toward a maladapted maternal immune system, which may involve aberrant placental expression of immunomodulatory human leukocyte antigen (HLA) class Ib molecules during pregnancy. Several studies have shown aberrant or reduced expression of HLA-G in the placenta and in maternal blood in cases of preeclampsia compared with controls. Unlike classical HLA class Ia loci, the nonclassical HLA-G has limited polymorphic variants. Most nucleotide variations are clustered in the 5'-upstream regulatory region (5'URR) and 3'-untranslated regulatory region (3'UTR) of HLA-G and reflect a stringent expressional control. Based on genotyping and full gene sequencing of HLA-G in a large number of cases and controls (n > 900), the present study, which to our knowledge is the largest and most comprehensive performed, investigated the association between the HLA-G 14-bp ins/del (rs66554220) and HLA-E polymorphisms in mother and newborn dyads from pregnancies complicated by severe preeclampsia/eclampsia and from uncomplicated pregnancies. Furthermore, results from extended HLA-G haplotyping in the newborns are presented in order to assess whether a combined contribution of nucleotide variations spanning the 5'URR, coding region, and 3'UTR of HLA-G describes the genetic association with severe preeclampsia more closely. In contrast to earlier findings, the HLA-G 14-bp ins/del polymorphism was not associated with severe preeclampsia. Furthermore, the polymorphism (rs1264457) defining the two nonsynonymous HLA-E alleles, HLA-E*01:01:xx:xx and HLA-E*01:03:xx:xx, were not associated with severe preeclampsia. Finally, no specific HLA-G haplotypes were significantly associated with increased risk of developing severe preeclampsia/eclampsia.
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Affiliation(s)
- L L Nilsson
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Zealand University Hospital (Roskilde), Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - S Djurisic
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Zealand University Hospital (Roskilde), Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - A-M N Andersen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - M Melbye
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - D Bjerre
- Research Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Copenhagen University Hospital, Roskilde, Denmark
| | - L Ferrero-Miliani
- Research Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Copenhagen University Hospital, Roskilde, Denmark
| | - R Hackmon
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - D E Geraghty
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - T V F Hviid
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Zealand University Hospital (Roskilde), Roskilde, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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27
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Emmer PM, Joosten I, Schut MH, Zusterzeel PLM, Hendriks JCM, Steegers EAP. Shift in Expression of HLA-G mRNA Spliceforms in Pregnancies Complicated by Preeclampsia. ACTA ACUST UNITED AC 2016; 11:220-6. [PMID: 15120695 DOI: 10.1016/j.jsgi.2003.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Despite emerging data on the in vitro modulatory effects of trophoblast-associated human leukocyte antigen G (HLA-G), its in vivo function needs to be determined. Immunohistochemical studies show a decrease in protein expression of trophoblast HLA-G in preeclampsia. Such a decrease in protein might be the consequence of a shift in HLA-G mRNA spliceform patterns. In an exploratory pilot study we determined trophoblast HLA-G mRNA spliceform distribution in preeclampsia. METHODS Placental samples were collected immediately after cesarean delivery from pregnancies complicated by preeclampsia or the syndrome hemolysis, elevated liver enzymes, and low platelet count (HELLP) and uncomplicated normotensive pregnancies as controls. HLA-G mRNA spliceform distribution was analyzed using a semiquantitative reverse transcriptase polymerase chain reaction procedure. RESULTS Analysis of HLA-G spliceform distribution showed a significant increase in frequency of the G5 form encoding for a soluble HLA-G molecule in preeclampsia. This increase in G5 form was not found in pregnancies complicated by HELLP. CONCLUSION The increased frequency in the expression of the HLA-G G5 spliceform may play a role in the pathophysiology of preeclampsia, in particular through a recently suggested effect of this soluble HLA-G molecule on remodeling of the spiral arteries.
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Affiliation(s)
- Peter M Emmer
- Departments of Department of Blood Transfusion and Transplantation Immunology, University Medical Center Nijmegen, The Netherlands
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Amodio G, Canti V, Maggio L, Rosa S, Castiglioni MT, Rovere-Querini P, Gregori S. Association of genetic variants in the 3'UTR of HLA-G with Recurrent Pregnancy Loss. Hum Immunol 2016; 77:886-891. [PMID: 27370685 PMCID: PMC5021086 DOI: 10.1016/j.humimm.2016.06.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 06/22/2016] [Accepted: 06/27/2016] [Indexed: 01/28/2023]
Abstract
Human Leukocyte Antigen (HLA)-G is involved in reprogramming immune responses at fetal-maternal interface during pregnancy. We evaluated the genetic diversity of the 3′ Un-Translated Region (UTR) of HLA-G, previously associated with HLA-G mRNA post-transcriptional regulation, in women with unexplained Recurrent Pregnancy Loss (RPL), with 2 pregnancy losses (RPL-2, n = 28), or 3 or more pregnancy losses (RPL-3, n = 24), and in 30 women with a history of successful pregnancy. Results showed in RPL-2, but not in RPL-3, women compared to controls: i) higher frequency of the 14 bp Ins allele, in single and in double copy; ii) significantly lower frequency of DelG/X genotype, iii) reduced frequency of the UTR-2, and UTR-3 haplotypes; iv) higher frequencies of the UTR-5, UTR-7, and UTR-8 haplotypes. This pilot study supports the relevance of performing 3′UTR HLA-G genetic screening, not limited to a specific polymorphism, but considering the extended haplotypes, as a possible predictor of pregnancy outcome.
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Affiliation(s)
- Giada Amodio
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), Division of Regenerative Medicine, Stem Cells and Gene Therapy, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
| | - Valentina Canti
- Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132 Milan, Italy
| | - Luana Maggio
- Obstetric and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Susanna Rosa
- Obstetric and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Patrizia Rovere-Querini
- Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132 Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - Silvia Gregori
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), Division of Regenerative Medicine, Stem Cells and Gene Therapy, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
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Abstract
Preeclampsia (PE) is one of the leading causes of maternal and fetal morbidity and mortality, with incidence rates ranging between 2 and 5 % in the Western World. The exact causes of the disease remain largely unknown, because of the complex pathophysiologic mechanisms involved in the process. Genetic, environmental, and epigenetic parameters have been implicated by various authors as culprits for the pathogenesis of PE. Recent reports in the literature highlight the paternal role. Still, the exact extent and mechanism remain elusive. In this systematic review, we attempt to present data regarding the paternal role in a concise and comprehensive manner.
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30
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Pabalan N, Jarjanazi H, Sun C, Iversen AC. Meta-analysis of the human leukocyte antigen-G (HLA-G) 14 bp insertion/deletion polymorphism as a risk factor for preeclampsia. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/tan.12627] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- N. Pabalan
- Center for Research and Development; Angeles University Foundation; Angeles City, 2009 Philippines
- School of Medicine; Saint Louis University; Baguio City, 2600 Philippines
| | - H. Jarjanazi
- Environmental Monitoring and Reporting Branch, Biomonitoring Unit; Ontario Ministry of the Environment and Climate Change; Ontario, M9P 3V6 Canada
| | - C. Sun
- Department of Obstetrics and Gynecology; Haukeland University Hospital; Bergen, N-5021 Norway
| | - A. C. Iversen
- Centre of Molecular Inflammation Research, and Department of Cancer Research and Molecular Medicine; Norwegian University of Science and Technology; Trondheim, N-7491 Norway
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31
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Mandò C, Pileri P, Mazzocco MI, Lattuada D, Zolin A, Plebani M, Massari M, Calabrese S, Milani S, Cetin I. Maternal and fetal HLA-G 14 bp gene polymorphism in pregnancy-induced hypertension, preeclampsia, intrauterine growth restricted and normal pregnancies. J Matern Fetal Neonatal Med 2015; 29:1509-14. [DOI: 10.3109/14767058.2015.1052398] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tang Y, Liu H, Li H, Peng T, Gu W, Li X. Hypermethylation of the HLA-G promoter is associated with preeclampsia. Mol Hum Reprod 2015; 21:736-44. [PMID: 26116450 DOI: 10.1093/molehr/gav037] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/22/2015] [Indexed: 01/09/2023] Open
Abstract
Preeclampsia (PE) is a severe pregnancy-induced disorder characterized by hypertension and proteinuria and a leading cause of perinatal maternal-fetal mortality and morbidity in developing countries. Dysregulated human leukocyte antigen (HLA)-G was found in placentas as well as in maternal sera from PE patients; however, the reason for this difference is unknown. As accumulating evidence has confirmed that DNA methylation is an important mechanism for regulating gene expression, we sought to test the hypothesis that alteration in the DNA methylation of the HLA-G promoter region is responsible for decreased expression of HLA-G in PE. Bisulfite pyrosequencing showed that a series of CpG sites in the HLA-G promoter region were significantly more highly methylated in PE than in normal pregnancy (NP). Interestingly, the hypermethylated CpG sites were mostly reported to be binding sites of active transcription factors. To further investigate the regulation of HLA-G methylation, we also defined the expression patterns of DNA methyltransferases (DNMTs) in placental tissue using immunohistochemistry and quantitative polymerase chain reaction analyses. Here, we demonstrate that DNMT-1 is overexpressed and HLA-G expression is reduced in PE women when compared with NP. Furthermore, both treatment with the DNMT inhibitor 5-aza-2'-deoxycytidine and specific knockdown of DNMT-1 using siRNAs can significantly increase the expression level of HLA-G in a trophoblastic cell line, indicating the potential mechanism of DNMT-1-mediated DNA methylation in HLA-G regulation. Taken together, our research confirms that DNMT-1-mediated promoter hypermethylation of HLA-G is associated with PE. These findings provide new insights into the diagnosis and treatment of PE.
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Affiliation(s)
- Yao Tang
- The Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, 419 FangXie Road, Shanghai 200011, PR China Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China
| | - Haiyan Liu
- The Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, 419 FangXie Road, Shanghai 200011, PR China
| | - Han Li
- The Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, 419 FangXie Road, Shanghai 200011, PR China
| | - Ting Peng
- The Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, 419 FangXie Road, Shanghai 200011, PR China
| | - Weirong Gu
- The Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, 419 FangXie Road, Shanghai 200011, PR China Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China
| | - Xiaotian Li
- The Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, 419 FangXie Road, Shanghai 200011, PR China Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China
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33
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Human Leukocyte Antigen-G Within the Male Reproductive System: Implications for Reproduction. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 868:171-90. [DOI: 10.1007/978-3-319-18881-2_8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Djurisic S, Hviid TVF. HLA Class Ib Molecules and Immune Cells in Pregnancy and Preeclampsia. Front Immunol 2014; 5:652. [PMID: 25566263 PMCID: PMC4274990 DOI: 10.3389/fimmu.2014.00652] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 12/05/2014] [Indexed: 01/14/2023] Open
Abstract
Despite decades of research, the highly prevalent pregnancy complication preeclampsia, “the disease of theories,” has remained an enigma. Indeed, the etiology of preeclampsia is largely unknown. A compiling amount of studies indicates that the pathological basis involves a complex array of genetic predisposition and immunological maladaptation, and that a contribution from the mother, the father, and the fetus is likely to be important. The Human Leukocyte Antigen (HLA)-G is an increasing focus of research in relation to preeclampsia. The HLA-G molecule is primarily expressed by the extravillous trophoblast cells lining the placenta together with the two other HLA class Ib molecules, HLA-E and HLA-F. Soluble isoforms of HLA-G have been detected in the early endometrium, the matured cumulus–oocyte complex, maternal blood of pregnant women, in umbilical cord blood, and lately, in seminal plasma. HLA-G is believed to be involved in modulating immune responses in the context of vascular remodeling during pregnancy as well as in dampening potential harmful immune attacks raised against the semi-allogeneic fetus. In addition, HLA-G genetic variants are associated with both membrane-bound and soluble forms of HLA-G, and, in some studies, with preeclampsia. In this review, a genetic contribution from the mother, the father, and the fetus, together with the presence and function of various immune cells of relevance in pregnancy are reviewed in relation to HLA-G and preeclampsia.
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Affiliation(s)
- Snezana Djurisic
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Copenhagen University Hospital (Roskilde), University of Copenhagen , Roskilde , Denmark
| | - Thomas Vauvert F Hviid
- Department of Clinical Biochemistry, Centre for Immune Regulation and Reproductive Immunology (CIRRI), Copenhagen University Hospital (Roskilde), University of Copenhagen , Roskilde , Denmark
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35
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Djurisic S, Teiblum S, Tolstrup C, Christiansen O, Hviid T. Allelic imbalance modulates surface expression of the tolerance-inducing HLA-G molecule on primary trophoblast cells. ACTA ACUST UNITED AC 2014; 21:281-95. [DOI: 10.1093/molehr/gau108] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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36
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Quach K, Grover SA, Kenigsberg S, Librach CL. A combination of single nucleotide polymorphisms in the 3'untranslated region of HLA-G is associated with preeclampsia. Hum Immunol 2014; 75:1163-70. [PMID: 25454622 DOI: 10.1016/j.humimm.2014.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 10/09/2014] [Accepted: 10/09/2014] [Indexed: 12/01/2022]
Abstract
Reduced expression of human leukocyte antigen-G (HLA-G) has been linked to onset of preeclampsia. Associations have also been reported between preeclampsia and single nucleotide polymorphisms (SNP) in the 3'-untranslated region (UTR) of the HLA-G gene. However, there are conflicting results between studies. This studied examined whether a SNP, by itself or in combination with other SNPs, in the 3'UTR of the HLA-G gene is associated with an increased risk of preeclampsia. Placenta samples were obtained from 47 preeclamptic and 68 control cases. DNA was extracted, and the 3'UTR was sequenced and analyzed for nine polymorphisms using different genetic models of inheritance. Four of these polymorphisms have never been analyzed for an association with preeclampsia. Disputing existing reports, preeclamptic cases were suggestively associated with a G/G-genotype at SNP +3187 (p<0.05). Several SNP combinations were more prevalent in preeclampsia cases. Following corrections for multiple testing, one SNP combination (+3027C/C and +3187G/G) was significantly more prevalent in preeclampsia cases using co-dominant, additive, and dominant models (p<0.001). Taken together with the current literature, the data suggests that HLA-G 3'UTR SNP-pair associations, and not individual SNPs, could be useful in a predictive test for the susceptibility to preeclampsia.
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Affiliation(s)
- K Quach
- The Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto M5G 1N8, Canada.
| | - S A Grover
- The Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto M5G 1N8, Canada
| | - S Kenigsberg
- The Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto M5G 1N8, Canada
| | - C L Librach
- The Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto M5G 1N8, Canada; Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre and Women's College Hospital, 2075 Bayview Avenue, Toronto M4N 3M5, Canada; Department of Obstetrics and Gynecology, University of Toronto, 563 Spadina Crescent, Toronto M5S 2J7, Canada
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37
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Rebmann V, da Silva Nardi F, Wagner B, Horn PA. HLA-G as a tolerogenic molecule in transplantation and pregnancy. J Immunol Res 2014; 2014:297073. [PMID: 25143957 PMCID: PMC4131093 DOI: 10.1155/2014/297073] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/07/2014] [Accepted: 05/21/2014] [Indexed: 12/28/2022] Open
Abstract
HLA-G is a nonclassical HLA class I molecule. In allogeneic situations such as pregnancy or allograft transplantation, the expression of HLA-G has been related to a better acceptance of the fetus or the allograft. Thus, it seems that HLA-G is crucially involved in mechanisms shaping an allogeneic immune response into tolerance. In this contribution we focus on (i) how HLA-G is involved in transplantation and human reproduction, (ii) how HLA-G is regulated by genetic and microenvironmental factors, and (iii) how HLA-G can offer novel perspectives with respect to therapy.
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Affiliation(s)
- Vera Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany
| | - Fabiola da Silva Nardi
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany
- CAPES Foundation, Ministry of Education of Brazil, 70.040-020 Brasília, DF, Brazil
| | - Bettina Wagner
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany
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38
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Abstract
Human leukocyte antigen-G (HLA-G) is a low polymorphic nonclassical HLA-I molecule restrictively expressed and with suppressive functions. HLA-G gene products are quite complex, with seven HLA-G isoforms, four membrane bound, and other three soluble isoforms that can suffer different posttranslational modifications or even complex formations. In addition, HLA-G has been described included in exosomes. In this review we will focus on HLA-G biochemistry with special emphasis to the mechanisms that regulate its expression and how the protein modifications affect the quantification in biological fluids.
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39
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Bortolotti D, Gentili V, Rotola A, Cassai E, Rizzo R, Luca DD. Impact of HLA-G analysis in prevention, diagnosis and treatment of pathological conditions. World J Methodol 2014; 4:11-25. [PMID: 25237627 PMCID: PMC4145573 DOI: 10.5662/wjm.v4.i1.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 12/28/2013] [Accepted: 01/16/2014] [Indexed: 02/06/2023] Open
Abstract
Human leukocyte antigen-G (HLA-G) is a non-classical HLA class I molecule that differs from classical HLA class I molecules by low polymorphism and tissue distribution. HLA-G is a tolerogenic molecule with an immune-modulatory and anti-inflammatory function on both innate and adaptative immunity. This peculiar characteristic of HLA-G has led to investigations of its role in pathological conditions in order to define possible uses in diagnosis, prevention and treatment. In recent years, HLA-G has been shown to have an important implication in different inflammatory and autoimmune diseases, pregnancy complications, tumor development and aggressiveness, and susceptibility to viral infections. In fact, HLA-G molecules have been reported to alternate at both genetic and protein level in different disease situations, supporting its crucial role in pathological conditions. Specific pathologies show altered levels of soluble (s)HLA-G and different HLA-G gene polymorphisms seem to correlate with disease. This review aims to update scientific knowledge on the contribution of HLA-G in managing pathological conditions.
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40
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The many faces of human leukocyte antigen-G: relevance to the fate of pregnancy. J Immunol Res 2014; 2014:591489. [PMID: 24741608 PMCID: PMC3987982 DOI: 10.1155/2014/591489] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 01/17/2014] [Indexed: 02/06/2023] Open
Abstract
Pregnancy is an immunological paradox, where fetal antigens encoded by polymorphic genes inherited from the father do not provoke a maternal immune response. The fetus is not rejected as it would be theorized according to principles of tissue transplantation. A major contribution to fetal tolerance is the human leukocyte antigen (HLA)-G, a nonclassical HLA protein displaying limited polymorphism, restricted tissue distribution, and a unique alternative splice pattern. HLA-G is primarily expressed in placenta and plays multifaceted roles during pregnancy, both as a soluble and a membrane-bound molecule. Its immunomodulatory functions involve interactions with different immune cells and possibly regulation of cell migration during placental development. Recent findings include HLA-G contributions from the father and the fetus itself. Much effort has been put into clarifying the role of HLA-G during pregnancy and pregnancy complications, such as preeclampsia, recurrent spontaneous abortions, and subfertility or infertility. This review aims to clarify the multifunctional role of HLA-G in pregnancy-related disorders by focusing on genetic variation, differences in mRNA stability between HLA-G alleles, differences in HLA-G isoform expression, and possible differences in functional activity. Furthermore, we highlight important observations regarding HLA-G genetics and expression in preeclampsia that future research should address.
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Hsu P, Santner-Nanan B, Joung S, Peek MJ, Nanan R. Expansion of CD4+HLA-G+T Cell in Human Pregnancy is Impaired in Pre-eclampsia. Am J Reprod Immunol 2014; 71:217-28. [DOI: 10.1111/aji.12195] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 12/05/2013] [Indexed: 12/25/2022] Open
Affiliation(s)
- Peter Hsu
- Sydney Medical School Nepean; The University of Sydney; Kingswood NSW Australia
- Department of Allergy and Immunology; The Children's Hospital at Westmead; Westmead NSW Australia
| | | | - Steven Joung
- Sydney Medical School Nepean; The University of Sydney; Kingswood NSW Australia
| | - Michael J. Peek
- Sydney Medical School Nepean; The University of Sydney; Kingswood NSW Australia
| | - Ralph Nanan
- Sydney Medical School Nepean; The University of Sydney; Kingswood NSW Australia
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Liu X, Gu W, Li X. HLA-G regulates the invasive properties of JEG-3 choriocarcinoma cells by controlling STAT3 activation. Placenta 2013; 34:1044-52. [PMID: 24054889 DOI: 10.1016/j.placenta.2013.07.070] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/28/2013] [Accepted: 07/31/2013] [Indexed: 11/29/2022]
Abstract
The expression of human leucocyte antigen-G (HLA-G) in trophoblasts plays a crucial role in successful embryonic implantation, and reduced HLA-G expression might contribute to adverse obstetric outcomes. In this study, we silenced HLA-G expression using RNA interference in JEG-3 cells, resulting in a notably attenuated invasion capacity of the cells in a Transwell assay; however, no alterations in cell proliferation or apoptosis were observed. The down-regulation of HLA-G dampened the activation of signal transducer and activator of transcription 3 (STAT3), whereas the up-regulation of HLA-G promoted STAT3 activation and invasion in JEG-3 cells treated with human galectin-1. Most importantly, interleukin-6 (IL-6), but not galectin-1, was shown to rescue invasion deficiency in a dose-dependent manner. Thus, we demonstrate that HLA-G is able to regulate JEG-3 cell invasion by influencing STAT3 activation, which may underlie the implantation defects accompanying HLA-G hypo-expression in pre-eclampsia.
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Affiliation(s)
- X Liu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, PR China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, PR China
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Lombardelli L, Aguerre-Girr M, Logiodice F, Kullolli O, Casart Y, Polgar B, Berrebi A, Romagnani S, Maggi E, Le Bouteiller P, Piccinni MP. HLA-G5 induces IL-4 secretion critical for successful pregnancy through differential expression of ILT2 receptor on decidual CD4⁺ T cells and macrophages. THE JOURNAL OF IMMUNOLOGY 2013; 191:3651-62. [PMID: 23997222 DOI: 10.4049/jimmunol.1300567] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Successful pregnancy in humans has been associated with production of IL-4 by T cells at the feto-maternal interface. Soluble HLA-G5 produced by trophoblasts potentially controls the decidual T cell cytokine profile. We studied the effect of HLA-G5 on the cytokine profile of purified human macrophages and Ag-specific T cells in vitro. We demonstrated that HLA-G5 increased production of IL-12 by purified peripheral blood macrophages. Although IL-12 production by macrophages is known to induce IFN-γ production by CD4(+) T cells, HLA-G5 increased production of IL-4 but not IFN-γ by CD4(+) T cells after Ag presentation by macrophages. We found that this apparent paradox was due to the differential expression of the ILT2 HLA-G5 receptor on activated T cells and macrophages. This receptor was upregulated in the former and downregulated in the latter after Ag presentation and activation of both cell types. This observation was confirmed in situ, where decidual macrophages and T cells are continuously exposed to HLA-G5 produced locally and activated by trophoblast alloantigens. Freshly isolated decidua basalis macrophages expressed lower levels of ILT2 than peripheral blood macrophages from the same pregnant women. They did not spontaneously produce IL-12, whereas freshly isolated decidual CD4(+) T cells expressed high levels of activation markers (CD25, HLA-DR, and CD69) as well as ILT2 and spontaneously produced IL-4 but not IFN-γ. Therefore, HLA-G5 could be responsible, at least in part, via its interaction with ILT2, for decidual T cell IL-4 production, known to be crucial for successful pregnancy.
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Affiliation(s)
- Letizia Lombardelli
- Department of Experimental and Clinical Medicine, Center of excellence for the study at molecular and clinical level of chronic, degenerative and neoplastic diseases to develop novel therapies, University of Florence, 50134 Florence, Italy
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Abstract
Preeclampsia, intrauterine growth retardation (IUGR), oligohydramnios, abortus, preterm birth and premature rupture of the membranes (PROM) are significant complications of pregnancy. Insufficient trophoblastic invasion plays an important role in the pathophysiology of pregnancy complications. Soluble human leukocyte antigen-gestation (HLA-G)1/G5 is a molecule associated with trophoblast invasion. When pregnancy complications are predicted early, strategies to prevent these complications can be implemented. The aim of this study was to investigate the relationship between first trimester maternal serum soluble HLA-G1/G5 levels and high-risk pregnancies. A total of 232 pregnant women were followed prospectively. Maternal blood samples were collected for determination of soluble HLA-G1/G5 levels at 11-14 weeks, during which routine serum free beta human chorionic gonadotropin (βhCG) and pregnancy associated plasma protein-A (PAPP-A) level determinations in addition to nuchal translucency (NT) measurements for Down's syndrome screening were done during 20-22 weeks gestation. The subjects were classified into normal pregnancy, preeclampsia, oligohydramnios, IUGR, preterm birth and PROM groups. First trimester maternal serum soluble HLA-G1/G5 levels were not significantly different between the groups. First trimester soluble HLA-G1/G5 did not predict high-risk pregnancies. Studies with larger number of cases are need to confirm our findings.
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Affiliation(s)
- Ismail Bıyık
- Department of Obstetrics and Gynecology, Karacabey State Hospital , Bursa , Turkey
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Barakonyi A, Miko E, Szereday L, Polgar PD, Nemeth T, Szekeres-Bartho J, Engels GL. Cell Death Mechanisms and Potentially Cytotoxic Natural Immune Cells in Human Pregnancies Complicated by Preeclampsia. Reprod Sci 2013; 21:155-66. [DOI: 10.1177/1933719113497288] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Aliz Barakonyi
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Eva Miko
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Laszlo Szereday
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Petra Dora Polgar
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
| | - Timea Nemeth
- Department of Languages for Specific Purposes, Medical School, University of Pecs, Pecs, Hungary
| | - Julia Szekeres-Bartho
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Geraldine Laura Engels
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
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González A, Rebmann V, LeMaoult J, Horn PA, Carosella ED, Alegre E. The immunosuppressive molecule HLA-G and its clinical implications. Crit Rev Clin Lab Sci 2012; 49:63-84. [PMID: 22537084 DOI: 10.3109/10408363.2012.677947] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Human leukocyte antigen G (HLA-G) is a non-classical major histocompatibility complex (MHC) class I molecule that, through interaction with its receptors, exerts important tolerogenic functions. Its main physiological expression occurs in placenta where it seems to participate in the maternal tolerance toward the fetus. HLA-G has been studied as a marker of pregnancy complications such as abortion or pre-eclapmsia. Although HLA-G is not expressed in most adult tissues, its ectopic expression has been observed in some diseases such as viral infections, autoimmune disorders, and especially cancer. HLA-G neo-expression in cancer is associated with the capability of tumor cells to evade the immune control. In this review, we will summarize HLA-G biology and how it participates in these physiopathological processes. Special attention will be paid to its role as a diagnostic tool and also as a therapeutic target.
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Affiliation(s)
- Alvaro González
- Department of Biochemistry, University Clinic of Navarra, Pamplona, Spain.
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Fukui A, Yokota M, Funamizu A, Nakamua R, Fukuhara R, Yamada K, Kimura H, Fukuyama A, Kamoi M, Tanaka K, Mizunuma H. Changes of NK Cells in Preeclampsia. Am J Reprod Immunol 2012; 67:278-86. [DOI: 10.1111/j.1600-0897.2012.01120.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 02/05/2012] [Indexed: 11/29/2022] Open
Affiliation(s)
- Atsushi Fukui
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Megumi Yokota
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Ayano Funamizu
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Rika Nakamua
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Rie Fukuhara
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Kenichi Yamada
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Hidetaka Kimura
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Asami Fukuyama
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Mai Kamoi
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Kanji Tanaka
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
| | - Hideki Mizunuma
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Aomori; Japan
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Rizzo R, Vercammen M, van de Velde H, Horn PA, Rebmann V. The importance of HLA-G expression in embryos, trophoblast cells, and embryonic stem cells. Cell Mol Life Sci 2011; 68:341-52. [PMID: 21080028 PMCID: PMC11114702 DOI: 10.1007/s00018-010-0578-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 10/22/2010] [Indexed: 10/18/2022]
Abstract
The nonclassical HLA-G molecule is a trophoblast-specific molecule present in almost every pregnancy. It differs from classical HLA class I molecules by the low degree of allelic variants and the high diversity of protein structures. HLA-G is reported to be a tolerogenic molecule that acts on cells of both innate and adaptive immunity. At the maternal-fetal interface HLA-G seems to be responsible largely for the reprogramming of local maternal immune response. This review will focus on the HLA-G gene expression profile in pregnancy, in preimplantation embryos, and in human embryonic stem cells with emphasis on the structural diversity of the HLA-G protein and its potential functional and diagnostic implications.
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Affiliation(s)
- Roberta Rizzo
- Department of Experimental and Diagnostic Medicine, Section of Medical Genetics, University of Ferrara, Ferrara, Italy
| | - Martine Vercammen
- Department of Hematology, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium
| | - Hilde van de Velde
- Centre for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium
- Department of Reproduction and Genetics, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital of Essen, Virchowstr. 179, 45122 Essen, Germany
| | - Vera Rebmann
- Institute for Transfusion Medicine, University Hospital of Essen, Virchowstr. 179, 45122 Essen, Germany
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Farina A, Zucchini C, De Sanctis P, Morano D, Sekizawa A, Purwosunu Y, Okai T, Rizzo N. Gene expression in chorionic villous samples at 11 weeks of gestation in women who develop pre-eclampsia later in pregnancy: implications for screening. Prenat Diagn 2011; 31:181-5. [PMID: 21268038 DOI: 10.1002/pd.2675] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2010] [Revised: 10/30/2010] [Accepted: 11/01/2010] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To determine the gene expression profile in chorionic villous samples (CVSs) of women destined to develop pre-eclampsia (PE). METHOD Case-control study encompassing five women destined to develop PE [cases matched for gestational age with 30 controls]. We quantified mRNA expression on tissue samples from CVS of normal and PE patients. We then assessed mRNA expressions of cathepsin (CTSD), angiopoietin 2 (ANGPT2), interleukin 8, chemokine (C-X-C motif) ligand 10, neurokinin B (NKB), matrix metallopeptidase 9, major histocompatibility complex, class I, C (HLA-C)and human leukocyte antigen-G (HLA-G). Data were analyzed by nonparametric rank analysis. RESULTS For all the mRNA species considered in this study, except CTSD and ANGPT2, all the mean observed ranks in the PE group were significantly altered compared with the rank expectation among controls. mRNA for NKB and HLA-C were the markers with the highest degree of aberration in PE, compared with those in controls. CONCLUSION Our study has directly showed that gene expressions relating to trophoblastic cell invasion or utero-placental hemodynamic adaptation are altered in the first trimester trophoblasts that go on to develop PE later. These results posit the use of residual CVS as a possible screening method for PE.
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Affiliation(s)
- Antonio Farina
- Division of Prenatal Medicine, University of Bologna, Bologna, Italy.
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50
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Ahn H, Park J, Gilman-Sachs A, Kwak-Kim J. Immunologic Characteristics of Preeclampsia, a Comprehensive Review. Am J Reprod Immunol 2010; 65:377-94. [DOI: 10.1111/j.1600-0897.2010.00913.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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