KIR-HLAC genotyping in married couples with early reproductive losses of unknown genesis

Aim. KIR-HLAC genotyping in married couples with early idiopathic pregnancy loss. Methods. DNA extraction and purification, PCR-SSP, agarose gel electrophoresis. Results. The spectrum of KIR genes was analyzed and the frequency of KIR genotypes in women with early reproductive losses was established. The most common (77.78 %) was the AB genotype, 20.37 % had the AA genotype, and 1.85 % had the BB genotype. HLAC genotyping of couples with regular early reproductive losses showed the C1/C2 genotype of the HLAC gene in 40.74 % of women and 44.44 % of men. The frequency of C1/C1 genotype in women was 27.78% versus 38.89 % in men. The C2/C2 genotype of the HLAC gene was detected in 31.48 % of women and 12.96 % of men. According to the results of KIR-HLAC analysis of genotyping of married couples with early reproductive losses, a high/significant risk of reproductive losses of immunological genesis was found in 55.56 % of cases. Conclusions. KIR-HLAC genotyping is a genetic test that allows to assess the risks of the embryo being rejected by the maternal immune system, and thus to direct medical interventions in order to achieve a successful pregnancy. Keywords: early reproductive losses, KIR, HLAC.

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Allocation features and frequency of KIR-genes in women with regular early reproductive losses

Faktori eksperimental'noi evolucii organizmiv ◽

10.7124/feeo.v21.863 ◽

1970 ◽

Vol 21 ◽

pp. 335-339

Author(s):

O. I. Terpyliak ◽

D. V. Zastavna ◽

N. V. Helner ◽

S. V. Osidach

Keyword(s):

Peripheral Blood ◽

Blood Cells ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Killer Cell ◽

Peripheral Blood Cells ◽

Kir Genes ◽

Reproductive Losses ◽

Genetically Determined

Aim. KIR (killer cell immunoglobulin-like receptors) are the transmembranous glycoprotein receptors, role of which is to activate or inhibit the functional activity of cells, the surfaces of which they are located on. Genetically determined balance between KIR-activating and KIR-inhibiting receptors can contribute to some diseases predisposition. In this work we have studied the spectrum and frequency of KIR-genes among women with regular early idiopathic reproductive failures. Methods. Gene typing was conducted by PCR-SSP method. Results. Typing of KIR-genes was conducted in 31 DNA samples, extracted from peripheral blood cells from women without reproductive losses and in 38 DNA samples, extracted from peripheral blood cells from women with early reproductive losses of idiopathic nature. We found, that in women with reproductive failures genotypes of KIR-genes were characterized by decreased amount of activating genes. The presence of 2DL3 and 2DL5 genes increases the risk of early reproductive failures in 2 and 3 times, respectively. Conclusions. The shift of repertoire of KIR-genes into the domination of inhibitory genes and the spectrum features of KIR-genes can increase the risk of early reproductive failures. Keywords: KIR-genes, recurrent pregnancy loss, PCR-SSP.

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A balancing act: mechanisms by which the fetus avoids rejection by the maternal immune system

Reproduction ◽

10.1530/rep-10-0360 ◽

2011 ◽

Vol 141 (6) ◽

pp. 715-724 ◽

Cited By ~ 147

Author(s):

J C Warning ◽

S A McCracken ◽

J M Morris

Keyword(s):

Immune Cells ◽

Vascular Remodeling ◽

Pregnancy Loss ◽

Extravillous Trophoblast ◽

Successful Pregnancy ◽

Temporal Regulation ◽

Maternal Immune System ◽

Inflammatory Processes ◽

Maternal Immune Response ◽

Placental Invasion

Successful pregnancy requires strict temporal regulation of maternal immune function to accommodate the growing fetus. Early implantation is facilitated by inflammatory processes that ensure adequate vascular remodeling and placental invasion. To prevent rejection of the fetus, this inflammation must be curtailed; reproductive immunologists are discovering that this process is orchestrated by the fetal unit and, in particular, the extravillous trophoblast. Soluble and particulate factors produced by the trophoblast regulate maternal immune cells within the decidua, as well as in the periphery. The aim of this review is to discuss the action of recently discovered immunomodulatory factors and mechanisms, and the potential effects of dysregulation of such mechanisms on the maternal immune response that may result in pregnancy loss or preeclampsia.

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PECULIARITIES OF ALLOGENIC INTERACTIONS IN THE SHORT-TERM CULTURE OF LYMPHOCYTES OF SPOUSES WHO HAVE CHILDREN WITH CONGENITAL HEART DISEASES OR EARLY REPRODUCTIVE LOSSES

Medical Immunology (Russia) ◽

10.15789/1563-0625-2019-2-279-292 ◽

2019 ◽

Vol 21 (2) ◽

pp. 279-292 ◽

Cited By ~ 1

Author(s):

A. V. Shabaldin ◽

S. A. Shmulevich ◽

G. N. Chistyakova ◽

I. I. Remizova ◽

E. B. Lukoyanycheva ◽

...

Keyword(s):

Immune Response ◽

Mixed Culture ◽

Congenital Heart Defects ◽

Congenital Heart ◽

Heart Defects ◽

Married Couples ◽

Healthy Children ◽

Short Term ◽

Reproductive Losses ◽

Short Term Culture

We have studied HLA allogeneic interactions in short-term cultures of lymphocytes from the parents having children with congenital heart defects (CHD), or subject to early reproductive losses. Twentyone married couples (CHD as the main group) who had children with sporadic CHD (interventricular septal defect) without chromosomal diseases were observed. Fifty married couples (a comparison group) had two or more reproductive losses in early gestation (up to 9 weeks), denoted as PNPs (miscarriages, missed abortions, habitual miscarriages. Forty-one families with three or more healthy children represented a control group. Immune response in cell cultures was evaluated by increasing expression of HLA-DR in a mixed culture, as compared to spontaneous lymphocyte cultures. Initial labeling of female and male lymphocytes with monoclonal antibodies to CD45 conjugated to different fluorescent dyes (PC-5 and PC-7) allowed us to evaluate the immune response of female lymphocytes to males and vice versa. The suppressor effect of autologous female serum upon the mixed culture of the lymphocytes of the spouses was also evaluated. Results of the present study showed a difference in HLA allogeneic interactions in the short-term culture of lymphocytes registered for spouses with reproductive losses and children with congenital heart defects. Reproductive losses were associated with a low blocking effect of female auto-serum upon allogeneic HLA interactions in the short-term culture of the lymphocytes of the spouses. Congenital heart defects were associated with high activity of female B-lymphocytes (CD3-/HL-DR+) in short-term mixed culture of lymphocytes from the spouses.

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Successful Pregnancy Outcomes after Septum or no Septum Resection in Patients with Recurrent Pregnancy Loss [4B]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000532906.57204.94 ◽

2018 ◽

Vol 131 ◽

pp. 20S

Author(s):

Anna Whelan ◽

Channing Burks ◽

Mary Stephenson

Keyword(s):

Pregnancy Outcomes ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Successful Pregnancy

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Successful Subsequent Pregnancy in a Woman Receiving Eculizumab for Pregnancy-Associated Atypical Haemolytic Uraemic Syndrome

Case Reports in Nephrology ◽

10.1155/2019/2738723 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Samantha Bateman ◽

Maleeka Ladhani ◽

Shilpanjali Jesudason

Keyword(s):

Renal Function ◽

Haemolytic Uraemic Syndrome ◽

Rescue Therapy ◽

Significant Risk ◽

First Trimester ◽

Subsequent Pregnancy ◽

Baby Girl ◽

Successful Pregnancy ◽

Atypical Haemolytic Uraemic Syndrome ◽

History Of

Atypical haemolytic uraemic syndrome (aHUS) is a form of thrombotic microangiopathy precipitated by unopposed complement activation, the treatment of which has been revolutionised by the availability of the monoclonal anti-complement (C5) antibody, eculizumab. Historically, women with aHUS would be unable to achieve a successful pregnancy due to the severity of their renal disease and for the few who could conceive, recurrence of aHUS was a significant risk. In spite of this, parenthood remains a priority for many. Experience with eculizumab use in the management of aHUS during pregnancy is growing and with it comes a significant change in the course of the disease. We present the case of a 28-year-old woman diagnosed with severe aHUS in the first trimester of her first pregnancy. She received rescue therapy with eculizumab and had a return to normal renal function. While this pregnancy was lost, she strongly desired a family. We managed her through a subsequent pregnancy while receiving eculizumab. This pregnancy was uncomplicated and carried to term and she birthed a healthy 2500 g baby girl. The complexities of managing a pregnancy in a woman with a history of aHUS are vast but not insurmountable, as demonstrated by this case.

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The Marital Helping Relationship Following Pregnancy Loss and Infant Death

Journal of Family Issues ◽

10.1177/019251392013001006 ◽

1992 ◽

Vol 13 (1) ◽

pp. 81-98 ◽

Cited By ~ 10

Author(s):

LAURA S. SMART

Keyword(s):

Qualitative Study ◽

Support Group ◽

Emotional Support ◽

Infant Death ◽

Pregnancy Loss ◽

Married Couples ◽

The Other ◽

Mutual Support ◽

Peer Support Group ◽

Helping Relationship

Few studies have examined the therapeutic helping relationship within married couples, and those that have done so have considered stressor events that affect one spouse more than the other. This qualitative study of couples who experienced pregnancy loss and infant death explores the emotional support that spouses give to their partner. A minority of couples did not provide support to each other. In most couples, however, the support was described by both partners as mutual. Among all couples who provided mutual support, most of these perceived a fairly even exchange; some saw the husband as providing more support than he received, and one couple felt that the wife had been the primary helper. Couples who provided very little support to each other were helped by attending a peer support group.

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Early embryonic losses at HLA compatibility in married couples

Journal of obstetrics and women s diseases ◽

10.17816/jowd64369-80 ◽

2015 ◽

Vol 64 (3) ◽

pp. 69-80

Author(s):

Alana Olegovna Agnaeva ◽

Olesya Nikolaevna Bespalova

Keyword(s):

Reproductive Medicine ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Married Couples ◽

Controversial Issue ◽

Spontaneous Abortions ◽

Hla System ◽

Frequent Complication ◽

Hla Compatibility

Despite achievements in area of reproductive medicine, recurrent pregnancy loss (RPL) remains the most frequent complication of pregnancy. While the majority of spontaneous abortions (50-75 %) are sporadic and don’t repeat, 2-5 % of couples face problem of repeated pregnancy losses. There is a set of various reasons of such situation. The immunological reasons occupy one of the leading places. Role of HLA system in reproductive failure and methods of their correction are studied since the beginning of the 1960th. A large number of works is devoted to this subject. However still there is a controversial issue: “does the immunization (active or passive) increase the frequency of pregnancy approach and childbirth in women with RPL and repeated implantation losses in ART cycles?”

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Modulation of systemic hemostatic parameters by enoxaparin during gestation in women with thrombophilia and pregnancy loss

Thrombosis and Haemostasis ◽

10.1160/th05-03-0212 ◽

2005 ◽

Vol 94 (11) ◽

pp. 980-985 ◽

Cited By ~ 20

Author(s):

Zeev Blumenfeld ◽

Ronit Leiba ◽

Naomi Lanir ◽

Benjamin Brenner ◽

Galit Sarig

Keyword(s):

Pregnancy Outcome ◽

Pregnancy Loss ◽

Protein S ◽

Study Groups ◽

Control Group ◽

Activity Levels ◽

Successful Pregnancy ◽

Free Protein ◽

Outcome Group ◽

D Dimer

SummaryRecurrent pregnancy loss (PL) is associated with maternal thrombophilia and prophylaxis with low molecular weight heparin (LMWH) can improve pregnancy outcome in this setting. The aim of this study was to investigate the modulation of systemic hemostatic parameters by enoxaparin in women with recurrent PL and to evaluate plasmatic parameters that would potentially enable monitoring LMWH prophylaxis effect during pregnancy. Study group included 87 women with thrombophilia and PL treated with enoxaparin 40 mg daily vs. 40 mg twice daily. The control group comprised 40 women with normal pregnancies. Blood samples have been collected throughout the period starting at 5-10 weeks of gestation until 6-10 weeks postpartum. The determined plasmatic markers included: anti-Xa activity, total and free tissue factor pathway inhibitor (TFPI), D-dimer, prothrombin fragment 1+2 (PT1+2), activated protein C resistance (APC-SR) and free protein S. Successful pregnancy outcome was recorded in 70 (80.5%) women treated with enoxaparin, with-out correlation to enoxaparin dosage. Seventeen women (19.5%) had pregnancy loss at 16±7 (6-32) weeks of gestation. Anti-Xa levels at 10-15 weeks of gestation were higher (0.39±0.38 u/ml) in the successful pregnancy outcome group compared to the abortion group (0.22±0.2 u/ml). Prophylactic anti-Xa activity levels (0.28±0.13 u/ml) were documented from 15 weeks of gestation until delivery in the successful pregnancy outcome group. Significant increase in anti-Xa, total TFPI and free TFPI levels (P<0.001) was achieved after beginning of LMWH prophylaxis in successful pregnancy outcome group but not in the abortion group. D-dimer and PT1+2 levels appeared to be significantly increased while APC-SR and free protein S levels gradually decreased during pregnancy, with no difference between study groups. These results suggest that LMWH prophylaxis during pregnancy enables modulation of systemic hemostatic parameters via inhibition of factor Xa and increase in plasmatic total and free TFPI levels.

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