HLA‐DR and DQ Antigens and Anticardiolipin Antibodies in Women With Recurrent Spontaneous Abortions

Abstract

IgG anticardiolipin antibodies (ACL) have been shown to occur in a high proportion of women with repeated unexplained miscarriages. Forty-nine women with unexplained recurrent spontaneous abortions (RSA), previously assayed for the presence of ACL by an enzyme-linked immunoabsorbent assay, were typed for HLA-DR and DQ antigens by the classical microlymphocytotoxicity test. Twenty-five women were positive for ACL and 24 were negative. HLA-DR7 was found in 24.5% of 49 habitually aborting women vs. 28% of healthy controls; but the DR7 frequency was 40% in ACL positive patients vs. 8.3% in ACL negative patients (P = 0.011). These results show that in the Italian population an association between HLA-DR7 antigen and ACL is present in women with unexplained RSA, suggesting that HLA-DR genes might control the susceptibility to specific autoantibody production.

Familial antiphospholipid antibody syndrome: Criteria for disease and evidence for autosomal dominant inheritance

“…Further confounding factors might be the underlying diagnosis (primary versus secondary APS) and the definition or measurement of antiphospholipid antibodies. Two studies of patients with primary APS have indicated an increased frequency of class II MHC alleles HLA-DR4 and DR7, specifically DRw53 (14,15). Other studies of SLE and patients with secondary APS have supported these findings (16)(17)(18)(19).…”

Is HLA class II susceptibility to primary antiphospholipid syndrome different from susceptibility to secondary antiphospholipid syndrome?

“…5 Genetic predisposition to APS and antiphospholipid antibodies has been reported in different studies, and may be conferred in part by the major histocompatibility complex. Antiphospholipid syndrome and PAPS are associated with DR4, DR5, DR7, DR53 and DQ7 antigens in Latin and Anglo-Saxon populations, [6][7][8][9][10][11][12] and the presence of aCL has been associated with HLA DR4, DR7 antigens and the DQB1 ¤ 0302 allele in a large series of European patients with SLE. 13 Recently, an association of the DQB1 ¤ 0604/5/6/7/9-DQA1 ¤ 0102-DRB1 ¤ 1302 haplotype with APS and also with the anti-b2-glycoprotein I (b2-GPI) antibody was demonstrated in Britons, however, the previous association with DR4 and DR7 was not observed.…”

HLA DRB1 and HLA DQB1 Alleles in Bulgarian Patients with Primary and Secondary Antiphospholipid Syndrome

“…In the third group (PAPS progressing subsequently to SLE) the allele prevalence was different: DRB1*03 and DQB1*0201 are less prevalent and DRB1*13, DQB1*06, and DQB1*0302 alleles are more prevalent. Trabace et al [5] investigated Italian women with recurrent spontaneous abortions and found that half of them were aCL-positive, and half were aCL-negative. HLA-DR7 was detected in 28% of the controls and in 24.5% of the investigated patients, but the prevalence of HLA-DR7 was much higher in the a CL-positive women (40%), compared to that in the aCL-negative (8,3%).…”

“…Some studies investigate the relation between APS and HLA class II alleles [4,6], others -the relation to LA [9], to aCL [5,13,15,17], LA and aCL [7,8], aB2GPI [10,11,14,16,18], or aCL, LA, aB2GPI, aPS/aPT [12]. Moreover, different ethnic groups have been studied -Hungarians [4], Italians [5,12], Southern Spain [6], Canadians [7], Caucasions [14], Americans [9], Caucasians, African Americans and Mexican Americans [10,16], British [8,11], Mexicans [13], Dannish and Czech [15], Brazilians [17], Europeans [18], Greek, Caucasian Americans, African Americans and Mexican Americans [16]. Different comparative analyses have been performed -SLE, SAPS, PAPS [4,6,7,8,9,11,12,17], SLE [10,13,14,18], patients with problematic pregnancy [5,15].…”