PREDICTION OF THE COURSE OF THE FIRST TRIMESTER OF PREGNANCY AT DIFFERENT LEVELS OF HLA CLASS I (G, E, C) IN THE BLOOD.
2Department of Immunology Cells-interactions, The Research Institute of Obstetrics, Gynecology and Reproductology Named After D.o.ott, Saint-Petersburg
Problem statement. HLA class I (C,E,G,F) controls the interaction of all immunocompetent cells and determines the recognition of its own and foreign cells, triggering and realizing the immune response: during the process of implantation, during transplantation of foreign organs and tissues. Thus, one of the most important areas of research in the field of reproductive medicine is the search for biological markers for predicting the development of threatened miscarriage and termination of pregnancy in the first trimester. Purpose — to assess the levels of biological molecules sHLA-G, HLA-G, HLA-E, HLA-C in the blood and to study the characteristics of the course of the first trimester in pregnant women with reproductive disorders depending on differences in the levels of HLA-G, -E and -C in the blood.
Methods. A prospective cohort study was conducted in 70 women in the first trimester of pregnancy (up to 13 weeks). All patients were determined the levels of HLA class I expression products (sHLA-G, HLA-G, HLA-E, HLA-C), PIBF and TBG in blood plasma and, depending on the reproductive history, they were divided into 2 groups: Group 1 - 38 pregnant women with a burdened reproductive history (one or more miscarriages, missed abortion, ART failures), group 2 - 32 pregnant women without reproductive losses. In all patients, the content of the HLA-C level in peripheral venous blood was determined, after which the women were monitored throughout pregnancy.
Results. Different levels of sHLA-G, HLA-G, HLA-E, HLA-C were identified in the blood plasma depending on the obstetric anamnesis and the clinical course of the current pregnancy. An HLA-C value of ≥118µg/mL predicts threatened early miscarriage with an accuracy of 81,5% and a specificity of 89,3%. Associations were established between the level of HLA-G and spontaneous miscarriages (p=0.017),HLA-E with chronic endometritis(p=0.020),HLA-C with missed abortions (0.017).
Conclusion. The level of HLA-C in blood makes it possible to predict the development of a threatened miscarriage in early gestational age, take preventive measures in a timely manner, has good reproducibility, simplicity and accessibility of performing and interpreting the results, suggests a single examination of a woman has high accuracy–81,5% and specificity-89,3%.
