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Human Reproduction, Vol. 15, No. 8, 1807-1812, August 2000
© 2000 European Society of Human Reproduction and Embryology

Increased HLA-DR homozygosity associated with pre-eclampsia

Irma de Luca Brunori1,4, Lorella Battini1, Maurizio Simonelli1, Francesco Clemente1, Elena Brunori2, Maria L. Mariotti3 and Andrea R. Genazzani1

1 Department of Reproductive Medicine and Child Development, Division of Gynaecology and Obstetrics, 2 Stella Maris Foundation and 3 Institute of Immunohematology, University of Pisa, S. Chiara Hospital, Via Roma 55, 56100-Pisa, Italy

It is generally accepted that maternal recognition of paternally derived fetal antigens occurs during normal pregnancy and may be beneficial for implantation and maintenance of gestation. Thus, we have investigated the human leukocyte class II DR antigens (HLA-DR), whose role in self and non-self recognition is well known, in women with pre-eclampsia, their partners and in control couples. The HLA-DR antigens were tested in 70 pre-eclamptic primigravidae women and their partners and 70 healthy control couples using the serological Terasaki technique. Our results did not show any particular HLA-DR antigen to be correlated with pre-eclampsia, but a statistically significant increase of only one identifiable HLA-DR antigen, which was presumed to express homozygosity at the HLA-DR locus, in the pre-eclamptic women and their partners: 67.1 versus 7.9% in the control couples (P < 0.000001). The analysis of HLA-DR compatibility between pre-eclamptic women and their partners showed a statistically highly significant increase of the female-to-male compatibility (P = 0.0003) and a lower but significant male-to-female compatibility in comparison with controls (P = 0.014). From our results, it emerges that HLA-DR homozygosity and reduced antigenic disparity seem to be associated to a major risk for pre-eclampsia, which consequently appears to be a `couple's disease'.

Key words: histocompatibility/HLA-DR antigens/homozygosity/pre-eclampsia

4 To whom correspondence should be addressed at: Lung'Arno Simonelli 3, 56100-Pisa, Italy. E-mail: g.arcidiacono{at}obgyn.med.unipi.it


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