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Hum. Reprod. Advance Access originally published online on September 18, 2006
Human Reproduction 2007 22(2):440-443; doi:10.1093/humrep/del377
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Toll-like receptor 4 polymorphisms and idiopathic chromosomally normal miscarriage

A.F. Hirschfeld1, R. Jiang2, W.P. Robinson2, D.E. McFadden3 and S.E. Turvey1,4

1 Department of Paediatrics, BC Children’s Hospital and Child & Family Research Institute 2 Department of Medical Genetics and 3 Department of Pathology, University of British Columbia, Vancouver, BC, Canada

4 To whom correspondence should be addressed at: Division of Infectious and Immunological Diseases, BC Children’s Hospital and Child & Family Research Institute, Room 371, 950 West 28 Avenue, Vancouver, BC, Canada V5Z 4H4. E-mail: sturvey{at}cw.bc.ca

BACKGROUND: Lipopolysaccharide (LPS or endotoxin) exposure resulting from microbial invasion of the endometrium disturbs the Th1/Th2 balance at the feto-maternal interface and has been linked to the risk of idiopathic miscarriage in a range of human and animal studies. Toll-like receptor 4 (TLR4) mediates LPS signalling, and the human TLR4 gene harbours two single-nucleotide polymorphisms (SNPs) known to reduce LPS responsiveness. We hypothesized that genetic variation altering TLR4 function may influence the risk of idiopathic pregnancy loss. METHODS AND RESULTS: We examined fetal TLR4 genotypes in a case-control cohort of chromosomally normal miscarriages (n = 96) and healthy term newborns (n = 113). The allele frequencies of the Asp299Gly and Thr399Ile TLR4 SNPs were determined by quantitative PCR using DNA extracted from extraembryonic tissues and umbilical cord blood, respectively. TLR4 genotype frequencies were not significantly different between cases and controls. CONCLUSIONS: There was no association between fetal TLR4 polymorphisms, Asp299Gly and Thr399Ile, known to blunt LPS responsiveness, and the risk of idiopathic, chromosomally normal miscarriage. Nevertheless, TLR4 or perhaps other LPS-binding chaperone molecules are biologically plausible candidate genes that may alter the risk of idiopathic miscarriage.

Key words: miscarriage/TLR4/polymorphism/innate immunity/lipopolysaccharide


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G. Rey, F. Skowronek, J. Alciaturi, J. Alonso, B. Bertoni, and R. Sapiro
Toll receptor 4 Asp299Gly polymorphism and its association with preterm birth and premature rupture of membranes in a South American population
Mol. Hum. Reprod., September 1, 2008; 14(9): 555 - 559.
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