Abstract:
The levels of maternal immunostimulation (required throughout the gestationperiod) and immunosuppression (needed from the 8th week to labour), asassessed by the mixed lymphocyte reaction (MLR), have been successfullycorrelated with the outcome of pregnancy. Our laboratory has recently reportedthat serum-soluble human leucocyte antigen (HLA) class I and II concentrationscan be predictive for successful pregnancy outcome. In fact, there is a directcorrelation between soluble class II concentrations and maternalimmunostimulation because, as expected, these serum HLA concentrations areaugmented in the first and second trimester of pregnancy and remain stablethereafter. By the same token, serum HLA class I concentrations are low duringthe first trimester, correlating with the required absence ofimmunosuppression, whereas they increase in subsequent trimesters assuppression becomes desirable for counteracting the maternal stimulation,which may otherwise become dangerous to the fetus. In this study, we presentbiological and statistical evidence that both states of maternalimmunostimulation and immunosuppression, reflected by serum soluble HLA classII and class I antigens, do correlate with results obtained by standard MLRand can be predictive of pregnancy failure. The establishment of statisticallysignificant correlations renders the measurement of soluble HLA a reliabletest for determining the immunological status of the gestating woman. Theunambiguous advantage of such an approach is that soluble HLA testing will nolonger require the 1 week delay necessary to obtain MLR results, a periodoccasionally crucial for applying treatment to women whose immunologicalindices call for immediate therapeutic intervention.Extra keywords: immunostimulation, immunosuppression,recurrent abortion, soluble class I antigens, soluble class II antigens.