Anne serumundaki çözünebilir HLA-G düzeylerinin missed abortuslar ile ilişkisi
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Dosyalar
Tarih
2012
Yazarlar
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Fetal genlerin yarısı baba kaynaklıdır ve gebelikte annede fetüse karşı immun toleransın nasıl geliştiği açık değildir. Fetal dokuların reddini önleyen moleküllerden biri de, aynı zamanda anne serumunda da saptanabilen çözünebilir HLA-G (sHLA-G)'dir. Bu molekül başlıca ekstravillöz trofoblastlar, plasental makrofajlar ve mezenkimal koryonik villuslardaki endotelyal hücreler tarafından üretilir. sHLA-G, gebe olmayan kadınların serumunda da saptanmasına rağmen gebelerde daha yüksek düzeylerde saptanır. Gebelik kayıplarının patogenezinde maternal immün tolerans ile ilgili sorunlar olduğu düşünülmektedir. Çalışmamızın amacı, anne serum sHLA-G düzeylerinin, missed abortus ile olan ilişkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 40 normal ve 40 missed abortus olmak üzere toplam 80 gebe dahil edildi. Rutin gebelik takibi için başvuran olgulara transvajinal ultrasonografi ve laboratuar parametrelerine ek olarak anne serumundaki sHLA-G düzeyine bakıldı. Bulgular: Gruplar arasında demografik parametreler açısından fark saptanmadı. Çalışma grubu hastalarının ortanca serum sHLA-G düzeyleri kontrol grubundaki gebelerin ortanca serum sHLA-G düzeylerinden anlamlı olarak daha düşük bulundu (P< 0,001). Sonuç: Missed abortus riski artmış kadınların öngörülmesinde, anne serum sHLA-G ölçümü prenatal tanıda önemli ve yeni bir tanısal araç olabilir.
Introduction: Half of fetal genome is originated from paternal chromosome, and it is unclear how immune tolerance develops to fetal tissues in pregnancy. Soluble HLA-G (sHLA-G) which is detectable in maternal serum is one of the molecules that prevent fetal rejection in pregnancy. This molecule is expressed by extravillous trophoblasts, placental macrophages and endothelial cells of mesenchymal chorionic villuses. Although sHLA-G is detectable in serum of non-pregnant women at low levels, it is detectable in mainly pregnancy with high serum levels. Problems concerning the maternal immune tolerance are thought to play role in pregnancy wastage. The aim of our study is to detect the relationship between the missed abortus and maternal serum HLA-G levels. Materials and Methods: 40 women with missed abortuses and 40 women with uncomplicated pregnancies, 80 women in total were included into the study. Serum HLA-G levels were measured in addition to routine transvaginal ultrasonography and laboratory work-up during pregnancy visits. Results: Demographic parameters were statistically similar between the groups. Median serum HLA-G level in study group was statistically lower than the median serum HLA-G level of control group (P< 0,001). Conclusion: Maternal serum sHLA-G measurement can be used as a new diagnostic tool in predicting the pregnant women with high risk of missed abortus.
Introduction: Half of fetal genome is originated from paternal chromosome, and it is unclear how immune tolerance develops to fetal tissues in pregnancy. Soluble HLA-G (sHLA-G) which is detectable in maternal serum is one of the molecules that prevent fetal rejection in pregnancy. This molecule is expressed by extravillous trophoblasts, placental macrophages and endothelial cells of mesenchymal chorionic villuses. Although sHLA-G is detectable in serum of non-pregnant women at low levels, it is detectable in mainly pregnancy with high serum levels. Problems concerning the maternal immune tolerance are thought to play role in pregnancy wastage. The aim of our study is to detect the relationship between the missed abortus and maternal serum HLA-G levels. Materials and Methods: 40 women with missed abortuses and 40 women with uncomplicated pregnancies, 80 women in total were included into the study. Serum HLA-G levels were measured in addition to routine transvaginal ultrasonography and laboratory work-up during pregnancy visits. Results: Demographic parameters were statistically similar between the groups. Median serum HLA-G level in study group was statistically lower than the median serum HLA-G level of control group (P< 0,001). Conclusion: Maternal serum sHLA-G measurement can be used as a new diagnostic tool in predicting the pregnant women with high risk of missed abortus.
Açıklama
YÖK Tez No: 498526
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
