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[Absence of HL-A homology in couples presenting repeated miscarriages. Trials with multidonor transfusions]
L Gebuhrer1, G Mellier, M Doillon
1Clinique Obstétricale, Hôpital Edouard Herriot, Lyon.
Maternal tolerance of the fetus involves maternal immuno-regulating mechanisms. The genetic control of this immune response depends on the HL-A system. An extreme HL-A antigenic community between parents might cause a decreased immune response and increased miscarriages. Contrary to some studies from the literature, in our experience, HL-A homology in couples with recurrent miscarriages does not seem significant. This absence of homology may be explained by an extreme polymorphism of HL-A antigens identified and isolated every year. The role of maternal blocking antibodies in maternal tolerance of the fetus is also discussed. The results of a protocol of multi-donor transfusions in 8 patients, is presented and reviewed according to the resulting pregnancies and data from the literature.
Maternal tolerance of the fetus involves maternal immuno-regulating mechanisms. The genetic control of this immune response depends on the HL-A system. An extreme HL-A antigenic community between parents might cause a decreased immune response and increased miscarriages. Contrary to some studies from the literature, in our experience, HL-A homology in couples with recurrent miscarriages does not seem significant. This absence of homology may be explained by an extreme polymorphism of HL-A antigens identified and isolated every year. The role of maternal blocking antibodies in maternal tolerance of the fetus is also discussed. The results of a protocol of multi-donor transfusions in 8 patients, is presented and reviewed according to the resulting pregnancies and data from the literature.