Association Between Maternal Soluble Human Leukocyte Antigen-G and Pre-eclampsia: A Case– control Study

Abstract

Introduction: Pre-eclampsia is a severe complication in pregnancy that is typified by high blood pressure (BP) and generalized endothelial ailment after 20 weeks of pregnancy. There is a growing body of evidence that maternal-fetal immune tolerance impairment is a contributor to its pathogenesis. Human leukocyte antigen-G (HLA-G) is a non-classical major histocompatibility complex class I molecule, is mainly expressed in the trophoblast cells and essential in the maternalfetal immune tolerance during pregnancy.

Objectives: This study aims to detect the soluble isoform of HLA-G (sHLA-G) in maternal blood and use it as a potential biomarker of pregnancy complications.

Methods: A case-control study included 120 pregnant women, 60 with a pre-eclampsia and 60 normotensives pregnant as controls. Concentrations of sHLA-G in maternal serum were detected using an enzyme-linked immunosorbent assay (ELISA). The comparative study of biomarker levels in the groups and the predictive power of sHLA-G was carried out with the help of statistical analyses.

Results: The levels of maternal serum sHLA-G were lower in women with pre-eclampsia than in controls (38.6 ± 10.4 U/mL vs. 62.3 ± 14.7 U/mL, p < 0.001). The logistic regression analysis proved that reduced sHLA-G was a common factor that predisposed to pre-eclampsia. Analysis using the ROC curve revealed moderate accuracy, as reflected by an area under the curve (AUC) of 0.79.

Conclusion: These results indicate that lower maternal levels of sHLA-G may associated with pre-eclampsia. Maternal sHLA-G measurement could be an interesting biomarker to monitor high-risk pregnancy and identify early diagnosis and risk.