Publication: Decidual ve plazma kompleman düzenleyici genlerin ekspresyon düzeyleri ile maternal serum anti-trophoblastik antikor (ATA) düzeylerinin idiyopatik tekrarlayan ve spontan abortlarda araştırılması
Abstract
Amaç: Tekrarlayan gebelik kaybı, yirminci gebelik haftası öncesi, iki ya da daha fazla gebelik kaybı olarak tanımlanır. Bu komplikasyon, multifaktöriyel patogenezi nedeniyle bazı durumlarda tam olarak açıklanamamaktadır. Bu çalışmada, patogenezde etkili kompleman gen ekspresyonu ve C3a, C5a kompleman ürünlerin araştırılması amaçlanmıştır. Ayrıca antikor aracılı reaksiyon gelişiminin tespiti için anti-HLA ve ATA serum faktörlerine bakılması planlanmıştır.Gereç ve yöntem: Spontan düşüğü olanlar (n=9), kontrol grubu olarak, tekrarlayan gebelik kaybı olanlar (n=16) hasta grubu olarak kullanılmıştır. Doku CD55, CD46 ve CD59 ekspresyon düzeyleri, eş zamanlı PZR yöntemiyle çalışılmıştır. Fetüs survisi için önemli olan C3a, C5a ve anti-trophoblastik antikor ise ELISA yöntemi ile analiz edilmiştir. Bulgular: Çalışmamızda hasta grubunda, kontrol grubuna kıyasla CD55 ekspresyon seviyesi yüksek, serum C3a düzeyi düşük saptandı (p<0,05). CD46 ekspresyon seviyeleri ise iki grup arasında farklı olmasına rağmen, CD55 ekspresyon artışı kadar dikkat çekici bulunmadı (p>0,05). Analiz edilen hastaların eşlerine karşı HLA açısından duyarlılaşma reaksiyonu saptanmadı.Sonuç: Sonuç olarak çalışmamızda vaka grubunda kontrollere kıyasla görülen yüksek CD55 ekspresyonu, kompleman aracılı doku hasarına işaret etmektedir. Tekrarlayan düşüklerin gerçekleşmeden öngörülebilmesi, erken ve uygun tedavi ile önlenebilmesi için kompleman sistemi düzenleyicilerin, özellikle CD55’in ve C3a’nın potansiyel bir biyobelirteç olabileceği düşünülebilir.
Objective: Recurrent pregnancy loss is defined as the loss of two or more pregnancies before the twentieth gestational week. This complication cannot be fully explained in some cases due to its multifactorial pathogenesis. In this study, it was aimed to investigate complement gene expression and C3a, C5a complement products effective in pathogenesis. In addition, it was planned to examine anti-HLA and ATA serum factors for the detection of antibody-mediated reaction development.Materials and methods: Those with spontaneous abortion (n = 9) were used as the control group, and those with recurrent pregnancy loss (n = 16) were used as the patient group. Tissue CD55, CD46 and CD59 expression levels were studied with the simultaneous PCR method. C3a, C5a and anti-trophoblastic antibodies, which are important for fetal survival, were analyzed by ELISA method.Results: In our study, CD55 expression level was higher and serum C3a level was lower in the patient group compared to the control group (p <0.05). Although CD46 expression levels were different between the two groups, it was not as remarkable as the increase in CD55 expression (p> 0.05). No sensitization reaction in terms of HLA was detected against the spouses of the analyzed patients.Conclusion: In conclusion, the high CD55 expression observed in the case group in our study compared to controls indicates complement-mediated tissue damage. It can be thought that complement system regulators, especially CD55 and C3a, can be a potential biomarker in order to predict recurrent miscarriages before they occur and to prevent them with early and appropriate treatment.
Objective: Recurrent pregnancy loss is defined as the loss of two or more pregnancies before the twentieth gestational week. This complication cannot be fully explained in some cases due to its multifactorial pathogenesis. In this study, it was aimed to investigate complement gene expression and C3a, C5a complement products effective in pathogenesis. In addition, it was planned to examine anti-HLA and ATA serum factors for the detection of antibody-mediated reaction development.Materials and methods: Those with spontaneous abortion (n = 9) were used as the control group, and those with recurrent pregnancy loss (n = 16) were used as the patient group. Tissue CD55, CD46 and CD59 expression levels were studied with the simultaneous PCR method. C3a, C5a and anti-trophoblastic antibodies, which are important for fetal survival, were analyzed by ELISA method.Results: In our study, CD55 expression level was higher and serum C3a level was lower in the patient group compared to the control group (p <0.05). Although CD46 expression levels were different between the two groups, it was not as remarkable as the increase in CD55 expression (p> 0.05). No sensitization reaction in terms of HLA was detected against the spouses of the analyzed patients.Conclusion: In conclusion, the high CD55 expression observed in the case group in our study compared to controls indicates complement-mediated tissue damage. It can be thought that complement system regulators, especially CD55 and C3a, can be a potential biomarker in order to predict recurrent miscarriages before they occur and to prevent them with early and appropriate treatment.