Abstract
The primary aim of the current study is to decide if genetic polymorphisms of the killer immunoglobulin-like receptor (KIR) and human leukocyte antigen (HLA-C) genes are related to recurrent spontaneous abortion (RSA) in the Saudi women who are affected with polycystic ovarian syndrome (PCO) and in PCO patients without RSA.
The study was conducted in Riyadh and included 199 cases divided as follows: 69 PCO Saudi women with an RSA history, i.e. three or more spontaneous abortion cases, 65 patients were exclusively with PCO and 65 healthy controls, typed for 17 KIR genes and the HLA-C1 and HLA-C2 allotypes using polymerase chain reaction-sequence-specific primer methodology.
The study reported that the recurrences of KIR3DL1, 2DS4ins, 2DL2, and KIR2DS2 significantly reduced among RSA-PCO women in comparison with healthy controls (OR = 337.45, 39.08, 2.4, 4.59 with p < 0.01) and a connection with maternal HLA-C genotypes was also examined. Furthermore, the analysis of KIR-HLA-C combinations demonstrated a preventive impact of KIR2DS2, 2DL2, 2DL2/2DL3, 2DL3 with its counterpart HLA-C1 ligand in both homozygote or heterozygote combinations. Such findings were also reported in PCO women. With regard to recurrences, KIR2DL1 marked the highest significant frequenting in both PCO women and RSA-PCO women in comparison with control in the presence of HLA-C2 and homozygote form (HLA-C2C2). However, this frequency decreases in the absence of HLA-C2 ligand. In addition, KIR2DS2, KIR2DL3 significantly increased in the absence of HLA-C1 ligand in both PCO group and RSA-PCO group when compared with healthy cases.
It can be concluded from the results of the study that the KIR genes (2DS2, 3DL1, 2DL2, 2DL3) may play a vital role in the protection opposing PCO and RSA in the presence of HLA-C1 ligand which ensures successful pregnancy, and KIR2DL1 is a risk factor for PCO and RSA with HLA-C2 ligand.