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2. Maternal and fetal human leukocyte antigen class Ia and II alleles in severe preeclampsia and eclampsia

Author

Emmery, J., Hachmon, R., Pyo, C. W., Nelson, W. C., Geraghty, D. E., Andersen, A. M. N., Melbye, M., Hviid, T. V. F., Emmery, J., Hachmon, R., Pyo, C. W., Nelson, W. C., Geraghty, D. E., Andersen, A. M. N., Melbye, M., and Hviid, T. V. F.

Abstract

A line of investigations indicate that genes in the human leukocyte antigen (HLA) complex are involved in a successful acceptance of the semiallogeneic fetus during pregnancy. In this study, associations between specific HLA class Ia (HLA-A and -B) and class II (HLA-DRB1, -DQA1, -DQB1, -DPA1 and -DPB1) alleles and the risk of developing severe preeclampsia/eclampsia were investigated in a detailed and large-scale study. In total, 259 women diagnosed with severe preeclampsia or eclampsia and 260 matched control women with no preeclampsia, together with their neonates, were included in the study. HLA genotyping for mothers and neonates was performed using next-generation sequencing. The HLA-DPB1*04:01:01G allele was significantly more frequent (Pc=0.044) among women diagnosed with severe preeclampsia/eclampsia compared with controls, and the DQA1*01:02:01G allele frequency was significantly lower (Pc=0.042) among newborns born by women with severe preeclampsia/eclampsia compared with controls. In mothers with severe preeclampsia/eclampsia, homozygosity was significantly more common compared with controls at the HLA-DPB1 locus (Pc=0.0028). Although the current large study shows some positive results, more studies, also with a functional focus, are needed to further clarify a possible role of the classical HLA genes in preeclampsia.

Published
2016

3. [Food-borne botulism with fatal outcome in a 59-year-old woman].

Author

Emmery J and Ellekvist P

Subjects
Animals, Fatal Outcome, Female, Food Microbiology, Humans, Middle Aged, Botulinum Toxins, Botulism diagnosis, Clostridium botulinum
Abstract

Botulism is a rare and potentially fatal disease caused by toxins produced by Clostridum botulinum. This is a case report of severe and fatal food-borne botulism in a 59-year-old woman. She developed cardiac arrest shortly after admission, most likely due to paralysis of the respiratory muscles. Food botulism was suggested, and she was treated with antiserum pending confirmation of the diagnosis by detection of botulinum toxin in a serum sample. The source of botulism was never confirmed, but was likely to be home-canned fish.

Published
2021

4. Associations between fetal HLA-G genotype and birth weight and placental weight in a large cohort of pregnant women - Possible implications for HLA diversity.

Author

Emmery J, Christiansen OB, Nilsson LL, Dahl M, Skovbo P, Møller AM, Steffensen R, and Hviid TVF

Subjects
Adaptive Immunity, Birth Weight, Case-Control Studies, Cohort Studies, DNA Mutational Analysis, Female, Gene Expression Regulation, Genetic Predisposition to Disease, Genotype, Gestational Age, HLA-G Antigens metabolism, Humans, Organ Size, Placenta pathology, Polymorphism, Genetic, Pregnancy, Transplantation Tolerance, Vascular Remodeling, HLA-G Antigens genetics, Placenta metabolism, Pre-Eclampsia genetics, Sequence Deletion genetics, Trophoblasts metabolism
Abstract

Birth weight and placental weight are crucial parameters for the survival of fetuses and newborns in mammals. High variation in the MHC is important for an effective adaptive immune response. The maternal immune system must be controlled in relation to the semi-allogenic fetus. The immunoregulatory HLA/MHC class Ib gene, HLA-G, is strongly expressed on extravillous trophoblast cells. We investigated birth weight and placental weight of the newborns in mothers heterozygous for an HLA-G 14bp insertion (Ins)/deletion (Del) gene polymorphism. Separate analyses for pregnancies without preeclampsia (n=185), pregnancies complicated by preeclampsia (n=101), and both groups combined, were performed. Interestingly, we observed the highest mean birth weight and placental weight in homozygous 14bp Del/Del newborns, and the lowest in 14bp Ins/Ins newborns (P=0.008 and P=0.009). The 14bp Del/Del genotype is also associated with high expression of HLA-G on the trophoblast membrane. In theory, fetuses and newborns with intermediate weights and sizes would be an optimal compromise for both the fetus/father and the mother compared with very high and low weights. If such fetuses/newborns more often are heterozygous at the HLA-G gene locus, then newborns with two distinct HLA haplotypes are favored, leading to a higher degree of HLA diversity. The results of the study may indicate that a compromise between an intermediate birth weight and placental weight, induction of maternal tolerance by a fetal-derived non-polymorphic HLA class Ib molecule, and favoring of HLA heterozygous offspring, have evolved in humans., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Published
2017
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