Comprehensive analysis of HLA-G expression, hormonal profiles, and inflammatory markers in women with recurrent pregnancy loss
Simi Nadarajan, Arumugam Suresh, Dinesh Roy Divakaran, Natrajan Muninathan, Venugopal Gopikrishnan, Jeena Jose, Aswathi Palakkattu VeetilAbstract
Objectives
This study aimed to investigate the role of Human Leukocyte Antigen-G (HLA-G) gene expression, inflammatory cytokines, and hormonal profiles in the pathogenesis of recurrent pregnancy loss (RPL) and to assess their potential as diagnostic and predictive markers.
Methods
A case-control study was conducted involving 240 women, including 120 with clinically confirmed RPL and 120 fertile controls. Serum levels of CRP (C-reactive protein) and IL-6 (interleukin-6) were measured using enzyme-linked immunosorbent assay (ELISA). Hormonal parameters, including thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH), were analyzed using chemiluminescence immunoassays (CLIA). HLA-G gene expression was quantified using quantitative real-time polymerase chain reaction (qRT-PCR). Statistical analyses included t-tests, receiver operating characteristic (ROC) curve analysis, and logistic regression to identify independent predictors.
Results
RPL cases showed significantly higher levels of TSH, FSH, CRP, and IL-6 and markedly lower HLA-G gene expression compared with controls (p < 0.001). CRP showed the highest diagnostic accuracy (AUC = 0.997), followed by HLA-G (AUC = 0.938) and IL-6 (AUC = 0.896). Logistic regression identified IL-6, FSH, TSH, and HLA-G as independent predictors of RPL.
Conclusions
The findings highlight the interplay between immune dysfunction, hormonal imbalance, and reduced HLA-G expression in RPL. These markers may help in the early identification and risk assessment of RPL, with HLA-G showing potential for further investigation as a therapeutic target.