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THE ROLE OF KILLER CELL IMMUNOGLOBULIN-LIKE RECEPTORS IN RECURRENT SPONTANEOUS ABORTION.
Laura Wright, MSc, Fionnuala Williams, PhD, Derek Middleton, PhD and Deborah Sage, PhD. London United Kingdom, National Blood Service, Tooting, SW17 0RB, Histocompatibility and Immunogenetics Department and Belfast United Kingdom, Belfast City Hospital, BT9 7AB, Northern Ireland Tissue Typing Laboratory.

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Over 40% of Recurrent Spontaneous Abortion (RSA) cases have no known cause. Recent evidence shows Natural Killer (NK) cell activity is abnormally high in women with RSA. Placental trophoblast cells express HLA-C, G, and E which are known killer immunoglobulin-like receptor (KIR) ligands.
We report the results of KIR repertoire analysis of 50 caucasoid RSA patients and their partners. 16 KIR genes were typed using PCR-SSOP.
Of the 50 couples studied, 2% were HLA matched for class I, and 6% KIR matched. Results of KIR gene typing show possible increases in frequency RSA women for KIR3DS1, 2DS1, 2DS3 and 2DL5; all other loci showed comparable frequencies to published data. 2% of RSA women possess the full range of activating KIR genes and 18% the full inhibitory repertoire. Among male partners, 6% possess the full activating KIR repertoire and 30% the full inhibitory repertoire. 64% of RSA women lack an inhibitory KIR present in their partner, and 38% of partners lack an inhibitory KIR present in the RSA women.
Dividing HLA-Cw typing data into group 1 and 2 KIR ligands, 48% of couples express ligands of the same Cw group, with 12% homozygous for opposite groups. 24% of women expressed HLA-C ligands from one group where the partner expressed both, 16% of partners express a single group where the RSA women expressed both.
Among RSA couples there is an increased frequency of activating KIR’s. RSA patients also posses a more limited KIR repertoire compared to their partners with 64% lacking an inhibitory KIR present in the partner.