Decidual killer immunoglobulin-like receptor (kir)2dl1 expression and the onset of preeclampsia, birth weight and placental weight in early and late onset preeclampsia

• Main Authors: Khairunnisa Abd Rauf, Gustaaf A. Dekker, Agus Sulistyono, Aditiawarman, Ariyanto Harsono, Khanisyah Erza Gumilar, Ernawati, Erry Gumilar Dachlan
• Format: Other NonPeerReviewed
• Language: English; English
• Published: ScenceDirect 2018
• Subjects: R Medicine (General); RG Gynecology and obstetrics
• Online Access: http://repository.unair.ac.id/105911/1/Decidual%20Killer.pdf; http://repository.unair.ac.id/105911/2/Decidual.pdf; http://repository.unair.ac.id/105911/; https://www.sciencedirect.com/science/article/pii/S2210778918303568?via%3Dihub; https://doi.org/10.1016/j.preghy.2018.08.166
• Institution: Universitas Airlangga

Introduction Successful remodelling of spiral artery ensures adequate uteroplacental perfusion and sufficient nutrient supply to the fetus. HLA-C interaction with maternal KIR determines the outcome of spiral artery remodelling. Strong inhibitory KIR2DL1 lower the expression of cytokines and angiogenic factors affecting uteroplacental perfusion and nutrient supply. Material and methods We analysed the decidual expression of KIR2DL1 in early and late preeclampsia groups by quantitative immunohistochemistry using anti human-KIR2DL1/CD158a antibody and its correlation with preeclampsia onset, birth weight and placental weight. 35 patients, 14 patients with early onset preeclampsia (EO-PE) and 21 with late preeclampsia (LO-PE) were analysed. Result There was a significant difference between the expression of KIR2DL1 between the EO-PE and LO-PE group (p < 0,001) with a strong negative correlation between decidual expression of KIR2DL1 and preeclampsia onset (p < 0,001, r = −0,723), birth weight (p < 0,001, r = −0,770) and placental weight (p < 0,001, r = −0,770). Conclusion In patients with EO-PE, the higher placental of KIR2DL1 and inhibitory KIR2DL1 contributes to earlier onset of preeclampsia, lower birth weight of the baby and low placental weight. The strong negative correlation might be due to much lower expression of cytokines and angiogenic factors in higher KIR2DL1 expression samples. The different expression of KIR2DL1 between EO-PE and LO-PE is in line with current concepts on different pathophysiologic pathway leading to these different PE phenotypes.