A study on the role of HLA-G 14bp and ACE IN/DEL polymorphisms in pre-eclamptic South Indian women.

Pre-eclampsia (PE) is a pregnancy specific syndrome characterized by hypertension and proteinuria. Defective placentation during early stages of pregnancy in combination with maternal and environmental factors could lead to systemic inflammation, endothelial dysfunction and the manifestation of the clinical symptoms. HLA-G is considered essential for feto-maternal immune tolerance and successful placentation in pregnancy. ACE promotes decidualization, trophoblast proliferation and plays an important role in blood pressure homeostasis. The HLA-G 14bp and ACE IN/DEL polymorphisms have been reported to be associated with the development of pre-eclampsia (PE). The present study aimed at investigating the role of HLA-G and ACE gene polymorphisms in the aetiopathogenesis of PE. A total of 412 (206 PE patients and 206 normal pregnant women) blood samples were collected from Govt. maternity hospital, Hyderabad, India. Genotyping was carried out for both the genes using PCR followed by PAGE for HLA-G and AGE for ACE gene polymorphisms. DD(ACE) genotype was observed to be elevated (52.9% vs. 31.1%) in the patient group and ID(ACE) (29.6% vs. 54.8%) in the control group (p<0.05). However, HLA-G polymorphism did not differ between patients and controls (p>0.05). Further, combined genotype analysis revealed ID(HLA-G) DD(ACE) to be predisposing genotypes and ID(HLA-G) ID(ACE) to be protective toward preeclampsia in south Indian Women. The ACE genotype (DD(ACE)) is associated with high levels of angiotensin and seems to predispose the individual to PE. However, women carrying the intermediate levels of ACE and HLA-G associated combined genotype (ID(HLA-G) ID(HLA-G)) appear to be protective against developing PE.