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Meta-Analysis
. 2020 May 1;24(2):197-213.
doi: 10.5935/1518-0557.20190067.

Recurrent Spontaneous Abortion (RSA) and Maternal KIR Genes: A Comprehensive Meta-Analysis

Soheila Akbari  1 , Farhad Shahsavar  2 , Reza Karami  1 , Fatemeh Yari  3 , Khatereh Anbari  4 , Seyyed Amir Yasin Ahmadi  5
Affiliations
Meta-Analysis

Recurrent Spontaneous Abortion (RSA) and Maternal KIR Genes: A Comprehensive Meta-Analysis

Soheila Akbari et al. JBRA Assist Reprod. .

Abstract

Natural killer cells (NKs) are the most important cells in the fetomaternal immune tolerance induced through interaction of maternal killer-cell immunoglobulin-like receptors (KIR) and fetal human leucocyte antigens (HLA). Hence, we intend to perform a meta-analysis on the role of maternal KIR genes diversity in recurrent spontaneous abortion (RSA). The present paper is a meta-analysis of previous genetic association studies and our previous original study. The results showed that KIR3DL1 was a significantly protecting factor for RSA (p=0.044; OR=0.833 [0.698-0.995]; fixed effect model). KIR2DS2 (p=0.034; OR=1.195 [1.013-1.408]; fixed effect model) and KIR2DS3 (p=0.013; OR=1.246 [1.047-1.483]; fixed effect model) were significantly risk factors for RSA. For KIR2DS1 there was a high heterogeneity and publication bias. Briefly, the inhibitory gene KIR3DL1 was a protecting factor, and the activating genes KIR2DS2 and KIR2DS3 were risk factors for RSA. However, the effect sizes were not suitable. We suggest further studies on different causes of pregnancy loss, to find the role of KIR2DS1.

Keywords: human leukocyte antigen; killer-cell immunoglobulin-like receptor; meta-analysis; recurrent spontaneous abortion.

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Conflict of interest statement

CONFLICT OF INTEREST

None to declare.

Figures

Figure 1
Figure 1
Cluster analysis of Table 2 based on complete linkage method. The numbers of studies are based on Tables 1 and 2.
Figure 2
Figure 2
KIR2DL1 Funnel plot showing a significant bias for Faridi et al. (2009).
Figure 3
Figure 3
Forest plot of KIR2DL1 (fixed). Favours A shows protecting effect and favours B shows harmful effect (in all figures).
Figure 4
Figure 4
KIR2DL2 Funnel plot showing a significant bias for Hong et al. (2008).
Figure 5
Figure 5
Forest plot of KIR2DL2 (fixed).
Figure 6
Figure 6
Funnel plot of KIR2DL3 shows no publication bias.
Figure 7
Figure 7
KIR2DL3 Forest plot (fixed).
Figure 8
Figure 8
KIR2DL5 Forest plot showing a significant bias for Hiby et al. (2008) study.
Figure 9
Figure 9
KIR2DL5 Forest plot (random).
Figure 10
Figure 10
KIR3DL1 Funnel plot showing a significant bias for Faridi et al. (2009).
Figure 11
Figure 11
KIR3DL1 Forest plot (fixed).
Figure 12
Figure 12
KIR2DS1 Funnel plot showing a huge publication bias which is inconclusive.
Figure 13
Figure 13
KIR2DS1 Forest plot (random).
Figure 14
Figure 14
KIR2DS2 Funnel plot showing a significant bias for Faridi et al. (2009).
Figure 15
Figure 15
KIR2DS2 Forest plot (fixed).
Figure 16
Figure 16
KIR2DS3 Funnel plot showing a rather significant bias for Faridi et al. (2009).
Figure 17
Figure 17
KIR2DS3 Forest plot (fixed).
Figure 18
Figure 18
Funnel plot of KIR2DS4 shows a significant bias for Faridi et al. (2009).
Figure 19
Figure 19
KIR2DS4 Forest plot (fixed).
Figure 20
Figure 20
KIR2DS5 Funnel plot showing a significant bias for Hiby et al. (2008).
Figure 21
Figure 21
KIR2DS5 Forest plot (fixed).
Figure 22
Figure 22
KIR3DS1 Funnel plot showing a significant bias for Hiby et al. (2008) and Faridi et al. (2009).
Figure 23
Figure 23
KIR3DS1 Forest plot (random).
See this image and copyright information in PMC

References

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