HLA-DEPENDENT TNF SECRETORY RESPONSE MAY PROVIDE AN IMMUNOGENETIC LINK BETWEEN PREECLAMPSIA AND TYPE-1 DIABETES-MELLITUS

Tumour necrosis factor (TNF) may be relevant to the pathogenesis of bo th pre-eclampsia and type I diabetes, and there is evidence than human TNF alpha responses to stimuli are HLA-DR dependent. To test the hypo thesis that pre-eclampsia and diabetes may share a common immunogeneti c susceptibility, 92 pre-eclampsia patients were compared with 264 gen eral population controls. The relative frequencies of individual HLA-D R antigens in pre-eclamptics were found to correlate with reported rel ative TNF alpha responses for those antigens. Moreover, putative high responder HLA-DR1, DR3 and DR4 alleles were significantly (p<0.001) mo re frequent in pre-eclampsia patients (79%) than in controls (59%). Th is hypothesis could explain the weak association between pre-eclampsia and diabetes and may help resolve the apparently conflicting literatu re on HLA in pre-eclampsia.