HLA-Dependent TNF Secretory Response May Provide an Immunogenetic Link between Pre-Eclampsia and Type 1 Diabetes Mellitus

Tumour necrosis factor (TNF) may be relevant to the pathogenesis of both pre-eclampsia and type I diabetes, and there is evidence than human TNFα responses to stimuli are HLA-DR dependent. To test the hypothesis that pre-eclampsia and diabetes may share a common immunogenetic susceptibility, 92 pre-eclampsia patients were compared with 264 general population controls. The relative frequencies of individual HLA-DR antigens in pre-eclamptics were found to correlate with reported relative TNFα responses for those antigens. Moreover, putative high responder HLA-DR I, DR3 and DR4 alleles were significantly (p<0.00 I) more frequent in pre-eclampsia patients (79%) than in controls (59%). This hypothesis could explain the weak association between pre-eclampsia and diabetes and may help resolve the apparently conflicting literature on HLA in pre-eclampsia.