Objective: Recurrent spontaneous abortion (RSA) represents a significant reproductive health challenge. The intricate balance of immune regulation at the maternal-fetal interface is crucial for maintaining pregnancy, involving complex interactions among multiple molecular pathways. In this way, TLR2 and the BAX have emerged as key players in immune modulation during pregnancy. This study examines the expression profiles of BAX and TLR2 in both mater-nal blood and fetal tissues across various trimesters, aiming to elucidate their potential role in RSA pathogenesis. Materials and Methods: Blood and fetal tissue samples were collected from 120 participants (60 RSA cases and 60 controls) in the first and second trimesters. The gene expression of all speci-mens was measured using real-time PCR analysis. Correspondingly, Western blot analysis was used to evaluate the protein expression of all samples. Results: The p-values of BAX (0.0168) and TLR2 (0.0014) are much smaller than 0.05, indicat-ing that the difference in these genes' expression between the two trimesters is statistically signif-icant. BAX expression is substantially different between the first and second trimesters (p-value = 0.0168). There is a significant difference in TLR2 expression between the first and second trimesters (p-value = 0.0014). The p-values for both comparisons are extremely small (p<0.05), indicating that the difference in BAX and TLR2 expression between normal and RSA patients is highly significant. Notably, both BAX and TLR2 are significantly upregulated in RSA patients compared to normal blood, with statistically significant differences in expression. BAX shows a substantial decrease in expression between the first and second trimesters, indicating a downreg-ulation of apoptotic processes as the pregnancy advances. Meanwhile, the protein expression of these genes had remarkable upregulation except for a decrease in the tissues of the embryos of the first trimester. Conclusion: The expression of BAX is highly upregulated in RSA patients compared to normal blood. The slight reduction in expression in the second trimester suggests that BAX, which is involved in apoptosis, may play a more prominent role in the early stages of pregnancy compli-cations such as RSA. Its continued elevated expression in the second trimester indicates its sus-tained involvement in the pathophysiology of RSA.
Babaei et al. (Fri,) studied this question.