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Autoantibodies and prediction of reproductive failure
Authors:Shoenfeld Yehuda  Carp Howard J A  Molina Vered  Blank Miri  Cervera Ricard  Balasch Juan  Tincani Angela  Faden David  Lojacono Andrea  Doria Andrea  Konova Emiliana  Meroni Per Luigi
Institution:Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. shoenfel@post.tau.ac.il
Abstract:PROBLEM: To determine which autoantibodies are associated with reproductive failure. METHOD OF STUDY: Sera from 269 patients with autoimmune disease and/or reproductive failure were analyzed for anti-phospholipid (aPL), anti-annexin-V, anti-lactoferrin, anti-thyroglobulin, anti-thyroid peroxidase, anti-prothrombin, anti-nuclear, and anti-saccharomycetes cerevisiae antibodies (ASCA), by enzyme-linked immunosorbent assay. Patients were classified as: recurrent pregnancy loss (RPL), infertility, and autoimmune diseases. The results were compared with those of 120 healthy volunteers. RESULTS: In autoimmune diseases, the prevalence of anti-prothrombin, anti-annexin, anti-phospholipid and anti-nuclear antibodies was significantly higher than in the control group, OR 11.0 CI, 3.5-35.2], 33 CI, 7.2-174.2], 13 CI, 1.4-309.7], and 16.1 CI 2.4-122], respectively. In infertility, the antibodies with significantly higher levels than controls were: aPL OR, 5.11 CI 1.2-25.4], and anti-prothrombin antibodies, OR, 5.15 CI, 2.1-12.7]. In RPL, ASCA, anti-prothrombin and aPL were more prevalent than in controls, OR 3.9 CI, 1.5-10.6], 5.4 CI, 2.4-12.5] and 4.8CI, 1.2-22.2] for each antibody, respectively. Anti-prothrombin antibodies and aPL were more significantly associated with late pregnancy losses than early losses. CONCLUSION: ASCA antibodies have not previously been described in RPL. Nor are anti-prothrombin antibodies usually assessed in infertility or RPL. If these results are confirmed in further studies, these antibodies might be assessed routinely in reproductive failure.
Keywords:Anti-phospholipid antibodies  anti-prothrombin  anti-saccharomycetes cerevisiae antibodies  autoimmunity  infertility  recurrent pregnancy loss
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