Presented lecture at the June 2002 annual meeting of the American Society for Reproductive immunology.
Antiphospholipid Antibodies in Implantation Failures*
Article first published online: 25 MAR 2003
American Journal of Reproductive Immunology
Volume 49, Issue 4, pages 221–229, April 2003
How to Cite
McIntyre, J. A. (2003), Antiphospholipid Antibodies in Implantation Failures. American Journal of Reproductive Immunology, 49: 221–229. doi: 10.1034/j.1600-0897.2003.01197.x
- Issue published online: 25 MAR 2003
- Article first published online: 25 MAR 2003
- Submitted July 24, 2002; revised August 1, 2002; accepted August 5, 2002.
- lupus anticoagulant;
PROBLEM: The amino phospholipids (PL), phosphatidylserine (PS) and phosphatidylethanolamine (PE) are distributed asymmetrically in the plasma membranes of eucaryotic cells. This arrangement involves active transport of PS and PE from the outer to inner membrane leaflet by an aminophospholipid translocase (flipase). Cell activation, injury and programmed cell death (apoptosis) cause collapse of the PS/PE asymmetry by activation of another enzyme system, scramblase. Unlike other cells, the developing trophoblast exteriorizes PS during its differentiation.
METHODS OF STUDY: An analysis of published and unpublished data.
RESULTS: The trophoblast is targeted by antiphospholipid antibodies (aPL), especially to PS (aPS). Cardiolipin is not present in the trophoblast plasma membrane, nonetheless, anticardiolipin (aCL) has been implicated in trophoblast pathology. The aPS and aCL are often crossreactive. Both animal and in vitro experimental models have shown monoclonal and polyclonal aPS and aCL to specifically destroy trophoblast, inhibit syncytium formation, halt human chorionic gonadatropin (hCG) production, and limit trophoblast invasion. Antibodies to PE (aPE) have not been well characterized, however, recent reports from several independent laboratories document that aPE are associated significantly with very early (embryonic) recurrent pregnancy loss (RPL). Umeda and coworkers have shown that during cytokinesis (late telophase) of Chinese hamster ovary (CHO) cells, formation of PE rafts in cleavage furrows is required for completion of cell division and formation of daughter cells. This raises the question whether aPE might interfere with implantation and cell division during embryogenesis.
CONCLUSIONS: A role for aPL in implantation failure and occult pregnancy loss constitutes the basis of this overview.