Autoantibodies and Prediction of Reproductive Failure

Authors

  • Yehuda Shoenfeld,

    1. Department of Internal Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; AESKU Institute for Research, Wendelsheim, Germany;
    2. Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmunity Diseases, Tel Aviv University, Tel Aviv, Israel;
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    • *

      These two authors contributed equally to the study.

  • Howard J. A. Carp,

    1. Department of Obstetrics & Genecology, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
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    • *

      These two authors contributed equally to the study.

  • Vered Molina,

    1. Department of Internal Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; AESKU Institute for Research, Wendelsheim, Germany;
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  • Miri Blank,

    1. Center for Autoimmune Diseases, Department of Medicine ‘B’, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel-Aviv;
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  • Ricard Cervera,

    1. Department of Autoimmune Diseases, Institute of Medicine & Dermatology Hospital Clinic, Villaroel, Barcelona, Catalonia, Spain;
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  • Juan Balasch,

    1. Fertility Unit, Institute Clinic of Gynecology, Obstetrics and Neonatology, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Catalonia, Spain;
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  • Angela Tincani,

    1. Rheumatology and Clinical Immunology Unit and Obstetric and Gynecology Dept. Hospital and University of Brescia, Brescia, Italy;
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  • David Faden,

    1. Rheumatology and Clinical Immunology Unit and Obstetric and Gynecology Dept. Hospital and University of Brescia, Brescia, Italy;
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    • This article is dedicated to the late David Faden.

  • Andrea Lojacono,

    1. Rheumatology and Clinical Immunology Unit and Obstetric and Gynecology Dept. Hospital and University of Brescia, Brescia, Italy;
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  • Andrea Doria,

    1. Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy;
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  • Emiliana Konova,

    1. Center for Reproductive Health, University Hospital ‘Dr. G. Stranski’, Pleven, Bulgaria;
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  • Per Luigi Meroni

    1. Allergy, Clinical Immunology & Rheumatology Unit, IRCCS Ist. Auxologico Italiano, University of Milan, Milan, Italy
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Y. Shoenfeld, Department of Internal Medicine ‘B’, Sheba Medical Center, Tel Hashomer, 52621, Israel.
E-mail: 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 4.8[CI, 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.

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