Abstract
ObjectiveThe role of antiphospholipid antibodies (aPL) during apparently normal pregnancy is still unclear. IgA aPL are prevalent in populations of African origin. Our aim was to measure all isotypes of anticardiolipin (anti-CL) and anti–β2 glycoprotein I (anti-β2GPI) in healthy pregnant and non-pregnant women of different ethnicities.MethodsHealthy Sudanese pregnant women (n = 165; 53 sampled shortly after delivery), 96 age-matched Sudanese female controls and 42 healthy pregnant and 249 non-pregnant Swedish women were included. IgA/G/M anti-CL and anti-β2GPI were tested at one time point only with two independent assays in Sudanese and serially in pregnant Swedes. IgA anti-β2GPI domain 1 and as controls IgA/G/M rheumatoid factor (RF), IgG anti–cyclic citrullinated peptide 2 (anti-CCP2) and anti–thyroid peroxidase (anti-TPO) were investigated in Sudanese females.ResultsPregnant Sudanese women had significantly higher median levels of IgA anti-CL, IgA anti-β2GPI (p < 0.0001 for both antibodies using two assays) and IgM anti-β2GPI (both assays; p < 0.0001 and 0.008) compared with non-pregnant Sudanese. IgA anti-CL and anti-β2GPI occurrence was increased among Sudanese pregnant women compared with national controls. No corresponding increase during pregnancy was found for IgA anti-β2GPI domain 1 antibodies. Both IgG anti-CL and IgG control autoantibodies decreased during and directly after pregnancy among Sudanese. Serially followed Swedish women showed no changes in IgA aPL, whereas IgG/M anti-CL decreased.ConclusionsIgA aPL are increased in Sudanese but not in Swedish women, without corresponding increase in IgA domain 1. Whether due to ethnicity and/or environmental influences the occurrence of IgA aPL during Sudanese pregnancies, and its clinical significance, is yet to be determined.
Highlights
Antiphospholipid antibodies are well-recognized as the most common acquired and treatable risk factor for recurrent fetal loss.[1] b2 glycoprotein I (b2GPI) is frequently described as the main culprit antigen in antiphospholipid syndrome (APS) including aPL-induced pregnancy morbidity.2,3! The Author(s), 2020
We investigated healthy nonpregnant women from Sudan and healthy pregnant and non-pregnant women from Sweden
In Sudanese women we investigated other autoantibodies: rheumatoid factor (RF) of all three isotypes, IgG anti–cyclic citrullinated peptide 2 and IgG anti–thyroid peroxidase
Summary
Antiphospholipid antibodies (aPL) are well-recognized as the most common acquired and treatable risk factor for recurrent fetal loss.[1] b2 glycoprotein I (b2GPI) is frequently described as the main culprit antigen in antiphospholipid syndrome (APS) including aPL-induced pregnancy morbidity.2,3! The Author(s), 2020. Antiphospholipid antibodies (aPL) are well-recognized as the most common acquired and treatable risk factor for recurrent fetal loss.[1] b2 glycoprotein I (b2GPI) is frequently described as the main culprit antigen in antiphospholipid syndrome (APS) including aPL-induced pregnancy morbidity.. As suggested by previous in vivo and in vitro studies, different aPL-mediated mechanisms are involved in the pathogenesis of pregnancy-related complications and fetal loss. According to the current Sapporo classification criteria APS includes only IgG and IgM but not IgA as isotypes for anticardiolipin (anti-CL) and anti-b2GPI testing.[1] The latest international task
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