Autoantibodies In Women Research Articles

High Prevalence of Anti-Prothrombin IgM and IgG Autoantibodies in Women With Unexplained Recurrent Pregnancy Loss.

To investigate the association between anti-prothrombin IgM and IgG antibodies and recurrent pregnancy loss (RPL) in a cohort of Lebanese women, and their impact on pregnancy outcomes. This was a retrospective case-control study involving 207 women with RPL and 179 age-matched multiparous controls. Quantitative sandwich ELISA assayed anti-prothrombin IgM and IgG antibodies. Univariate and multivariate logistic regression were employed to assess the risk imparted by anti-prothrombin antibodies, while ROC analysis was used to determine their sensitivity and specificity. Our study revealed that women with RPL had significantly higher serum levels of anti-prothrombin IgM and IgG than controls. Univariate regression analysis demonstrated that elevated anti-prothrombin IgM (OR = 1.13; 95% CI = 1.07, 1.19; P < 0.001) and IgG (OR = 1.05; 95% CI = 1.03, 1.08; P < 0.001) were associated with increased RPL risk. Multivariate analysis confirmed these findings, indicating that anti-prothrombin IgM (aOR = 1.13; 95% CI = 1.05, 1.20; P < 0.001) and IgG (aOR = 1.08; 95% CI = 1.05, 1.11; P < 0.001) are independent risk factors. ROC analysis yielded an AUC of 0.720 for IgM and 0.649 for IgG, underscoring their predictive value and offering hope for improved risk assessment and management of RPL. Elevated levels of anti-prothrombin IgM and IgG are significantly associated with RPL, suggesting an autoimmune component to pregnancy loss. These findings highlight the importance of screening for these antibodies in women with unexplained RPL to guide management and therapeutic strategies.

Profile of serum autoantibodies in women with premature ovarian insufficiency receiving complex treatment using new surgical technologies

Profile of serum autoantibodies in women with premature ovarian insufficiency receiving complex treatment using new surgical technologies

Allergic manifestations in women with silicone breast implants

IntroductionSilicone breast implants (SBI) result in immune dysregulation and are associated with autoimmune diseases. Recently, we reported dysregulated levels of IgG autoantibodies directed against G protein-coupled receptors (GPCRs) of the autonomic nervous system which were linked to the autoimmune dysautonomia in silicone breast implant illness (SBII). AimsWe aimed to explore the possible association between allergy with dysregulated IgE autoantibodies directed against GPCRs of the autonomic nervous system in women with SBI. MethodsCirculating levels of IgE autoantibodies against GPCRs of the autonomic nervous system (adrenergic, muscarinic, endothelin and angiotensin receptors) have been evaluated in women with SBIs who complained of allergic symptoms, and compared to subjects with SBI without allergic manifestations and to age-matched healthy women without SBI. ResultsWe report a significant dysregulation in three circulating autoantibodies: IgE-beta1 adrenergic receptor (B1AR), IgE-alpha 1 adrenergic receptor (A1AR) and IgE-muscarinic acetylcholine receptor type 1 (M1R) autoantibodies in women with SBI who complained of allergic symptoms. ConclusionsAllergic reactions associated with SBI are not uncommon. Imbalance of circulating levels of IgE autoantibodies against GPCRs of the autonomic nervous system might play a role not only in allergic reactions, but also in other enigmatic aspects of SBII such as autoimmune dysautonomia.

Сравнение профиля сывороточных аутоантител у женщин при разных формах эндометриоза

Сравнение профиля сывороточных аутоантител у женщин при разных формах эндометриоза

Functional thyrotropin receptor autoantibodies in women with thyroid autoimmunity and the impact of ovarian stimulation

Functional thyrotropin receptor autoantibodies in women with thyroid autoimmunity and the impact of ovarian stimulation

Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature.

Published data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing. To comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities. Nine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion. PCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population. PCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.

Ovarian Stimulation Does Not Induce Thyrotropin Receptor Autoantibodies in Women with Thyroid Autoimmunity.

Women of subfertile couples with thyroid autoimmunity (TAI) have an increased risk of miscarriage when pregnant after an assisted reproductive technology (ART) treatment. This might amongst others be due to the presence of thyrotropin receptor antibodies (TSH-R-Ab) that can impede the development of the corpus luteum. TSH-R-Ab can be present in women with TAI and/or be induced by the ovarian stimulation procedure (OS) that is performed to initiate the ART. In this prospective pilot study, we determined the presence of both binding and functional TSH-R-Ab (stimulating or blocking) with five different assays before and after OS in ten women (eleven cycles) with TAI of subfertile couples and in one woman without TAI. Mean (SD) age was 38.8 (±3.2) years, median (range) cumulative OS dose 1413 (613-2925) IU/L. Median baseline serum levels of thyrotropin, free thyroxine, and thyro-peroxidase antibodies were 2.33 (2.23-2.61) mIU/L, 16.8 (14.4-18.5) pmol/L and 152 (86-326) kIU/L, respectively. Oestradiol levels increased during OS from 40 (26-56) ng/L to 963 (383-5095) ng/L; p < 0.01. TSH-R-Ab measurements in all subject samples were below the cut-off of the corresponding immunoassay and four bioassays before or after OS.

Immune interface of patients with reproductive loss in the North-West region of the Russian Federation

BACKGROUND: Currently, more than a hundred immunological biomarkers are known that are important for fertilization, implantation and placentation.&#x0D; AIM: The aim of this study was to assess the immunological profile for the main allo- and autoantibodies in women with reproductive loss and infertility in the North-West region of the Russian Federation.&#x0D; MATERIALS AND METHODS: This prospective cohort study was conducted at the stage of pregnancy planning in 325 women with reproductive disorders (spontaneous miscarriages, missed abortions, infertility, IVF failures) on the premises of the D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductive Medicine (St. Petersburg, Russia) from 2015 to 2022. The study assessed the immune interface of women with a history of reproductive disorders and matching loci of the HLA class II system (DQA1, DQB1, DRB1) among 100 married couples.&#x0D; RESULTS: In couples with reproductive disorders, coincidences of HLA class II allele (DQA1, DQB1, DRB1) loci were diagnosed in 14% (at 2 loci), 31% (at 3 loci), 14% (at 4 loci), 3% (at 5 loci) and 10% (at 6 loci) of couples. In 34.4% of women, we found an elevated number of spontaneously activated NK cells (CD107a). As many as 31.15% of women had a high level of antibodies to human chorionic gonadotropin. We found that 22.34% of women were carriers of at least one criteria antiphospholipid antibody, and 3.16% of women of two antiphospholipid antibodies. The diagnosis of antiphospholipid syndrome was not established in any patient. Non-criteria antiphospholipid antibodies were found in 6.15% of women. In 12.2% of women, we diagnosed a high level of antibodies to thyroperoxidase, while the average antibody value was 30.76 IU/ml. Only one patient had a high level of antisperm antibodies in the blood serum.&#x0D; CONCLUSIONS: In 59% of patients with a history of reproductive disorders, we identified some features of the immunological profile, which can lead to this pathology. Thus, 32% of women had a deviation in one immunological parameter, while 20% of patients had it in two parameters, and 7% in three or more parameters.

Effect of COVID-19 vaccination on the immune status and autoantibody profile in women of reproductive age

In the context of the COVID-19 pandemic, scientific interest is growing in studying the impact of the proposed vaccination on women’s reproductive health. As is known, alterations in the state of the immune system and activation of an autoimmune response can lead to reproductive failure in women and potential complications of subsequent pregnancy. Objective: to evaluate the effect of the “Gam-COVID-Vac” on the immune status parameters, the relationship of their changes and the specific immune response to vaccination with the dynamics of the level of autoantibodies in women of reproductive age.The prospective study included 120 women who were vaccinated against COVID-19 with the “Gam-COVIDVac”. The criteria for inclusion in the study were: the age from 18 to 49 years, the absence of COVID-19 in the anamnesis, a negative result of a study on SARS-CoV-2 by PCR and negative results of tests for antibodies of classes G and M to SARS-CoV-2 before vaccination, the absence of pregnancy and serious somatic diseases. The patients were examined twice: immediately before vaccination and 90-100 days after the introduction of the 1st component of the vaccine. The level of IgG antibodies to SARS-CoV-2 after vaccination was assessed using ELISA. Before and after vaccination, the levels of antiphospholipid, anti-nuclear, organ-specific and antihormonal autoantibodies were determined, peripheral blood lymphocytes were immunophenotyped to determine the main subpopulations (CD3, CD4, CD8, CD19, CD5, CD16, CD56), as well as the expression of activation markers of lymphocytes (HLA-DR, CD25, CD147) using monoclonal antibodies.The effectiveness and safety of the combined vector vaccine against COVID-19 were high. Specific IgG antibodies to SARS-CoV-2 were produced in 98.3% of vaccinated women, no serious adverse reactions were observed. After vaccination, there was an increase in the level of some autoantibodies within the reference ranges, only IgM antibodies to phosphatidylethanolamine (PE) and IgG antibodies to DNA increased above the reference values. However, this increase was transient. After vaccination, the following changes in the parameters of the immunogram were observed: an increase in the content of cells with CD3+CD25+, CD19+ phenotype in peripheral blood and a decrease in the content of cells with CD56+CD16+ phenotype within the reference ranges, a decrease in CD147+/CD3+. Weak correlations were noted between these changes in immunogram parameters and the levels of some autoantibodies. The specific antiviral immune response to vaccination did not correlate with the autoimmune response.Vaccination with “Gam-COVID-Vac” is effective and safe and does not lead to disorders in the immune system. The observed increase in the level of autoantibodies to PE and DNA is transient. Changes in the parameters of the immune status within the reference ranges may be due to vaccination and the development of a specific antiviral immune response.

Scientific Impact Paper No. 70: Subclinical Hypothyroidism and Antithyroid Autoantibodies in Women with Subfertility or Recurrent Pregnancy Loss

The Obstetrician & GynaecologistVolume 24, Issue 4 p. 297-297 SIP Summary Scientific Impact Paper No. 70: Subclinical Hypothyroidism and Antithyroid Autoantibodies in Women with Subfertility or Recurrent Pregnancy Loss First published: 17 October 2022 https://doi.org/10.1111/tog.12843Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume24, Issue4October 2022Pages 297-297 RelatedInformation

TSH receptor antibodies (TRAb) – A potential new biomarker for endometriosis

ObjectivesThe prevalence of several autoimmune diseases, including thyroid dysfunction, has been reported to be increased in patients with endometriosis. Upregulated thyroid stimulation hormone (TSH) receptors in ectopic endometrium and elevated serum titers of TSH receptor antibodies (TRAb) IgG in endometriosis patients indicates an overlap in pathophysiology. However, cross-reactivity with other antibodies must be excluded. The objective of this study was to compare the expression of autoantibodies in women with endometriosis and two control groups to evaluate the potential of TRAb IgG as a diagnostic marker for endometriosis. Study designThis cross-sectional study was carried out in 172 women with surgically confirmed endometriosis and two control groups consisting of 50 healthy blood donors and 114 women from Malmö Offspring Study consisting of people from the general population. Serum levels of thyroid hormones, TSH and TRAb autoantibodies, AXIN1, and autoantibodies against follicle stimulating hormone (FSH), human chorionic gonadotropin (hCG), luteinizing hormone (LH), and their receptors, were analyzed. The patients answered a questionnaire and estimated their gastrointestinal symptoms using the Visual Analogue Scale for Irritable Bowel Syndrome. ResultsOf the endometriosis patients, 29.1 % had TRAb IgG above the present detection limit of ≥ 1.0 IE/L compared to 2.6 % of the controls from MOS (p < 0.001) and 94.5 % had levels of TRAb over the previous detection limit ≥ 0.3 IE/L compared to 7.9 % of the controls (p < 0.001). Titers of both TRAb IgG and IgM were increased in patients compared to controls from MOS and blood donors, respectively (p < 0.001). There was no increase of autoantibodies against FSH, FSH receptor (FSHR), hCG, LH, LH receptor (LHR) or TSH compared to the blood donor controls. TRAb titers did not correlate with age, disease duration, AXIN1, TSH, thyroid hormones or gastrointestinal symptoms. ConclusionTRAb IgG and IgM are slightly elevated in patients with endometriosis with no cross-reactivity with other autoantibodies. The results indicate that TRAb is truly elevated and thereby has the potential to be used to support the diagnosing of endometriosis.

An Investigation on the Risk Factors of Thyroid Diseases in Community Population in Hainan.

Background In recent years, the incidence of thyroid diseases has increased significantly, which has seriously affected people's work and life. The purpose of this study was to explore the epidemiological characteristics of thyroid diseases and autoantibodies. Method According to the principle of overall sampling, resident residents ≥18 years and who will not move within 5 years are randomly selected. A total of 2136 eligible individuals were divided into case and control groups according to whether they have thyroid disease. Finally, the impact of potential risk factors on thyroid diseases was evaluated. Results The overall prevalence of thyroid disease was 58.3%, and there was a significant difference in the prevalence of thyroid disease between women and men (p = 0.004). Except for the age group ≥70 years, with the increase in age, the prevalence gradually increased (p < 0.05). Participants with positive thyroid autoantibodies (TPOAb or TgAb) had a higher prevalence than participants with negative autoantibodies. The positive rate of autoantibodies in women was higher than that in men (p < 0.05). UIC (p = 0.004) and free thyroid hormone (FT4) (p = 0.001) levels of men were higher than those of women, and the TSH level of women was higher than that of men (p = 0.002). The regression analysis showed that women, older age, and family history of thyroid disease were independent risk factors for thyroid disease. Conclusion The prevalence of thyroid diseases in Hainan was high. Women are more susceptible to thyroid disease than men, and the prevalence increased with age.

O-129 Subclinical hypothyroidism and antithyroid autoantibodies in women with subfertility or recurrent pregnancy loss: a scientific impact paper

Abstract Study question How should subclinical hypothyroidism (SCH) and autoimmune thyroid disease (ATD) be managed in women with subfertility or recurrent pregnancy loss? Summary answer This Royal College of Obstetricians and Gynaecologists (RCOG) scientific impact paper provides evidence based recommendations on the testing for and management of SCH and ATD. What is known already Subclinical hypothyroidism and autoimmune thyroid disease have been linked to adverse pregnancy outcomes such as miscarriage and premature birth. There is debate about whether there should be routine testing of thyroid function in both the general population and individuals who are trying for a baby. In addition, the strategies used to manage certain thyroid problems are questioned. Discussions around testing and subsequent management particularly relate to women with a history of subfertility or recurrent pregnancy loss (RPL). Study design, size, duration The purpose of this scientific impact paper is to provide evidence based clinical practice recommendations about the controversial subjects of SCH and antithyroid autoantibodies in women with a history of subfertility or RPL. This has been done by reviewing and collating the published evidence and international guidance. Participants/materials, setting, methods This body of work is a literature review of published primary studies, systematic reviews and international guidelines relating to the screening for and management of SCH and ATD in women with subfertility or recurrent pregnancy loss. Recommendations for practice and areas for further research have been identified. Main results and the role of chance Population-trimester and laboratory-specific reference ranges for serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) should be applied when defining SCH. Untreated mild–moderate SCH (TSH 4.0-10.0mIU/l) is associated with early pregnancy loss and there is low-quality evidence that levothyroxine (LT4) treatment of such women is associated with improved pregnancy and live birth rates. Routine preconception TSH and fT4 testing should be offered to women with history of RPL or subfertile women undergoing assisted reproduction. Women receiving LT4 treatment for SCH should have an empirical dose increase in pregnancy, doubling the dose on 2days per week once pregnancy is confirmed, with regular TSH measurements from 7–9weeks gestation. There is no benefit from LT4 treatment in improving pregnancy outcomes for euthyroid TPOAb-negative women. Knowing TPOAb status allows for stratification of women who will require thyroid function monitoring during pregnancy. The option of performing preconception TPOAb testing for women with infertility or a history of RPL versus routine early pregnancy thyroid function testing alone are both acceptable strategies, until clinical and cost-effectiveness analyses are available. Further studies are required to determine the role of selenium or steroids in improving pregnancy outcomes for euthyroid TPOAb-positive women. Limitations, reasons for caution The evidence for treatment of SCH in women with RPL or subfertility is of low quality and therefore must be interpreted with caution. Wider implications of the findings SCH and ATD are common conditions and management strategies are widely debated, particularly in women with history of subfertility or recurrent pregnancy loss. Further high quality studies are needed in this area to help strengthen our knowledge on how to manage such patients. Trial registration number Not applicable

Subclinical hypothyroidism and antithyroid autoantibodies in women with subfertility or recurrent pregnancy loss: Scientific Impact Paper No. 70 June 2022: Scientific Impact Paper No. 70 June 2022.

The thyroid is a gland located in the neck and is important for many processes in the body. Problems with the thyroid gland are common in women of reproductive age. It is essential to have a normal working thyroid gland in order to achieve a successful pregnancy. One of the most common problems with the thyroid is underactivity (known as hypothyroidism). An early, mild form of an underactive thyroid is called subclinical hypothyroidism. Often people with this condition do not have any symptoms. Another common problem is thyroid autoimmunity. Here, the immune system attacks the thyroid gland, sometimes leading to the development of abnormal thyroid function. This can be diagnosed by the presence of proteins in the bloodstream called antibodies. Mild thyroid problems and the presence of high levels of thyroid antibodies have been linked to miscarriage and premature birth. There is debate in medicine about whether there should be routine testing of thyroid function both in the general population and in individuals who are trying for a baby. In addition, the strategies used to manage certain thyroid problems are questioned. Discussions around testing and subsequent management particularly relate to women with a history of subfertility or repeated miscarriages. This Scientific Impact Paper provides information on thyroid testing and the management of mild thyroid problems and thyroid antibodies in women with a history of subfertility or recurrent miscarriages, using the latest evidence and guidelines. It concludes that there may be a role for treating these women with thyroxine tablets (the hormone produced by the thyroid gland) when subclinical hypothyroidism is present, and gives guidance on the cut-off levels for treatment.

Autoimmune dysautonomia in women with silicone breast implants

Importance and objectivesThere is unmet medical need to understand the pathogenic mechanism of the panoply of clinical manifestations associated with silicone breast implants (SBIs) such as severe fatigue, widespread pain, palpitations, dry mouth and eyes, depression, hearing loss etc. We aimed to determine whether autoantibodies against the autonomic nervous system receptors can explain the enigmatic and subjective clinical manifestation reported by women with SBIs. ResultsCirculating level of autoantibodies against G protein-coupled receptors (GPCRs) of the autonomic nervous system (adrenergic, muscarinic, endothelin and angiotensin receptors) have been evaluated in symptomatic women with SBIs using an ELISA method. These women with SBIs addressed our clinic due to various subjective and autonomic-related manifestations such as chronic severe fatigue, cognitive impairment, widespread pain, memory loss, sleep disorders, palpitations, depression, hearing abnormalities etc. We report for the first time, a significant reduction in the sera level of anti-β1 adrenergic receptor (p < 0.001), anti-angiotensin II type 1 receptor (p < 0.001) and anti-endothelin receptor type A (p = 0.001) autoantibodies in women with SBIs (n = 93) as compared with aged matched healthy women (n = 36). Importantly, anti-β1 adrenergic receptor autoantibody was found to significantly correlate with autonomic-related manifestations such as: sleep disorders and depression in women with SBIs. ConclusionsChronic immune stimulation by silicone material may lead to an autoimmune dysautonomia in a subgroup of potentially genetically susceptible women with SBIs. The appearance of autoantibodies against GPCRs of the autonomic nervous system serve as an explanation for the subjective autonomic-related manifestations reported in women with SBIs.

Autoimmune markers for non-invasive diagnosis of endometriosis in women

Endometriosis is a common estrogen-dependent chronic disease in women of reproductive age; it is associated with dysregulation of the immune response, local inflammation, and increased formation of autoantibodies. The aim of the study was to investigate the profile of autoantibodies in women with endometriosis and to evaluate their diagnostic value using new modifications of enzyme immunoassay. In women with endometriosis of stage III-IV (n=39), a wide spectrum of autoantibodies was detected, mainly of class G, including antibodies to endometrial antigens (tropomyosin 3, tropomodulin 3), the enzyme α-enolase, steroid (estradiol, progesterone) and gonadotropic hormones. At the same time, the frequency of detection of IgG antibodies to tropomyosin 3, α-enolase, estradiol and human chorionic gonadotropin and their levels in patients with endometriosis were higher than in healthy women (n=26) (p<0.05). IgG-antibodies to tropomyosin 3, α-enolase and estradiol were characterized by higher diagnostic value for endometriosis. The diagnostic value was significantly increased when these antibodies were combined: the AUC reached 0.875 [0.772-0.978] (p<0.0001), the sensitivity and specificity were 83.3% each. Thus, autoantibodies to tropomyosin 3, α-enolase, and estradiol are promising for inclusion in the panel of biomarkers for non-invasive diagnosis of endometriosis.

Detection of non-criteria autoantibodies in women without apparent causes for pregnancy loss.

BackgroundSome of the non‐criteria autoantibodies, especially non‐conventional antiphospholipid (aPL) antibodies, were present with high prevalence in sporadic miscarriages and recurrent pregnant loss. However, whether these autoantibodies are associated with miscarriage patients without apparent causes remain unclear.MethodsThe subjects were recruited from the female patients visiting the Infertility Center at the Beijing Obstetrics and Gynecology Hospital from January 2017 to March 2018. The women who experienced one sporadic miscarriage (n = 89) or recurrent pregnancy loss (n = 125) were enrolled. The control participants (n = 59) were those women with normal pregnancy history and with no miscarriage or thrombosis experience. The collected serum specimens from above patients and controls were subjected to the 13 non‐criteria autoantibody examinations, targeting non‐conventional phospholipids, thyroid, sperm, endometrial, and anti‐nuclear antigens.ResultsWhen compared with the controls, the following non‐criteria antibodies stood out in present study with significantly increased frequency and were listed in the order of decreasing positive rates: aPE IgM (40.0%), ANA (15.2%), aEM IgG (13.6%), aPE IgG (12.8%), and aPT IgM (10.4%). Except for ANA, the presence of aPE IgM, aEM IgG, aPE IgG, and aPT IgM was not associated with positivity of LA tests. In receiver operating characteristic analyses, the combined aPE IgG and aEM IgG biomarker panel had the best discriminating power between miscarriage patients and healthy controls.ConclusionOur findings suggested that the non‐criteria could be included as part of the pregnancy loss evaluation when apparent causes are absent, and the conventional aPLs tests failed to provide interpretations.

Testing for type 1 diabetes autoantibodies in gestational diabetes mellitus (GDM): is it clinically useful?

Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder in pregnancy, and it is associated with increased risk of morbidity in maternal-fetal outcomes. GDM is also associated with a higher risk to develop diabetes in the future. Diabetes-related autoantibodies (AABs) have been detected in a small percentage (usually less than 10%) of women with gestational diabetes. The prevalence in gestational diabetes of these autoimmune markers of type 1 diabetes (T1D) has been assessed in many studies, together with the risk of progression of AABs-positive GDM towards impaired glucose regulation (IFG or IGT) and overt diabetes after pregancy. The question whether it is necessary to test for T1D autoantibodies in all pregnancies with GDM is still debated. Here we examine the epidemiology of T1D autoantibodies in GDM, their clinical relevance in term of future risk of diabetes or impaired glucose regulation and in term of maternal-fetal outcomes, and discuss when it may be the most appropriate time to search for T1D autoantibodies in women with gestational diabetes.

Elevated autoimmunity in residents living near abandoned uranium mine sites on the Navajo Nation

Specific autoantibodies were assessed among residents of the Navajo Nation in New Mexico chronically exposed to metal mixtures from uranium mine wastes and in drinking water supplies. Age and the extent of exposure to legacy waste from 100 abandoned uranium mine and mill sites were associated with antibodies to denatured DNA, previously known to be an early indicator of medication-induced autoimmunity. Surprisingly, autoantibodies to native DNA and/or chromatin were also linked to environmental exposure, specifically uranium consumption through drinking water for both men and women, while urinary arsenic was negatively associated with these autoantibodies in women. These findings suggest that contaminants derived from uranium mine waste enhanced development of autoantibodies in some individuals, while arsenic may be globally immunosuppressive with gender-specific effects. Specific autoantibodies may be a sensitive indicator of immune perturbation by environmental toxicants, an adverse effect not considered in current drinking water standards or regulatory risk assessment evaluations.

Prevention of pregnancy loss in women with circulation of non-conventional antiphospholipid autoantibodies

Hypothesis/aims of study. Patients with a history of pregnancy complications that meet the clinical criteria of antiphospholipid syndrome (APS), with circulation of autoantibodies not related to the laboratory criteria for APS, present difficulties in choosing a method for preventing recurrent complications. The aim of this study was to determine the frequency of autoantibodies in women with severe obstetric complications and habitual miscarriage and to evaluate the effectiveness of therapy used in APS for the prevention of recurrent reproductive losses in women with non-criteria autoantibodies.&#x0D; Study design, materials and methods. 358 women with a history of APS clinical criteria or two pregnancy losses up to 10 weeks were examined. Anti-beta2-glycoprotein I and anti-cardiolipin (IgG/IgM) antibodies, as well as non-conventional autoantibodies for phosphatidylinositol, phosphatidylserine, phosphatidyl acid, annexin V, and prothrombin were determined in serum, with lupus anticoagulant test performed. In 39 women with clinical criteria for APS and circulating anti-annexin V or prothrombin antibodies during pregnancy, enoxaparin sodium was used (in 100% of the cases) in combination with acetylsalicylic acid (ASA) at a dose of 50-100 mg per day (in 69.2% of the cases).&#x0D; Results. The frequency of all types of autoantibodies was 38.8%. Non-conventional antibodies were detected in 17.6% of the cases (isolated circulation in 11.5% of the cases); with anti-annexin V antibodies (73.0%) prevailed among them. In 39 patients with non-criteria antibodies, after the use of a prophylactic dose of enoxaparin sodium and ASA, live births were the outcome of pregnancy in 84.6% of the cases.&#x0D; Conclusion. Testing for non-conventional autoantibodies may be appropriate in patients with only APS clinical criteria. Standard treatment of APS prescribed for this group of patients led to a significant increase in the frequency of live births. Further large studies are needed to evaluate the efficacy of medical prophylaxis of adverse pregnancy outcomes in women with non-criteria obstetric ABS.