Alpha-enolase: a novel autoantigen in patients with premature ovarian failure.

Objective: Although controversial, the presence of circulating antiovarian antibodies (AOA) may be considered a marker of autoimmune premature ovarian failure (POF). The purpose of the present work was to evaluate the presence of AOA in POF patients, and to identify a possible autoantigen in order to develop a reliable diagnostic tool that might help to determine the real prevalence of autoimmune POF.

Design: Non-randomised study. Blood sampling for determination of circulating AOA.

Patients: One hundred and ten patients with POF and 60 normally menstruating women with no record of autoimmune diseases (controls).

Measurements: Presence of circulating AOA was assessed by Western-blot, using cytosolic fraction from human ovarian homogenate as antigen.

Results: Twenty-one of 110 women with POF presented circulating antibodies directed toward an antigen of approximately 50 kD. Sixty control subjects proved negative. After purification and analysis by mass spectrometry, the antigen was identified as alpha-enolase.

Conclusion: Determination of the presence of circulating antialpha-enolase antibodies might be instrumental in identifying those patients who may present a putative defect in immunoregulation and therefore a possible autoimmune aetiolgy for POF.