Vascular dysfunction has been reported in women with recurrent pregnancy loss (RPL). We investigated the severity of vascular dysfunction in non-pregnant women with RPL and its correlation with anti-heat shock protein (HSP) antibodies that are known to induce arteriosclerosis. We measured the serum anti-HSP60 antibodies, anti-HSP70 antibodies, and anti-phospholipid antibodies (APA) in 68 women with RPL and 29 healthy controls. Among the women with RPL, 14 had a diagnosis of antiphospholipid syndrome (APS), and in the remaining 54, the causes for RPL were unexplained. Compared to the controls, the brachial-ankle pulse wave velocity (baPWV), carotid augmentation index (cAI), and uterine artery pulsatility index (PI) were all significantly higher in the women with both APS and unexplained RPL. Compared to the controls, the anti-HSP60 antibody levels were significantly higher in the APA-positive group of women with unexplained RPL, and the anti-HSP70 antibody levels were significantly higher in APS and APA-positive group of women with unexplained RPL. However, the anti-HSP60 and anti-HSP70 antibody levels did not correlate with the values of baPWV or cAI. Our results demonstrated anti-HSP60 and anti-HSP70 antibodies are increased in women with unexplained RPL. Further studies are needed to elucidate the roles of anti-HSP antibodies and their pathophysiology in unexplained RPL.
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http://dx.doi.org/10.18926/AMO/55202 | DOI Listing |
Front Physiol
December 2024
Department of Obstetrics and Gynecology, Deyang People's Hospital, Deyang, Sichuan, China.
Background: Recurrent pregnancy loss (RPL) poses significant challenges in clinical management due to an unclear etiology in over half the cases. Traditional screening methods, including ultrasonographic evaluation of endometrial receptivity (ER), have been debated for their efficacy in identifying high-risk individuals. Despite the potential of artificial intelligence, notably deep learning (DL), to enhance medical imaging analysis, its application in ER assessment for RPL risk stratification remains underexplored.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Internal Medicine and Clinical Immunology, University Hospital of Rennes, 35000 Rennes, France.
Current guidelines recommend systematic screening for rheumatic diseases (RDs), including antiphospholipid syndrome (APS), in patients with recurrent pregnancy loss (RPL). However, these recommendations are based on limited evidence, as data on the prevalence of RD in this specific population remain scarce. In particular, the impact of the recent update to the ACR/EULAR classification criteria for APS on the prevalence of RD among RPL patients has yet to be clarified.
View Article and Find Full Text PDFRev Med Interne
December 2024
Service de médecine interne et inflammation, département inflammation-immunopathologie-biothérapie (DMU I3), CEREMAIAA, hôpital Saint-Antoine, AP-HP, Sorbonne université, Paris, France.
Hydroxychloroquine (HCQ), a synthetic antimalarial, is recognized for its immunomodulatory, anti-inflammatory and vascular-protective effects. In 20-30% of cases of primary obstetrical antiphospholipid syndrome (APS), the combination of antiplatelet aggregation and prophylactic anticoagulation fails to prevent obstetrical complications, a situation referred to as refractory obstetrical APS. This is partly due to the pro-inflammatory effects of antiphospholipid antibodies (aPL) binding to decidual and trophoblastic cells, which compromise embryonic implantation and placentation.
View Article and Find Full Text PDFActa Obstet Gynecol Scand
December 2024
The Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Introduction: Recurrent pregnancy loss (RPL), defined as two or more pregnancy losses, might be associated with elevated obstetrical and perinatal risks in the following pregnancies. RPL and pregnancy problems related to placental development may have similar etiological features. This study explores the incidences of pregnancy and perinatal outcomes in women with RPL.
View Article and Find Full Text PDFHum Reprod
December 2024
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Aichi, Japan.
Study Question: Can antinuclear antibodies (ANA) affect the subsequent live birth rate (LBR) in patients with unexplained recurrent pregnancy loss (RPL) in the absence of antiphospholipid antibodies (aPL)?
Summary Answer: Women with unexplained RPL have a high probability of live birth following a positive pregnancy test (>70%), being similar between those with positive and negative ANA testing, regardless of the cut-off value.
What Is Known Already: The RPL guidelines of the ESHRE state that 'ANA testing can be considered for explanatory purposes'. However, there have been a limited number of studies on this issue and sample sizes have been small, and the impact of ANA on the pregnancy prognosis is unclear.
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