Ornoy Asher, Chen Limor, Silver Robert M, Miller Richard K
Laboratory of Teratology, Department of Anatomy and Cell Biology, Hebrew University Hadassah Medical School, Jerusalem, Israel.
Birth Defects Res A Clin Mol Teratol. 2004 Jun;70(6):371-81. doi: 10.1002/bdra.20021.
Autoimmune diseases are a group of illnesses in which autoantibodies are produced against various organs, presenting with a variety of clinical symptoms. In this review, we discuss the different aspects of autoimmune diseases in pregnancy. We also describe experimental models that help to understand the etiology and pathogenesis of the effects of this maternal disease on the developing embryo, fetus and placenta.
The possible direct effects of sera or IgG obtained from women with systemic lupus erythematosus/antiphospholipid syndrome (SLE/APS) and recurrent pregnancy loss (RPL) were examined on cultured 10.5- and 11.5-day-old rat embryos and on cultured human placental explants, as compared to sera from healthy women or synthetic medium that were used as controls. In addition, we examined the effects of the sera obtained from these women after successful treatment that allowed the birth of normal infants.
We observed increased embryonic death and anomalies in embryos cultured on sera and IgG from SLE/APS women. Similarly, when human placental explants were cultured on these sera, trophoblastic cell growth was reduced and apoptotic rate was increased. Successful treatment also reduced the damage caused by the sera from these women in the cultured embryos and placentas.
Our results, and the cited studies, point to the important role of the placental damage in the etiology of RPL associated with SLE/APS. Animal models, both in vivo and in vitro, as well as cultured early human placental explants can be used successfully to understand some of the pathogenic aspects of SLE/APS and RPL.
自身免疫性疾病是一组产生针对各种器官的自身抗体并伴有多种临床症状的疾病。在本综述中，我们讨论了妊娠期间自身免疫性疾病的不同方面。我们还描述了有助于理解这种母体疾病对发育中的胚胎、胎儿和胎盘影响的病因和发病机制的实验模型。
将系统性红斑狼疮/抗磷脂综合征（SLE/APS）和复发性流产（RPL）女性的血清或IgG对培养的10.5天和11.5天大的大鼠胚胎以及培养的人胎盘外植体的可能直接影响，与作为对照的健康女性血清或合成培养基进行比较。此外，我们还研究了这些女性成功治疗后血清的影响，这些治疗使正常婴儿得以出生。
我们观察到在SLE/APS女性的血清和IgG中培养的胚胎中胚胎死亡增加和出现异常。同样，当在这些血清中培养人胎盘外植体时，滋养层细胞生长减少，凋亡率增加。成功治疗也减少了这些女性血清对培养的胚胎和胎盘造成的损害。
我们的结果以及引用的研究表明，胎盘损伤在与SLE/APS相关的复发性流产病因中起重要作用。体内和体外动物模型以及培养的早期人胎盘外植体可成功用于了解SLE/APS和复发性流产的一些致病方面。
