Molloy Anne M, Quadros Edward V, Sequeira Jeffrey M, Troendle James F, Scott John M, Kirke Peadar N, Mills James L
School of Medicine, Trinity College, Dublin, Ireland.
N Engl J Med. 2009 Jul 9;361(2):152-60. doi: 10.1056/NEJMoa0803783.
A previous report described the presence of autoantibodies against folate receptors in 75% of serum samples from women with a history of pregnancy complicated by a neural-tube defect, as compared with 10% of controls. We sought to confirm this finding in an Irish population, which traditionally has had a high prevalence of neural-tube defects.
We performed two studies. Study 1 consisted of analysis of stored frozen blood samples collected from 1993 through 1994 from 103 mothers with a history of pregnancy complicated by a neural-tube defect (case mothers), 103 mothers with a history of pregnancy but no complication by a neural-tube defect (matched with regard to number of pregnancies and sampling dates), 58 women who had never been pregnant, and 36 men. Study 2, conducted to confirm that the storage of samples did not influence the folate-receptor autoantibodies, included fresh samples from 37 case mothers, 22 control mothers, 10 women who had never been pregnant, and 9 men. All samples were assayed for blocking and binding autoantibodies against folate receptors.
In Study 1, blocking autoantibodies were found in 17% of case mothers, as compared with 13% of control mothers (odds ratio, 1.54; 95% confidence interval [CI], 0.70 to 3.39), and binding autoantibodies in 29%, as compared with 32%, respectively (odds ratio, 0.82; 95% CI, 0.44 to 1.50). Study 2 showed similar results, indicating that sample degradation was unlikely.
The presence and titer of maternal folate-receptor autoantibodies were not significantly associated with a neural-tube defect-affected pregnancy in this Irish population.
先前的一份报告指出,有神经管缺陷妊娠史的女性血清样本中,75%存在抗叶酸受体自身抗体,而对照组这一比例为10%。我们试图在传统上神经管缺陷患病率较高的爱尔兰人群中证实这一发现。
我们进行了两项研究。研究1包括对1993年至1994年采集的冷冻血样进行分析,这些血样来自103名有神经管缺陷妊娠史的母亲(病例母亲)、103名有妊娠史但无神经管缺陷并发症的母亲(根据妊娠次数和采样日期匹配)、58名从未怀孕的女性以及36名男性。研究2旨在确认样本储存不会影响叶酸受体自身抗体,该研究纳入了来自37名病例母亲、22名对照母亲、10名从未怀孕的女性以及9名男性的新鲜样本。所有样本均检测了针对叶酸受体的阻断性和结合性自身抗体。
在研究1中,17%的病例母亲检测到阻断性自身抗体,对照母亲为13%(比值比,1.54;95%置信区间[CI],0.70至3.39);29%的病例母亲检测到结合性自身抗体,对照母亲为32%(比值比,0.82;95%CI,0.44至1.50)。研究2显示了相似的结果,表明样本降解的可能性不大。
在这个爱尔兰人群中,母亲叶酸受体自身抗体的存在和滴度与受神经管缺陷影响的妊娠并无显著关联。