Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
J Reprod Immunol. 2010 Jan;84(1):95-9. doi: 10.1016/j.jri.2009.10.005. Epub 2009 Dec 8.
The aim of this study was to evaluate whether anti-beta2 glycoprotein-I antibody (anti-beta2GPI) of the IgG or IgM classes is associated with the development of pregnancy-induced hypertension (PIH) or preeclampsia in the Japanese population. In a case-controlled cohort study, peripheral blood was obtained at 8-14 weeks of gestation from a consecutive series of 1155 women. The case group comprised 36 patients who later developed PIH during the pregnancy. Of the 36 PIH patients, 13 had severe PIH, 18 had preeclampsia and 11 had severe preeclampsia. One hundred and eleven age- and parity-matched women whose pregnancies ended in normal delivery without obstetric complications were selected as controls. We found that a titer of anti-beta2GPI IgG>or=1.0 U/ml was a risk factor for severe PIH (P=0.023, OR 5.7 95%CI 1.4-22.8). In addition, titers of anti-beta2GPI IgM>or=1.2 U/ml was found to be a risk factor for PIH (P=0.001, OR 8.8 95%CI 1.6-47.5). In women positive for anti-beta2GPI but negative for lupus anticoagulant, anti-cardiolipin, phosphatidylserine-dependent anti-prothrombin, or kininogen-dependent anti-phosphatidylethanolamine antibodies, the presence of anti-beta2GPI was not a significant risk factor for development of PIH or preeclampsia. In conclusion, the presence of anti-beta2GPI antibody represents a risk factor for developing PIH and severe PIH. This finding supports the utility of anti-beta2GPI determination as one of the laboratory criteria for anti-phospholipid syndrome classification. The usefulness of anti-beta2GPI measurement among women without other anti-phospholipid antibodies requires further study.
本研究旨在评估 IgG 或 IgM 类抗β2 糖蛋白 I 抗体（抗β2GPI）是否与日本人群妊娠高血压（PIH）或子痫前期的发生有关。在一项病例对照队列研究中，连续采集了 1155 名 8-14 孕周孕妇的外周血。病例组包括 36 名妊娠期间发生 PIH 的患者。36 名 PIH 患者中，13 名患有重度 PIH，18 名患有子痫前期，11 名患有重度子痫前期。选择 111 名年龄和产次匹配、妊娠结局正常分娩且无产科并发症的孕妇作为对照组。我们发现抗β2GPI IgG>1.0 U/ml 滴度是重度 PIH 的危险因素（P=0.023，OR 5.7 95%CI 1.4-22.8）。此外，抗β2GPI IgM>1.2 U/ml 滴度与 PIH 相关（P=0.001，OR 8.8 95%CI 1.6-47.5）。在抗β2GPI 阳性但狼疮抗凝物、抗心磷脂抗体、磷脂酰丝氨酸依赖的抗凝血酶原抗体或激肽原依赖的抗磷脂酰乙醇胺抗体阴性的妇女中，抗β2GPI 的存在不是 PIH 或子痫前期发生的显著危险因素。总之，抗β2GPI 抗体的存在是 PIH 和重度 PIH 的危险因素。这一发现支持抗β2GPI 测定作为抗磷脂综合征分类的实验室标准之一的实用性。在没有其他抗磷脂抗体的妇女中，抗β2GPI 测量的有效性需要进一步研究。
