Department of Rheumatology, Erasmus University Medical Center Rotterdam, Dr. Molewaterplein 50, NL-3015 GE, Rotterdam, The Netherlands.
Arthritis Res Ther. 2011 Jan 31;13(1):R10. doi: 10.1186/ar3231.
Rheumatoid arthritis (RA) improves during pregnancy and flares after delivery. It has been hypothesized that high levels of the complement factor mannose-binding lectin (MBL) are associated with a favourable disease course of RA by facilitating the clearance of pathogenic immunoglobulin G (IgG) lacking galactose sugar moieties. During pregnancy, increased galactosylation of IgG and simultaneously increased MBL levels can be observed, with the latter being strictly related to maternal MBL genotypes. Therefore, increased MBL levels in concert with increased IgG galactosylation may be associated with pregnancy-induced improvement of RA. The objective of this study was to investigate whether MBL genotypes are associated with changes in RA disease activity and with changes in IgG galactosylation during pregnancy and in the postpartum period. We also studied the association between MBL genotypes and pregnancy outcomes in RA.
Serum from 216 patients with RA and 31 healthy controls participating in the Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) Study was collected before, during and after pregnancy. IgG galactosylation was determined by performing matrix-assisted laser desorption/ionization time of flight mass spectrometry. Disease activity was determined using the internationally recognized Disease Activity Score 28 (DAS28). MBL genotypes were determined. The pregnancy outcome measures studied were gestational age, birth weight, miscarriage and hypertensive disorders.
No association was found between the MBL genotype groups and changes in RA disease activity (P = 0.89) or changes in IgG galactosylation (patients, P = 0.75, and controls, P = 0.54) during pregnancy and in the postpartum period. Furthermore, MBL genotype groups were not related to the studied pregnancy outcome measures.
This study does not provide evidence for a role for MBL in the improvement of RA during pregnancy or for a role for MBL in pregnancy outcome.
类风湿关节炎（RA）在怀孕期间会改善，分娩后会恶化。有人假设，高水平的补体因子甘露糖结合凝集素（MBL）通过促进缺乏半乳糖糖基的致病性免疫球蛋白 G（IgG）的清除，与 RA 的有利疾病进程相关。在怀孕期间，可观察到 IgG 的半乳糖基化增加和 MBL 水平同时增加，后者与母体 MBL 基因型严格相关。因此，MBL 水平增加与 IgG 半乳糖基化增加可能与 RA 引起的妊娠改善有关。本研究旨在调查 MBL 基因型是否与 RA 疾病活动的变化以及怀孕期间和产后 IgG 半乳糖基化的变化相关。我们还研究了 MBL 基因型与 RA 妊娠结局之间的关联。
216 名患有 RA 的患者和 31 名健康对照者参加了妊娠改善类风湿关节炎（PARA）研究，在妊娠前、妊娠中和产后采集了血清。通过基质辅助激光解吸/电离飞行时间质谱法测定 IgG 半乳糖基化。使用国际公认的疾病活动评分 28（DAS28）确定疾病活动度。确定 MBL 基因型。研究的妊娠结局指标是胎龄、出生体重、流产和高血压疾病。
MBL 基因型组与 RA 疾病活动的变化（P = 0.89）或妊娠和产后 IgG 半乳糖基化的变化之间没有关联（患者，P = 0.75，对照组，P = 0.54）。此外，MBL 基因型组与研究的妊娠结局指标无关。
本研究没有证据表明 MBL 在怀孕期间改善 RA 中起作用，也没有证据表明 MBL 在妊娠结局中起作用。
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