Matsuda Miwa, Sasaki Aiko, Shimizu Keiko, Kamada Yasuhiko, Noguchi Soichi, Hiramatsu Yuji, Nakatsuka Mikiya
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Acta Med Okayama. 2017 Jun;71(3):201-208. doi: 10.18926/AMO/55202.
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.
复发性流产(RPL)女性中已报道存在血管功能障碍。我们调查了非妊娠RPL女性血管功能障碍的严重程度及其与已知可诱导动脉硬化的抗热休克蛋白(HSP)抗体的相关性。我们检测了68例RPL女性和29例健康对照者的血清抗HSP60抗体、抗HSP70抗体和抗磷脂抗体(APA)。在RPL女性中,14例诊断为抗磷脂综合征(APS),其余54例RPL病因不明。与对照组相比,APS和不明原因RPL女性的肱踝脉搏波速度(baPWV)、颈动脉增强指数(cAI)和子宫动脉搏动指数(PI)均显著升高。与对照组相比,不明原因RPL的APA阳性女性组中抗HSP60抗体水平显著升高,不明原因RPL的APS和APA阳性女性组中抗HSP70抗体水平显著升高。然而,抗HSP60和抗HSP70抗体水平与baPWV或cAI值无关。我们的结果表明,不明原因RPL女性中抗HSP60和抗HSP70抗体增加。需要进一步研究以阐明抗HSP抗体在不明原因RPL中的作用及其病理生理学。