Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan.
Lupus. 2020 Apr;29(5):463-473. doi: 10.1177/0961203320908949. Epub 2020 Feb 27.
The role of antiphospholipid antibodies (aPL) during apparently normal pregnancy is still unclear. IgA aPL are prevalent in populations of African origin. Our aim was to measure all isotypes of anticardiolipin (anti-CL) and anti-β glycoprotein I (anti-βGPI) in healthy pregnant and non-pregnant women of different ethnicities.
Healthy Sudanese pregnant women ( = 165; 53 sampled shortly after delivery), 96 age-matched Sudanese female controls and 42 healthy pregnant and 249 non-pregnant Swedish women were included. IgA/G/M anti-CL and anti-βGPI were tested at one time point only with two independent assays in Sudanese and serially in pregnant Swedes. IgA anti-βGPI domain 1 and as controls IgA/G/M rheumatoid factor (RF), IgG anti-cyclic citrullinated peptide 2 (anti-CCP2) and anti-thyroid peroxidase (anti-TPO) were investigated in Sudanese females.
Pregnant Sudanese women had significantly higher median levels of IgA anti-CL, IgA anti-βGPI ( < 0.0001 for both antibodies using two assays) and IgM anti-βGPI (both assays; < 0.0001 and 0.008) compared with non-pregnant Sudanese. IgA anti-CL and anti-βGPI occurrence was increased among Sudanese pregnant women compared with national controls. No corresponding increase during pregnancy was found for IgA anti-βGPI domain 1 antibodies. Both IgG anti-CL and IgG control autoantibodies decreased during and directly after pregnancy among Sudanese. Serially followed Swedish women showed no changes in IgA aPL, whereas IgG/M anti-CL decreased.
IgA aPL are increased in Sudanese but not in Swedish women, without corresponding increase in IgA domain 1. Whether due to ethnicity and/or environmental influences the occurrence of IgA aPL during Sudanese pregnancies, and its clinical significance, is yet to be determined.
抗磷脂抗体（aPL）在貌似正常妊娠中的作用仍不清楚。IgA aPL 在非洲裔人群中较为常见。我们的目的是测量不同种族的健康妊娠和非妊娠妇女的所有抗心磷脂（anti-CL）和抗-β糖蛋白 I（anti-βGPI）的同种型。
纳入 165 例苏丹妊娠妇女（产后不久即采样 53 例）、96 例年龄匹配的苏丹女性对照者和 42 例健康妊娠及 249 例非妊娠瑞典妇女。仅在苏丹使用两种独立的检测方法在同一时间点检测 IgA/G/M 抗-CL 和抗-βGPI，并对妊娠瑞典妇女进行连续检测。在苏丹女性中还检测了 IgA 抗-βGPI 结构域 1 以及对照的 IgA/G/M 类风湿因子（RF）、IgG 抗环瓜氨酸肽 2（anti-CCP2）和抗甲状腺过氧化物酶（anti-TPO）。
与非妊娠苏丹女性相比，苏丹妊娠女性的 IgA 抗-CL、IgA 抗-βGPI（两种检测方法均为 <0.0001）和 IgM 抗-βGPI（两种检测方法均为 <0.0001 和 0.008）的中位数水平显著更高。与全国对照相比，苏丹妊娠女性的 IgA 抗-CL 和抗-βGPI 发生更为常见。苏丹妊娠期间，IgA 抗-βGPI 结构域 1 抗体并未相应增加。苏丹妊娠期间和妊娠后，IgG 抗-CL 和 IgG 对照自身抗体减少。连续随访的瑞典女性的 IgA aPL 无变化，而 IgG/M 抗-CL 减少。
苏丹人而非瑞典人的 IgA aPL 增加，但 IgA 结构域 1 没有相应增加。IgA aPL 在苏丹妊娠中的发生及其临床意义是否归因于种族和/或环境影响，尚待确定。
