Ornoy A, Yacobi S, Avraham S, Blumenfeld Z
Department of Anatomy & Cell Biology, Hebrew University Hadassah Medical School, Jerusalem, Israel.
Reprod Toxicol. 1998 Mar-Apr;12(2):185-91. doi: 10.1016/s0890-6238(97)00149-4.
Women with systemic lupus erythematosus (SLE) with or without antiphospholipid antibodies (APLA) suffer from a high rate of recurrent abortions perhaps as a result of specific antibodies that may damage the conceptus. We studied the effects of sera from women with SLE--with or without--APLA and recurrent abortions on 10.5-d-old rat embryos in culture. This was compared to the results of culture on sera from control women and on rat sera. In addition, we studied sera from women with SLE with or without APLA after treatment with low doses of aspirin and glucocorticosteroids. Seventy-three percent of embryos cultured in sera from women with SLE with or without APLA were malformed in comparison to only 10.2% in embryos cultured on control sera and 5.4% in embryos cultured on rat sera. The rate of anomalies was reduced to 37.5% in embryos cultured on sera from women with SLE with or without APLA after treatment, as in 6 of 13 sera, the treatment reduced or prevented the occurrence of embryonic anomalies. When sera were divided in to low- and high-risk sera, the effect of treatment was even more significant, as the average percentage of embryonic anomalies per serum was reduced from 81.7 to 44.7%. Specific ultrastructural changes were found in the yolk sacs of the embryos cultured on the sera from women with SLE with or without APLA by transmission electron microscopy and by scanning electron microscopy. It seems that the rat embryo culture system may be an important clinical diagnostic tool to identify women with recurrent abortions in whom the etiology may be immunologic rejection of the embryo and to assess the efficacy of various treatment modalities.
患有或不患有抗磷脂抗体（APLA）的系统性红斑狼疮（SLE）女性反复流产率很高，这可能是由于特定抗体可能损害胚胎所致。我们研究了患有或不患有APLA及反复流产的SLE女性血清对体外培养的10.5日龄大鼠胚胎的影响，并将其与对照女性血清和大鼠血清的培养结果进行比较。此外，我们还研究了患有或不患有APLA的SLE女性在接受低剂量阿司匹林和糖皮质激素治疗后的血清。与对照血清培养的胚胎中仅10.2%以及大鼠血清培养的胚胎中5.4%出现畸形相比，在患有或不患有APLA的SLE女性血清中培养的胚胎有73%出现畸形。在接受治疗的患有或不患有APLA的SLE女性血清中培养的胚胎，畸形率降至37.5%，因为在13份血清中有6份，治疗减少或预防了胚胎畸形的发生。当血清分为低风险和高风险血清时，治疗效果更显著，因为每份血清中胚胎畸形的平均百分比从81.7%降至44.7%。通过透射电子显微镜和扫描电子显微镜在患有或不患有APLA的SLE女性血清中培养的胚胎卵黄囊中发现了特定的超微结构变化。大鼠胚胎培养系统似乎可能是一种重要的临床诊断工具，可用于识别反复流产且病因可能是胚胎免疫排斥的女性，并评估各种治疗方式的疗效。
