Anti-protein Z antibodies in women with pathologic pregnancies.
Protein Z deficiencies have recently been described in women with unexplained early fetal loss. Using a new, specifically elaborated, commercially available enzyme-linked immunosorbent assay (ELISA), we performed a case-control study on anti-protein Z immunoglobulin G (IgG) and IgM antibodies in 191 nonthrombotic, nonthrombophilic women with consecutive pathologic pregnancies. Levels of anti-protein Z antibodies were categorized in 3 strata (percentiles 1 through 74, 75 through 97, 98 through 100 among controls). The 2 upper levels of IgG and IgM anti-protein Z antibodies were associated with the risk of unexplained recurrent embryo loss or fetal death independently from habitual antiphospholipid/anticofactor antibodies, and a dose-effect relationship between antibody levels and the clinical risks was evidenced. In women, enhanced immune-complex formation with protein Z may play a role in unexplained embryo losses and, from the 10th week of gestation, may favor hypercoagulability in the maternal placenta side.
Gris
Jean-Christophe
JC
Laboratoire d'Hématologie, Unité de Formation et de Recherche (UFR) des sciences pharmaceutiques et biologiques, Université Montpellier 1, France. jcgris@chu-nimes.fr
Amadio
Cécile
C
Mercier
Eric
E
Lavigne-Lissalde
Géraldine
G
Déchaud
Hervé
H
Hoffet
Médéric
M
Quéré
Isabelle
I
Amiral
Jean
J
Dauzat
Michel
M
Marès
Pierre
P
D000022:Abortion, Spontaneous / Q000276:immunology*; D017153:Antibodies, Anticardiolipin / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D001798:Blood Proteins / Q000032:analysis / Q000172:deficiency / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D005313:Fetal Death / Q000276:immunology; D005865:Gestational Age; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016015:Logistic Models; D011225:Pre-Eclampsia / Q000276:immunology; D011247:Pregnancy; D053482:beta 2-Glycoprotein I
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; D001798:Blood Proteins; D006023:Glycoproteins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D053482:beta 2-Glycoprotein I; C026080:plasma protein Z