title: Association between the presence of autoantibodies against adrenoreceptors and severe pre-eclampsia: a pilot study.
abstract: BACKGROUND
  Pre-eclampsia is the leading cause of maternal and neonatal morbidity and mortality with incompletely understood etiopathogenesis. The purpose of the current study is to determine whether there is a relationship between the presence of autoantibodies against β1, β2 and α1 adrenoreceptors and severe pre-eclampsia.
  
  
  RESULTS
  Synthetic peptides corresponding to amino acid sequences of the second extracellular loops of β1, β2 and α1 adrenoreceptors were synthesized as antigens to test 34 patients with severe pre-eclampsia, 36 normal pregnancy women and 40 non-pregnant controls for the presence of autoantibodies using enzyme-linked immunosorbent assay. The respective frequencies of autoantibodies against β1, β2 and α1 adrenoreceptors were 50.0% (17/34), 52.9% (18/34) and 55.9% (19/34) in patients with severe pre-eclampsia, 19.4% (7/36) (p = 0.011), 19.4% (7/36) (p = 0.006) and 17.6% (6/36) (p = 0.001) in normal pregnancy women and 10% (4/40), 7.5% (3/40) and 10% (4/40) (p<0.001) in non-pregnant controls. Titers of these autoantibodies were also significantly increased in patients with severe pre-eclampsia. By logistic regression analysis, the presence of these three autoantibodies significantly increased the risk of neonatal death (odds ratio, 13.5; 95% confidence interval, 1.3-141.3; p = 0.030) and long-term neonatal hospitalization (odds ratio, 5.0; 95% confidence interval, 1.3-19.1; p = 0.018). The risk of hypertension and fetal distress were also associated with the presence of these three autoantibodies.
  
  
  CONCLUSIONS
  This novel pilot study demonstrated for the first time that the presence of autoantibodies against β1, β2 and α1 adrenoreceptors are increased in patients with severe pre-eclampsia. Pregnant women who are positive for the three autoantibodies are at increased risks of neonatal mortality and morbidity. We posit that these autoantibodies may be involved in the pathogenesis of severe pre-eclampsia.
authors.affiliation: Heart Centre, Capital Medical University, Chao-Yang Hospital, Beijing, China.
authors.forename: Guiling
authors.initials: G
authors.lastname: Ma
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Li
authors.forename: Juan
authors.initials: J
authors.lastname: Zhang
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Dongyan
authors.initials: D
authors.lastname: Hou
authors.forename: Lei
authors.initials: L
authors.lastname: Zhu
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001034:Apgar Score; D001323:Autoantibodies / Q000276:immunology*; D001724:Birth Weight; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009929:Organ Size; D010865:Pilot Projects; D010920:Placenta / Q000473:pathology; D011225:Pre-Eclampsia / Q000276:immunology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology; D011941:Receptors, Adrenergic / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D011941:Receptors, Adrenergic