title: Anti-Ro/SSA-p200 antibodies in the prediction of congenital heart block. An Italian multicentre cross-sectional study on behalf of the 'Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni (FIRMA) Group'.
abstract: OBJECTIVE
  To verify the association between the presence of specific anti-52 Ro/SSA-p200 antibodies and congenital heart block (CHB).
  
  
  METHODS
  207 pregnant Italian women carrying anti-Ro/SSA Ab were retrospectively evaluated. Anti-p200 Ab were investigated in the mothers' sera by ELISA (Euro-Diagnostica,Wieslab SS-A p200).
  
  
  RESULTS
  CHB occurred in 42 children (34 complete CHB), whereas 165 were not affected. All CHB cases were previously identified with an ELISA screening for anti-Ro/SSA 60 kD Ab. Anti-p200 Ab were more frequently positive (81.0% vs. 59.1%, p=0.013) and at a higher titer in CHB mothers (Absorbance ratio: 2.030 (0.208-4.052) vs. 0.925 (0.200-3.816); p=0.017). This association was maintained even when the 42 mothers of children with CHB were compared with a control group matched for age and diagnosis (80.9% vs. 50.0%; p=0.006). The presence of anti-p200 Ab provided an odds ratio (OR) for CHB of 2.98 (CI: 1.30-6.83), which was higher than that of other variables, such as maternal disease and other antibody specificities. CHB risk significantly decreased in the absence of this fine specificity (OR:0.34, CI: 0.15-0.77). However, while the negative predictive value related to anti-Ro/SSA 60 kD Ab ELISA was 100%, almost 20% of mothers negative for anti-p200 Ab delivered babies with CHB.
  
  
  CONCLUSIONS
  Anti-p200 antibodies seem to be associated with CHB with a higher probability than anti-Ro/SSA Ab, and therefore may be an additional test to identify mothers at higher risk to deliver affected children. An ELISA screening for anti-Ro/SSA 60 kD Ab is nevertheless mandatory given the probability of developing CHB also in the absence of anti-p200 Ab.
authors.affiliation: Rheumatology and Clinical Immunology Unit, Spedali Civili and University of Brescia, Italy. mirko_scarsi@libero.it.
authors.forename: Mirko
authors.initials: M
authors.lastname: Scarsi
authors.forename: Antonella
authors.initials: A
authors.lastname: Radice
authors.forename: Francesca
authors.initials: F
authors.lastname: Pregnolato
authors.forename: Veronique
authors.initials: V
authors.lastname: Ramoni
authors.forename: Chiara
authors.initials: C
authors.lastname: Grava
authors.forename: Laura
authors.initials: L
authors.lastname: Bianchi
authors.forename: Maria
authors.initials: M
authors.lastname: Gerosa
authors.forename: Marta
authors.initials: M
authors.lastname: Mosca
authors.forename: Anna
authors.initials: A
authors.lastname: Ghirardello
authors.forename: Chiara
authors.initials: C
authors.lastname: Tani
authors.forename: Mario
authors.initials: M
authors.lastname: Motta
authors.forename: Marzia
authors.initials: M
authors.lastname: Quinzanini
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
authors.forename: Amelia
authors.initials: A
authors.lastname: Ruffatti
authors.forename: Paola
authors.initials: P
authors.lastname: Migliorini
authors.forename: Andrea
authors.initials: A
authors.lastname: Doria
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Meroni
authors.forename: Antonio
authors.initials: A
authors.lastname: Brucato
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006327:Heart Block / Q000097:blood / Q000151:congenital* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D007558:Italy; D008431:Maternal-Fetal Exchange; D016017:Odds Ratio; D010446:Peptide Fragments / Q000276:immunology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D012261:Ribonucleoproteins / Q000276:immunology*; D012307:Risk Factors; D000099207:SS-A Antigen
chemical_list: D000974:Antibodies, Antinuclear; D015415:Biomarkers; D010446:Peptide Fragments; D012261:Ribonucleoproteins; D000099207:SS-A Antigen; C035356:SS-A antibodies