title: Higher levels of procoagulant microparticles in women with recurrent miscarriage are not associated with antiphospholipid antibodies.
abstract: OBJECTIVE
  Are the levels of circulating cell-derived microparticles (cMPs) in patients with recurrent miscarriage (RM) associated with the antiphospholipid syndrome (APS)?
  
  
  CONCLUSIONS
  cMPs in women with RM are not associated with antiphospholipid antibodies (aPLs).
  
  
  BACKGROUND
  Previous studies have focused on cMP levels in RM patients. Most studies have shown higher levels of cMPs in RM patients whereas others have reported lower levels. Data regarding cMPs in patients with the APS are scanty in the literature.
  
  
  METHODS
  A case-control study including three groups of patients. A total of 154 women were prospectively recruited from September 2009 to October 2013. Four patients refused to participate. The APS group consisted of 50 women that had been previously diagnosed with primary APS and had had ≥3 consecutive first trimester miscarriages. The uRM group included 52 couples with ≥3 consecutive first trimester miscarriages of unknown etiology. The fertile control (FER) group was composed of 52 healthy fertile women with no history of pregnancy losses. Miscarriage was defined as intrauterine pregnancy loss at <10 weeks' size on ultrasound.
  
  
  METHODS
  Venous blood samples for coagulation studies and cMP determinations were obtained. All patients underwent a thrombophilia study.
  
  
  RESULTS
  cMP levels were significantly higher in the APS and uRM groups versus the FER group (P < 0.0001 and P = 0.009, respectively) (cMP number × 10(3)/ml plasma [mean ± SD]: APS: 18.5 ± 13.6; uRM: 16.3 ± 13.8; FER: 9.7 ± 4.6). There were no statistically significant differences in cMP levels between the APS and uRM groups.
  
  
  CONCLUSIONS
  The sample size was arbitrarily decided according to previous studies analyzing cMPs in RM patients. Different cMP subtypes were not investigated.
  
  
  CONCLUSIONS
  The present study adds further data on the subject showing that patients with RM, irrespective of testing positive for aPLs, have increased levels of cMPs compared with healthy fertile controls. The presence of elevated cMPs in RM women may reflect an ongoing systemic pathological, albeit asymptomatic, status that can become deleterious in the setting of pregnancy.
  
  
  BACKGROUND
  This study was supported in part by grant from FIS-PI11/01560 within the 'Plan Nacional de I+D+I' and co-funded by the 'ISCIII-Subdirección General de Evaluación' and the 'Fondo Europeo de Desarrollo Regional (FEDER)'. The authors have no competing interests to disclose.
  
  
  BACKGROUND
  Not applicable.
authors.affiliation: Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d' Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Martínez-Zamora
authors.affiliation: Hemotherapy and Hemostasis Unit, Hospital Clínic of Barcelona, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Tàssies
authors.affiliation: Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d' Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Creus
authors.affiliation: Hemotherapy and Hemostasis Unit, Hospital Clínic of Barcelona, Barcelona, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: Reverter
authors.affiliation: Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d' Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Puerto
authors.affiliation: Hemotherapy and Hemostasis Unit, Hospital Clínic of Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Monteagudo
authors.affiliation: Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d' Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Carmona
authors.affiliation: Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d' Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain jbalasch@ub.edu.
authors.forename: J
authors.initials: J
authors.lastname: Balasch
mesh_terms: D000026:Abortion, Habitual / Q000097:blood* / Q000209:etiology; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000150:complications; D016022:Case-Control Studies; D055252:Cell-Derived Microparticles; D005260:Female; D006801:Humans; D011247:Pregnancy
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: antiphosholipid antibodies; antiphospholipid syndrome; cell-derived microparticles; microparticles; recurrent miscarriage; recurrent pregnancy loss