A Retrospective Study on the Association between Thyroid Autoantibodies with β2-glycoprotein and Cardiolipin Antibodies in Recurrent Miscarriage
Abstract
Etiologic factors for recurrent miscarriage (RM) include autoimmune diseases, the most frequently antiphospholipid syndrome and thyroiditis. Some women who suffer from RM might also have an altered immune system. We aimed to evaluate possible associations between anti-thyroid and anti-phospholipid antibodies in women with RM. In a retrospective case series 1 on 156 women with RM, major outcome parameters were antibodies against cardiolipin, β2-glycoprotein I, thyreoperoxidase (TPO-Ab), and thyroglobulin (TG-Ab). Significant (p<0.05) positive correlations were found between TPO-Ab and TG-Ab (r=0.577), TPO-Ab and IgG anti-cardiolipin antibodies (r=0.284), TPO-Ab and IgG anti- β2-glycoprotein I antibodies (r=0.196), and TG-Ab and IgG anti-cardiolipin antibodies (r=0.193), as well as between all types of anti-phospholipid antibodies. Women with both increased TPO-Ab and TG-Ab levels revealed higher (p<0.001) IgG anti-cardiolipin and IgG anti-β2-glycoprotein I antibodies. Anti-thyroid antibodies were linked to anti-phospholipid antibodies and should be in the focus of future research on RM.
1. American College of Obstetricians and Gynecologists (ACOG). ACOG practice bulletin. Management of recurrent pregnancy loss. Number 24, February 2001. (Replaces Technical Bulletin Number 212, September 1995). Int J Gynaecol Obstet 2002; 78(2):179-190.
2. Garrido-Gimenez C, Alijotas-Reig J. Recurrent miscarriage: causes, evaluation and management. Postgrad Med J 2015; 91(1073):151-162.
3. Zenclussen AC. Adaptive immune responses during pregnancy. Am J Reprod Immunol 2013; 69(4):291-303.
4. Williams Z. Inducing tolerance to pregnancy. N Engl J Med 2012; 367(12):1159–1161.
5. Rowe JH, Ertelt JM, Xin L, Way SS. Pregnancy imprints regulatory memory that sustains anergy to fetal antigen. Nature 2012; 490(7418):102-106.
6. van den Boogaard E, Vissenberg R, Land JA, van Wely M, van der Post JA, Goddijn M, et al. Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update 2011; 17(5):605-619.
7. Tektonidou MG, Margarita A, Vlachoyiannopoulos P, Moutsopoulos HM. Presence of systemic autoimmune disorders in patients with autoimmune thyroid diseases. Ann Rheum Dis 2004; 63(9):1159-1161.
8. De Carolis C, Greco E, Guarino MD, Perricone C, Dal Lago A, Giacomelli R, et al. Anti-thyroid antibodies and antiphospholipid syndrome: evidence of reduced fecundity and of poor pregnancy outcome in recurrent spontaneous aborters. Am J Reprod Immunol 2004; 52(4):263-266.
9. Hazeldine J, Arlt W, Lord JM. Dehydroepiandrosterone as a regulator of immune cell function. J Steroid Biochem Mol Biol 2010; 120(2-3):127-136.
10. Ott J, Pecnik P, Promberger R, Pils S, Seemann R, Hermann M, et al. Dehydroepiandrosterone in women with premature ovarian failure and Hashimoto's thyroiditis. Climacteric 2014; 17(1):92-96.
11. Tempfer CB, Kurz C, Bentz EK, Unfried G, Walch K, Czizek U, et al. A combination treatment of prednisone, aspirin, folate, and progesterone in women with idiopathic recurrent miscarriage: a matched-pair study. Fertil Steril 2006; 86(1):145-148.
12. Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4(2):295-306.
13. Promberger R, Hermann M, Ott J. Hashimoto’s thyroiditis in patients with normal thyroid stimulating hormone levels. Expert Rev Endocrinol Metab 2012; 7:175-179.
14. Franchini M, Lippi G, Manzato F, Vescovi PP. Thyroid-associated autoimmune coagulation disorders. J. Thromb. Thrombolysis 2010; 29(1):87-91.
15. Drbalová K, Matucha P, Matejková-Behanová M, Bílek R, Kríz L, Kazihnitková H, et al. Immunoprotective steroids and SHBG in non-treated hypothyroidism and their relationship to autoimmune thyroid disorders. Physiol Res 2008; 57(suppl):S119-S125.
16. Schwartz KE. Autoimmunity, dehydroepiandrosterone (DHEA), and stress. J Adolesc Health 2002; 30(suppl):S37-S43.
17. Greer LG, Casey BM, Halvorson LM, Spong CY, McIntire DD, Cunningham FG. Antithyroid antibodies and parity: further evidence for microchimerism in autoimmune thyroid disease. Am J Obstet Gynecol 2011; 205(5):471e1-e4.
18. Ott J, Promberger R, Kober F, Neuhold N, Tea M, Huber JC, et al. Hashimoto's thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case-control study in women undergoing thyroidectomy for benign goiter. Thyroid 2011; 21(2):161-167.
19. Weetman AP. Immunity, thyroid function and pregnancy molecular mechanisms. Nat Rev Endocrinol 2010; 6(6):311-318.
| Files | ||
| Issue | Vol 16, No 1 (2017) | |
| Section | Brief Communication | |
| Keywords | ||
| Antiphospholipid syndrome Autoimmunity Dehydroepiandrosterone Recurrent early pregnancy loss Recurrent miscarriage Thyroiditis | ||
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