Autoantibodies in endometriosis sera recognize a Thomsen-Friedenreich-like carbohydrate antigen

Autoantibody responses to endometrial antigens are a common feature of endometriosis. Antibody responses to a number of serum and tissue antigens such as alpha(2)-Heremans Schmidt glycoprotein (alpha(2)-HSG), transferrin, and carbonic anhydrase have been identified. The nature of the epitopes recognized on these proteins has not been determined. In this study we show that the serum antibody response to alpha(2)-HSG and carbonic anhydrase is against a common carbohydrate epitope which is also expressed on bovine fetuin. Removal of carbohydrate moieties from these antigens resulted in loss of antibody binding. Antibody reactivity with alpha(2)-HSG, fetuin and other antigens was removed by binding with the lectin jacalin. Jacalin specifically binds the Thomsen-Friedenreich antigen (Galbeta1-3GalNAc). Demonstrating that the autoantibodies also reacted with other Thomsen-Friedenreich antigen-bearing proteins, serum IgA1 and haemopexin confirmed an association with this epitope. These antigens have not been previously described as autoantigens in endometriosis and are of interest since they raise the possibility that this autoimmune response may either play a direct role in the disease process or reflect an abnormality of glycosylation in endometriosis. These results may also prove useful in the development of a serum diagnostic test for endometriosis.