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Disruption of the Mouse Blood-Brain Barrier by Small Extracellular Vesicles from Hypoxic Human Placentas

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Antiphospholipid syndrome and pre-eclampsia.

Lothar Heilmann¹, Martin Schorsch, Thomas Hahn

¹Institute of Reproduction, Wiesbaden, Germany. lothar.heilmann@googlemail.com

Seminars in Thrombosis and Hemostasis

|March 4, 2011

Summary

Antiphospholipid antibodies (APAs) are elevated in 20% of women with severe pre-eclampsia (P-EC) before 34 weeks gestation. This finding suggests APAs may indicate a higher risk for this condition in early pregnancy.

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Published on: November 20, 2015

Area of Science:

Obstetrics and Gynecology
Immunology
Autoimmune Diseases

Background:

Antiphospholipid syndrome (APS) is an autoimmune disorder linked to recurrent thrombosis or obstetric complications.
Obstetric morbidity in APS includes recurrent miscarriage and severe pre-eclampsia (P-EC).
The Sydney recommendations (2006) revised criteria for diagnosing APS clinical and laboratory events.

Purpose of the Study:

To investigate the prevalence of antiphospholipid antibodies (APAs) in women with severe P-EC.
To compare APA levels in severe P-EC patients with women experiencing uncomplicated pregnancies.
To determine if APA levels correlate with gestational age at P-EC onset.

Main Methods:

Retrospective analysis of blood samples from women with severe P-EC and controls.
Classification of severe P-EC patients based on 2006 Sydney criteria subgroups.
Measurement of antiphospholipid antibodies (anticardiolipin, lupus anticoagulant, β-2 glycoprotein-1).

Main Results:

Elevated APAs were found in 20% of women with severe P-EC.
Increased APA prevalence was significant in severe P-EC (odds ratio: 2.45) but not in controls.
Elevated APAs were specifically observed in severe P-EC cases occurring before 34 weeks of gestation.

Conclusions:

Determination of anticardiolipin antibodies, lupus anticoagulant, and β-2 glycoprotein-1 antibodies is recommended for patients with severe P-EC before 34 weeks gestation.
Early detection of APAs in early-onset severe P-EC may aid in risk assessment and management.
Further research is warranted to elucidate the causal relationship between APAs and early-onset severe P-EC.