Macroprolactin in mothers and their babies: what is its origin?
Norito Nishiyama1, Naoki Hattori1, Kohozo Aisaka2
1Department of Orthopedic Surgery, Kansai Medical University, Osaka, Japan.
Objectives:
Macroprolactinemia is one of the major causes of hyperprolactinemia. The aim of this study was to clarify the origin of macroprolactin (macro-PRL).
Methods:
We examined macro-PRL in the sera of 826 pregnant women and in those of their babies' umbilical cords at delivery. Macro-PRL was evaluated by precipitation with polyethylene glycol (PEG), gel filtration chromatography (GFC), and absorption with protein G (PG).
Results:
We detected macro-PRL in 16 out of the 826 pregnant women (1.94 %) and in 14 of their babies, which may indicate the possibility of hereditary origin of macro-PRL. However, the macro-PRL ratios of the babies correlated positively with those of their mothers (r=0.72 for GFC, p<0.001 and r=0.77 for PG, p<0.001), suggesting that the immunoglobulin (Ig)G-type anti-PRL autoantibodies might be actively transferred to babies via the placenta and form macro-PRL by binding to their babies' PRL or PRL-IgG complexes may possibly pass through the placenta. There were two cases in which only mothers had macro-PRL, indicating that the mothers had autoantibodies that did not pass through the placenta, such as IgA, PRL bound to the other proteins or PRL aggregates. No cases were found in which only the babies had macro-PRL and their mothers did not, suggesting that macro-PRL might not arise by non-hereditary congenital causes.
Conclusions:
Macro-PRL in women of reproductive age might be mostly IgG-type anti-PRL autoantibody-bound PRL. The likely origin of macro-PRL in babies is the transplacental transfer of IgG-type anti-PRL autoantibodies or PRL-IgG complexes from the mothers to their babies.
Insights
Macroprolactinemia in pregnant women is often due to IgG autoantibodies binding to prolactin (PRL). This macro-PRL can transfer to babies via the placenta, suggesting a transplacental origin.
Area of Science:
- Endocrinology
- Immunology
- Reproductive Medicine
Background:
- Macroprolactinemia is a significant cause of hyperprolactinemia.
- Understanding the origin of macroprolactin (macro-PRL) is crucial for clinical management.
Purpose of the Study:
- To investigate the origin of macroprolactin (macro-PRL) in pregnant women and their newborns.
- To determine the role of autoantibodies in macroprolactinemia during pregnancy.
Main Methods:
- Analysis of macro-PRL in sera from 826 pregnant women and their newborns.
- Evaluation of macro-PRL using polyethylene glycol (PEG) precipitation, gel filtration chromatography (GFC), and protein G (PG) absorption.
Main Results:
- Macro-PRL was detected in 1.94% of pregnant women and their babies.
- Strong positive correlations were observed between maternal and infant macro-PRL levels, particularly for IgG-type anti-PRL autoantibodies.
- Findings suggest transplacental transfer of maternal autoantibodies or PRL-IgG complexes to the fetus.
Conclusions:
- Macro-PRL in reproductive-aged women is predominantly macroprolactin (macro-PRL) bound to IgG-type anti-PRL autoantibodies.
- The primary source of macro-PRL in newborns is likely the transplacental transfer of these maternal autoantibodies or PRL-IgG complexes.
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