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Neonatal lupus syndromes

J P Buyon1

  • 1Department of Rheumatic Diseases, Hospital for Joint Diseases, New York, NY 10003.

Current Opinion in Rheumatology
|September 1, 1994
PubMed
Summary
This summary is machine-generated.

Maternal autoantibodies, specifically anti-Ro/SS-A and anti-La/SS-B, can cause heart block in newborns. Rabbit heart studies suggest calcium channel involvement, and clinical data show high antibody titers in affected infants.

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Area of Science:

  • Immunology
  • Cardiology
  • Neonatology

Background:

  • Neonatal lupus is a rare condition involving passively acquired autoimmunity from maternal autoantibodies.
  • Maternal anti-Ro/SS-A and anti-La/SS-B antibodies are implicated in the pathogenesis of neonatal lupus.
  • Congenital heart block is a significant manifestation of neonatal lupus.

Purpose of the Study:

  • To investigate the pathogenicity of maternal anti-Ro/SS-A and anti-La/SS-B antibodies in a rabbit model.
  • To analyze serologic profiles of mothers with infants diagnosed with congenital heart block.
  • To understand the role of autoantibodies in the development of fetal heart conduction abnormalities.

Main Methods:

  • Perfusion of adult rabbit hearts with maternal sera containing anti-Ro/SS-A and anti-La/SS-B antibodies.

Related Experiment Videos

  • Patch-clamp experiments on isolated rabbit ventricular myocytes to assess current reduction.
  • Analysis of sera from mothers of infants with congenital heart block, comparing with controls.

    • Main Results:

    • Maternal anti-Ro/SS-A and anti-La/SS-B antibodies induced conduction abnormalities in rabbit hearts.
    • These antibodies reduced the peak slow inward current in isolated ventricular myocytes, suggesting calcium channel involvement.
    • High titers of anti-Ro/SS-A and associated anti-La/SS-B antibodies were prevalent in mothers of affected infants.

    Conclusions:

    • Maternal anti-Ro/SS-A and anti-La/SS-B autoantibodies are directly implicated in the development of congenital heart block.
    • Calcium channels are likely involved in the mechanism of antibody-induced cardiac conduction defects.
    • While dexamethasone can reduce effusions, it has not reversed established third-degree heart block in affected fetuses.