Low titer, isolated anti Ro/SSA 60 kd antibodies is correlated with positive pregnancy outcomes in women at risk of congenital heart block

Clin Rheumatol. 2017 May;36(5):1155-1160. doi: 10.1007/s10067-017-3572-2. Epub 2017 Feb 15.

Abstract

Congenital heart block (CHB) is an autoantibody mediated disorder presumably caused by placental transmission of maternal autoantibodies to Ro/SSA 52 kd, p200, Ro/SSA 60 kd, La/SSB ribonucleoproteins. This study investigated the clinical significance of isolated anti-Ro/SSA 52 kd, anti-p200, anti-Ro/SSA 60 kd, and anti-La/SSB antibodies in positive pregnant patients. One hundred sixty-three pregnant women positive to anti-Ro/SSA 52 kd and/or anti-Ro/SSA 60 kd and/or anti-La/SSB antibodies were prospectively enrolled in the study. Anti-Ro52, anti-Ro60, anti-p200, and anti-La antibodies were assayed using home-made ELISA assays. Isolated antibody positivity was found in 25 women (15.3%), while multiple antibody positivity in 138 (84.7%). Twenty-four developed CHB, and the 139 had a favorable pregnancy outcome. The prevalence of isolated anti-Ro/SSA 60 kd antibodies was significantly higher (p < 0.046) as the prevalence of lower mean antibody titers (p < 0.0001) in the later group. Confirmation of these results by large-scale studies could lead clinicians to recommend less stringent fetal echocardiography monitoring in women with isolated anti-Ro/SSA 60 kd antibodies.

Keywords: Anti-La/SSB; Anti-Ro/SSA 52kd; Anti-Ro/SSA 60 kd; Anti-p200; Congenital heart block; Isolated autoantibodies.

MeSH terms

  • Adult
  • Antibodies, Antinuclear / blood
  • Antibodies, Antinuclear / immunology*
  • Autoantibodies / blood
  • Autoantibodies / immunology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Heart Block / blood
  • Heart Block / congenital*
  • Heart Block / epidemiology
  • Heart Block / immunology
  • Humans
  • Incidence
  • Infant, Newborn
  • Italy / epidemiology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular*
  • Pregnancy Outcome
  • Prospective Studies
  • Time Factors

Substances

  • Antibodies, Antinuclear
  • Autoantibodies
  • SS-A antibodies

Supplementary concepts

  • Congenital heart block