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The role of antiphospholipid antibodies (aPls) in infertile women: the long-lasting experience

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Reproductive Medicine and Biology

Abstract

Antiphospholipid antibodies (aPls) are generally characterized as heterogeneous and non-specific autoantibodies directed against various phospholipids such as cardiolipin, ph-serine, ph-inositol, ph-acid, ph-glycerol, ph-sphyngomyelin, ph-choline, annexins, and co-factor β2-glycoprotein I. aPls occur not only during autoimmune diseases but also during infectious diseases, essential hypertension, neurological complication, metabolic diseases, some drug abuse, and transplant loss. aPls are very often found in connection with reproductive failure such as repeated pregnancy loss and/or missed abortion, intrauterine fetal death, in preeclampsia, and repeated delivery of hypothrophic fetus. The presence of aPls, thrombosis, and fertility failure create primary or secondary antiphospholipid syndrome. This article explains some aspects and clinical and laboratory significance of the aPls in female infertility.

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References

  1. Wasserman A. Über die Entwicklung und den gegenwärtigen Stand der Serodiagnostik gegenüber Syphilis. Berl Klin Wochenschr. 1907;44:1599–605.

    Google Scholar 

  2. Pangborn MC. A new serologically active phospholipids from beef heart. Proc Soc Exp Biol Med. 1941;48:484–6.

    Article  CAS  Google Scholar 

  3. Conley CL, Hartman RC. Haemorrhagic disorders caused by circulating anticoagulant in patients with disseminated lupus erythematosus. J Clin Invest. 1952;31:621–6.

    Google Scholar 

  4. Laurell A, Nilsson IM. Hypergammaglobulinemia, circulating anticoagulant, and biologic false-positive Wasserman reaction. J Lab Clin Med. 1957;49:694–707.

    CAS  PubMed  Google Scholar 

  5. Shapiro SS, Thiagarajan P. Lupus anticoagulants. Prog Hemost Thromb. 1982;6:263–85.

    CAS  PubMed  Google Scholar 

  6. Harris EN, Ghavari AE, Boey ML. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet. 1983;2:1211–4.

    Article  CAS  PubMed  Google Scholar 

  7. Loizou S, McCrea JD, Rudge AC. Measurement of anticardiolipin antibodies by an enzyme-linked immunosorbent assay (ELISA): standardisation and quantitation of results. Clin Exp Immunol. 1985;62:738–45.

    PubMed Central  CAS  PubMed  Google Scholar 

  8. Harris EN, Gharavi AE, Wasley GD, Hughes GRV. Use of an enzyme-linked immunosorbent assay and inhibition studies to distinguish between antibodies to cardiolipin from patients with syphilis or autoimmune disorders. J Infect Dis. 1988;157:23–31.

    Article  CAS  PubMed  Google Scholar 

  9. Koike T, Sueishi M, Funaki H. Antiphospholipid antibodies and biological false-positive serological tests for syphilis in patients with systemic lupus erythematosus. Clin Exp Immunol. 1984;56:193–9.

    PubMed Central  CAS  PubMed  Google Scholar 

  10. Olhoffer IH, Peng SL, Craft J. Revisiting autoantibody profiles in systemic lupus erythematosus. J Rheumatol. 1997;24:297–302.

    CAS  PubMed  Google Scholar 

  11. Mills JA. Systemic lupus erythematosus. N Engl J Med. 1994;330:1871–9.

    Article  CAS  PubMed  Google Scholar 

  12. McNeil HP, Chesterman CN, Krilis SA. Immunology and clinical importance of antiphospholipid antibodies. Adv Immunol. 1991;49:193–279.

    Article  CAS  PubMed  Google Scholar 

  13. Asheron RA, Cervera R. Antiphospholipid antibodies and infectious. Ann Rheum Dis. 2003;49:388–93.

    Article  Google Scholar 

  14. Vaarla O, Puurunen M, Manttari M, Manninen V, Aho K, Palosuo T. Antibodies to prothrombin imply a risk of myocardial infarction in middle-aged men. Thromb Haemost. 1996;75:456–9.

    Google Scholar 

  15. Asherson RA. The catastrophic antiphospholipid syndrome. J Rheumatol. 1992;19:508–12.

    CAS  PubMed  Google Scholar 

  16. Briley DP, Coull BM, Goodnight SH. Neurological disease associated with antiphospholipid antibodies. Ann Neurol. 1989;44:221–7.

    Article  Google Scholar 

  17. Shoenfeld Y, Lev S, Blatt I. Features associated with epilepsy in the antiphospholipid syndrome. J Rheumatol. 2004;31:1344–8.

    PubMed  Google Scholar 

  18. Singer HS, Krumholz A, Giuliano J, Kiessling LS. Antiphospholipid antibodies: an epiphenomenon in Tourette syndrome. Mov Disord. 1997;12:738–42.

    Article  CAS  PubMed  Google Scholar 

  19. Mori T, Takai Y, Minakuchi R. Inhibitory action of chlorpromazine, dibucaine and other phospholipid-interacting drugs on calcium-activated phospholipid-dependent protein kinase. J Biol Chem. 1980;225:8378–80.

    Google Scholar 

  20. Chedid A, Kurmanadha CR, Morgan TR, Moritz TE, Mendenhall CL, Hammong JB. Antiphospholipid antibodies in alcoholic liver disease. Hepatology. 1994;31:141–2.

    Google Scholar 

  21. Gargiulo P, Goldberg J, Romani B, Schiaffini R, Ciampalini P, Faulk WP. Qualitative and quantitative studies of autoantibodies to phospholipids in diabetes mellitus. Clin Exp Immunol. 1999;118:30–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Wagenknecht DR, Becker DG, LeFor WM, McIntyre JA. Antiphospholipid antibodies are a risk factor for early renal allograft failure. Transplantation. 1999;68:241–6.

    Article  CAS  PubMed  Google Scholar 

  23. McIntyre JA, Wagenknecht DR, Faulk WP. Antiphospholipid antibodies: discovery, definitions, detection and disease. Prog Lipid Res. 2003;42:176–237.

    Article  CAS  PubMed  Google Scholar 

  24. Passam FH, Krilis SA. Laboratory tests for the antiphospholipid syndrome: current concepts. Pathology. 2004;36:129–38.

    Article  PubMed  Google Scholar 

  25. Wilson WA, Gharavi AE, Koike T, Lockshin MD, Branch DW. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum. 1999;42:1309–11.

    Article  CAS  PubMed  Google Scholar 

  26. Graves M. Antiphospholipid antibodies and thrombosis. Lancet. 1999;353:1348–53.

    Article  Google Scholar 

  27. Koike T. Antiphospholipid antibodies in arterial thrombosis. Ann Med. 2000;1:27–31.

    Google Scholar 

  28. Stoheger ZM, Mozes E, Tartakovsky B. Anti-cardiolipin antibodies induce pregnancy failure by impairing embryonic implantation. Proc Natl Acad Sci USA. 1993;90:6464–7.

    Article  Google Scholar 

  29. Triplett DA. Antiphospholipid antibodies and recurrent pregnancy loss. Am J Reprod Immunol. 1989;20:52–67.

    Article  CAS  PubMed  Google Scholar 

  30. Devreese KM. Antiphospholipid antibody testing and standardization. Int J Lab Hematol. 2014;36(3):352–63.

    Article  CAS  PubMed  Google Scholar 

  31. Kwak JY, Gilman-Sachs A, Beaman KD, Beer AE. Autoantibodies in women with primary recurrent spontaneous abortion of unknown etiology. J Reprod Immunol. 1992;22:15–31.

    Article  CAS  PubMed  Google Scholar 

  32. Lockshim MD, Erkan D. Treatment of the antiphospholipid syndrome. N Engl J Med. 2003;349:1177–9.

    Article  Google Scholar 

  33. Derksen RHWM, Khamasta MA, Branch DW. Management of the obstetric antiphospholipid syndrome. Arthritis Rheum. 2004;50:1028–39.

    Article  CAS  PubMed  Google Scholar 

  34. Soulier JP, Boffa MC. Avortement repetition, thromboses, et anticoagulant circulant antithromboplastine. Nouv Presse Med. 1980;9:859–64.

    Google Scholar 

  35. Branch DW, Silver RM. Criteria for antiphospholipid syndrome: early pregnancy loss, fetal loss, or recurrent pregnancy loss? Lupus. 1996;5:409–13.

    CAS  PubMed  Google Scholar 

  36. El-Roeiy A, Gleicher N, Friberg J, Myers A. Correlation between peripheral blood and follicular fluid autoantibodies and impact on in vitro fertilization. Obstet Gynecol. 1987;70:163–70.

    CAS  PubMed  Google Scholar 

  37. Geva E, Amit A, Lerner-Geva L, Lessing JB, Yaron Y. Autoimmune disorders: another possible cause for in vitro fertilization and embryo transfer failure. Hum Reprod. 1995;10:2560–3.

    CAS  PubMed  Google Scholar 

  38. Kwak JYH, Gilman-Sachs A, Beaman KD, Beer AE. Autoantibodies in women with primary recurrent spontaneous abortion of unknown etiology. J Reprod Immunol. 1992;22:15–31.

    Article  CAS  PubMed  Google Scholar 

  39. Mardesic T, Ulcova-Gallova Z, Huttelova R, Muller P, Voboril J, Hulvert J. The influence of different types of antibodies on in vitro fertilization results. Am J Reprod Immunol. 2000;43:1–5.

    Article  CAS  PubMed  Google Scholar 

  40. Gleicher N. Antiphospholipid antibodies and reproductive failure: what they do and what they do not do; how to, and how not to treat. Hum Reprod. 1997;12:13–6.

    Article  CAS  PubMed  Google Scholar 

  41. Christiansen OB, Ulcova-Gallova Z, Mohapeloa H, Krauz V. Studies on associations between human leucocyte antigen (HLA) class II and antiphospholipid antibodies in Danish and Czech women with recurrent miscarriages. Hum Reprod. 1998;13:3326–31.

    Article  CAS  PubMed  Google Scholar 

  42. Ulcova-Gallova Z, Krauz V, Novakova P, Milichovska L, Micanova Z, Bibkova K, Sucha R, Turek J, Balvin M, Rokyta Z. Anti-phospholipid antibodies against phosphatidylinositol, and phosphatidylserine are more significant in reproductive failure than antibodies against cardiolipin only. Am J Reprod Immunol. 2005;54:112–7.

    Article  CAS  PubMed  Google Scholar 

  43. Dmowski WP, Rana N, Michalowska J. The effect of endometriosis, its stage and activity, and of autoantibodies on in vitro fertilization and embryo transfer rates. Fertil Steril. 1995;63:555–62.

    CAS  PubMed  Google Scholar 

  44. Ulcova-Gallova Z, Bouse V, Svabek L, Turek J, Rokyta Z. Endometriosis in reproductive immunology. Am J Reprod Immunol. 2002;47:269–74.

    Article  PubMed  Google Scholar 

  45. Ulcova-Gallova Z. Diagnosis infertility—the attack of immunity. 2nd ed. Prague: Grada; 2013. p. 1–99.

    Google Scholar 

  46. Subrt I, Ulcova-Gallova Z, Bibkova K, Micanova Z, Hejnalova M, Cerna M. Recurrent pregnancy loss and frequency of eight antiphospholipid antibodies and genetic thrombophilic factors in Czech women. Am J Reprod Immunol. 2008;59(3):193–200.

    Article  CAS  PubMed  Google Scholar 

  47. Subrt I, Ulcova-Gallova Z, Cerna M, Hejnalova M, Slovanova J, Bibkova K, Micanova Z. Recurrent pregnancy loss, plasminogen activator inhibitor-1 (−675) 4G/5G polymorphism and antiphospholipid antibodies in Czech women. Am J Reprod Immunol. 2013;70(1):54–8.

    Article  CAS  PubMed  Google Scholar 

  48. Rai RM, Cohen H, Dave M, Regan L. Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with phospholipid antibodies. Br Med J. 1997;314:253–7.

    Article  CAS  Google Scholar 

  49. Silver RK, MacGregor SN, Sholl JS, Hobart JM, Neerhof MG, Ragin A. Comparative trial of prednisone plus aspirin versus aspirin alone in the treatment of anticardiolipin antibody-positive obstetric patients. Am J Obstet Gynecol. 1993;169:1411–7.

    Article  CAS  PubMed  Google Scholar 

  50. Ulcova-Gallova Z, Krauz V, Rokyta Z. Six kinds of antiphospholipid antibodies in ovulatory cervical mucus and seminal plasma from couples with repeated miscarriages. Int J Fertil Womens Med. 2000;45(4):292–6.

    CAS  PubMed  Google Scholar 

  51. Hradecky L, Subrt I, Ulcova-Gallova Z. Urgent termination of pregnancy in pre-eclampsia and panel of antiphospholipid antibodies. Am J Reprod Immunol. 2009;62(6):412–7.

    Article  CAS  PubMed  Google Scholar 

  52. Mockova A, Ulcova-Gallova Z, Nahlovsky J, Lukasova V, Dort J, Bibkova K, Micanova Z. Occurrence of selected antiphospholipid antibodies in offspring born from mothers with autoimmunity. Lupus. 2012;21(7):793–5.

    Article  CAS  PubMed  Google Scholar 

  53. Ulcova-Gallova Z, Bibkova K, Micanova Z, Babcova K, Losan P. Moglicher Einfluss der verlangerten Einnahme hormonaler Kontrazeptiva auf eine Erhohung der Anti-Phospholipid-Antikorper-Konzentration bei infertilen Frauen. 2014 (Ready for publication).

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Conflict of interest

Z. Ulcova-Gallova declares that she has no conflict of interest.

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Informed consent was obtained from all patients included in all of our cited studies in this article.

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This article does not contain any studies with animal subjects performed by any of the authors.

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Correspondence to Zdenka Ulcova-Gallova.

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Ulcova-Gallova, Z. The role of antiphospholipid antibodies (aPls) in infertile women: the long-lasting experience. Reprod Med Biol 14, 49–55 (2015). https://doi.org/10.1007/s12522-014-0196-y

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  • DOI: https://doi.org/10.1007/s12522-014-0196-y

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