Document Detail

Umbilical cord blood levels of maternal antibodies reactive with p200 and full-length Ro 52 in the assessment of risk for cardiac manifestations of neonatal lupus.
MedLine Citation:
PMID:  22511615     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Maternal anti-Ro autoantibodies are associated with cardiac manifestations of neonatal lupus (cardiac NL), yet only 2% of women with this reactivity have an affected child. Identification of a more specific marker would channel intense monitoring to fetuses at greater risk. This study aimed to determine whether autoantibodies against Ro 52 amino acids 200-239 (p200) confer added risk over autoantibodies to full-length Ro 52, Ro 60, or La.
METHODS: Anti-Ro-exposed pregnancies resulting in cardiac NL or no cardiac manifestations were identified from the Research Registry for Neonatal Lupus and the PR Interval and Dexamethasone Evaluation study. Umbilical cord (n = 123) and maternal (n = 115) samples were evaluated by enzyme-linked immunosorbent assay.
RESULTS: The frequencies of p200, Ro 52, Ro 60, and La autoantibodies were not significantly different between affected and unaffected children. However, neonatal anti-Ro 52 and Ro 60 titers were highest in cardiac NL and their unaffected siblings compared to unaffected neonates without a cardiac NL sibling. Although both maternal anti-Ro 52 and p200 autoantibodies were less than 50% specific for cardiac NL, anti-p200 was the least likely of the Ro autoantibodies to be false-positive in mothers who have never had an affected child. Titers of anti-Ro 52 and p200 did not differ during a cardiac NL or unaffected pregnancy from the same mother.
CONCLUSION: Maternal reactivity to p200 does not confer an added risk to fetal conduction defects over full-length Ro 52 or Ro 60 autoantibodies. Mothers who may never be at risk for having an affected child have lower anti-Ro 60 titers and may require less stringent echocardiographic monitoring compared to women with high-titer autoantibodies.
Joanne H Reed; Robert M Clancy; Kristen H Lee; Amit Saxena; Peter M Izmirly; Jill P Buyon
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis care & research     Volume:  64     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-28     Completed Date:  2012-11-01     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1373-81     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
New York University School of Medicine, New York, USA.
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MeSH Terms
Antibodies, Antinuclear / blood*
Biological Markers / blood
Enzyme-Linked Immunosorbent Assay
Fetal Blood / immunology*
Heart Block / blood,  etiology*,  immunology
Immunodominant Epitopes*
Linear Models
Lupus Erythematosus, Systemic / blood,  congenital*,  etiology,  immunology
Peptide Fragments / immunology*
Ribonucleoproteins / immunology*
Risk Assessment
Risk Factors
United States
Grant Support
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/Biological Markers; 0/Immunodominant Epitopes; 0/Peptide Fragments; 0/Ribonucleoproteins; 0/SS-A antibodies; 0/SS-A antigen

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