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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

Reed, Joanne H; Clancy, Robert M; Lee, Kristen H; Saxena, Amit; Izmirly, Peter M; Buyon, Jill P

Description

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...[Show more]

dc.contributor.authorReed, Joanne H
dc.contributor.authorClancy, Robert M
dc.contributor.authorLee, Kristen H
dc.contributor.authorSaxena, Amit
dc.contributor.authorIzmirly, Peter M
dc.contributor.authorBuyon, Jill P
dc.date.accessioned2014-03-14T05:30:17Z
dc.date.available2014-03-14T05:30:17Z
dc.identifier.otherESSN: 2151-4658
dc.identifier.urihttp://hdl.handle.net/1885/11459
dc.description.abstractObjective 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.
dc.description.sponsorshipSupported by the NIH (grants R01-AR42455-16 and N01- AR-4-2271) and a Mary Kirkland Center for Lupus Research Grant. Dr. Reed’s work was supported by an Australian National Health and Medical Research Council Postgraduate Training Fellowship Grant (595989).
dc.format9 pages
dc.publisherWiley
dc.rights© 2012, American College of Rheumatology
dc.sourceArthritis Care and Research 64.9(2012): 1373–1381
dc.subjectLupus
dc.subjectrisk
dc.subjectautoantibodies
dc.titleUmbilical 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
dc.typeJournal article
dcterms.dateAccepted2012-04-09
dc.date.issued2012-09
local.publisher.urlhttp://au.wiley.com/WileyCDA/
local.type.statusPublished Version
local.contributor.affiliationReed, Joanne H, College of Medicine, Biology and Environment, The Australian National University
dc.relationhttp://purl.org/au-research/grants/nhmrc/595989
local.identifier.doi10.1002/acr.21704
local.identifier.doi10.1002/acr.21704/full
CollectionsANU Research Publications

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