Anti-Ro/SSA-p200 antibodies in the prediction of congenital heart block. An Italian multicentre cross-sectional study on behalf of the 'Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni (FIRMA) Group'.

Abstract

OBJECTIVES:

To verify the association between the presence of specific anti-52 Ro/SSA-p200 antibodies and congenital heart block (CHB).

METHODS:

207 pregnant Italian women carrying anti-Ro/SSA Ab were retrospectively evaluated. Anti-p200 Ab were investigated in the mothers' sera by ELISA (Euro-Diagnostica,Wieslab SS-A p200).

RESULTS:

CHB occurred in 42 children (34 complete CHB), whereas 165 were not affected. All CHB cases were previously identified with an ELISA screening for anti-Ro/SSA 60 kD Ab. Anti-p200 Ab were more frequently positive (81.0% vs. 59.1%, p=0.013) and at a higher titer in CHB mothers (Absorbance ratio: 2.030 (0.208-4.052) vs. 0.925 (0.200-3.816); p=0.017). This association was maintained even when the 42 mothers of children with CHB were compared with a control group matched for age and diagnosis (80.9% vs. 50.0%; p=0.006). The presence of anti-p200 Ab provided an odds ratio (OR) for CHB of 2.98 (CI: 1.30-6.83), which was higher than that of other variables, such as maternal disease and other antibody specificities. CHB risk significantly decreased in the absence of this fine specificity (OR:0.34, CI: 0.15-0.77). However, while the negative predictive value related to anti-Ro/SSA 60 kD Ab ELISA was 100%, almost 20% of mothers negative for anti-p200 Ab delivered babies with CHB.

CONCLUSIONS:

Anti-p200 antibodies seem to be associated with CHB with a higher probability than anti-Ro/SSA Ab, and therefore may be an additional test to identify mothers at higher risk to deliver affected children. An ELISA screening for anti-Ro/SSA 60 kD Ab is nevertheless mandatory given the probability of developing CHB also in the absence of anti-p200 Ab.

• Authors: Mirko Scarsi, Antonella Radice, Francesca Pregnolato, Veronique Ramoni, Chiara Grava, Laura Bianchi, Maria Gerosa, Marta Mosca, Anna Ghirardello, Chiara Tani, Mario Motta, Marzia Quinzanini, Angela Tincani, Amelia Ruffatti, Paola Migliorini, Andrea Doria, Pier Luigi Meroni, Antonio Brucato
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2014 Nov-Dec Vol. 32 Issue 6 Pg. 848-54 ISSN: 0392-856X [Print] Italy
• PMID: 25327946 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Antibodies, Antinuclear
• Biomarkers
• Peptide Fragments
• Ribonucleoproteins
• SS-A antibodies
• SS-A antigen

Topics

• Adult
• Antibodies, Antinuclear (blood)
• Biomarkers (blood)
• Cross-Sectional Studies
• Enzyme-Linked Immunosorbent Assay
• Female
• Heart Block (blood, congenital, diagnosis, immunology)
• Humans
• Italy
• Maternal-Fetal Exchange
• Odds Ratio
• Peptide Fragments (immunology)
• Predictive Value of Tests
• Pregnancy
• Retrospective Studies
• Ribonucleoproteins (immunology)
• Risk Factors