N Gleicher1, L Harlow, M Zilberstein. 1. Department of Obstetrics and Gynecology, Mount Sinai Hospital Medical Center of Chicago.
Abstract
OBJECTIVES: The broad range of reproductive processes apparently affected by antiphospholipid antibodies suggests that antiphospholipid antibodies have to exert their clinical effects at every basic cellular level. Because phospholipids constitute essential components of every cell membrane, and because signal transduction processes are dependent on second messengers with phospholipid epitopes, we investigated the hypothesis that interference with signal transduction processes by antiphospholipid antibodies could represent such a basic cellular process. STUDY DESIGN: To test this hypothesis we established an in vitro placental culture system in which the stimulation of explants by phospholipase A2 and phospholipase C in the presence of normal human serum resulted in a significant increase in human chorionic gonadotropin secretion. RESULTS: When normal human sera were replaced with antiphospholipid antibody-containing sera from two women with established histories of reproductive failure, this increase in human chorionic gonadotropin production was inhibited 42% to 44% under phospholipase A2 stimulation and by 34% to 39% under phospholipase C stimulation. The hypothesis that antiphospholipid antibodies can interfere with signal transduction processes was further strengthened by the observation that antiphospholipid antibody-positive sera contained significantly higher immunoglobulin A antibody reactivity toward the second messenger inositol 1,4,5-triphosphate than control sera (p less than 0.049). CONCLUSIONS: These observations suggest the possibility that if present at excessive levels antiphospholipid antibodies may exert their adverse effect on reproductive processes through the interception of signal transduction processes.
OBJECTIVES: The broad range of reproductive processes apparently affected by antiphospholipid antibodies suggests that antiphospholipid antibodies have to exert their clinical effects at every basic cellular level. Because phospholipids constitute essential components of every cell membrane, and because signal transduction processes are dependent on second messengers with phospholipid epitopes, we investigated the hypothesis that interference with signal transduction processes by antiphospholipid antibodies could represent such a basic cellular process. STUDY DESIGN: To test this hypothesis we established an in vitro placental culture system in which the stimulation of explants by phospholipase A2 and phospholipase C in the presence of normal human serum resulted in a significant increase in human chorionic gonadotropin secretion. RESULTS: When normal human sera were replaced with antiphospholipid antibody-containing sera from two women with established histories of reproductive failure, this increase in human chorionic gonadotropin production was inhibited 42% to 44% under phospholipase A2 stimulation and by 34% to 39% under phospholipase C stimulation. The hypothesis that antiphospholipid antibodies can interfere with signal transduction processes was further strengthened by the observation that antiphospholipid antibody-positive sera contained significantly higher immunoglobulin A antibody reactivity toward the second messenger inositol 1,4,5-triphosphate than control sera (p less than 0.049). CONCLUSIONS: These observations suggest the possibility that if present at excessive levels antiphospholipid antibodies may exert their adverse effect on reproductive processes through the interception of signal transduction processes.
Authors: Yeon Hee Hong; Se Jeong Kim; Kyoung Yong Moon; Seul Ki Kim; Byung Chul Jee; Won Don Lee; Seok Hyun Kim Journal: Obstet Gynecol Sci Date: 2018-05-08