Higher levels of procoagulant microparticles in women with recurrent miscarriage are not associated with antiphospholipid antibodies

作者：Martinez Zamora M A; Tassies D; Creus M; Reverter J C; Puerto B; Monteagudo J; Carmona F; Balasch J

来源：Human Reproduction, 2016, 31(1): 46-52.

DOI：10.1093/humrep/dev278

• antiphosholipid antibodies
• antiphospholipid syndrome
• recurrent miscarriage
• recurrent pregnancy loss
• microparticles
• cell-derived microparticles

STUDY QUESTION: Are the levels of circulating cell-derived microparticles (cMPs) in patients with recurrent miscarriage (RM) associated with the antiphospholipid syndrome (APS)?
SUMMARY ANSWER: cMPs in women with RM are not associated with antiphospholipid antibodies (aPLs).
WHAT IS KNOWN ALREADY: Previous studies have focused on cMP levels in RM patients. Most studies have shown higher levels of cMPs in RM patients whereas others have reported lower levels. Data regarding cMPs in patients with the APS are scanty in the literature.
STUDY DESIGN, SIZE, DURATION: A case-control study including three groups of patients. A total of 154 women were prospectively recruited from September 2009 to October 2013. Four patients refused to participate. The APS group consisted of 50 women that had been previously diagnosed with primary APS and had had a parts per thousand yen3 consecutive first trimester miscarriages. The uRM group included 52 couples with a parts per thousand yen3 consecutive first trimester miscarriages of unknown etiology. The fertile control (FER) group was composed of 52 healthy fertile women with no history of pregnancy losses. Miscarriage was defined as intrauterine pregnancy loss at < 10 weeks' size on ultrasound.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Venous blood samples for coagulation studies and cMP determinations were obtained. All patients underwent a thrombophilia study.
MAIN RESULTS AND THE ROLE OF CHANCE: cMP levels were significantly higher in the APS and uRM groups versus the FER group (P < 0.0001 and P = 0.009, respectively) (cMP number x 10(3)/ml plasma [mean +/- SD]: APS: 18.5 +/- 13.6; uRM: 16.3 +/- 13.8; FER: 9.7 +/- 4.6). There were no statistically significant differences in cMP levels between the APS and uRM groups.
LIMITATIONS, REASONS FOR CAUTION: The sample size was arbitrarily decided according to previous studies analyzing cMPs in RM patients. Different cMP subtypes were not investigated.
WIDER IMPLICATIONS OF THE FINDINGS: The present study adds further data on the subject showing that patients with RM, irrespective of testing positive for aPLs, have increased levels of cMPs compared with healthy fertile controls. The presence of elevated cMPs in RM women may reflect an ongoing systemic pathological, albeit asymptomatic, status that can become deleterious in the setting of pregnancy.

• 出版日期2016-1