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Giambalvo S, Garaffoni C, Silvagni E, Furini F, Rizzo R, Govoni M, Bortoluzzi A. Factors associated with fertility abnormalities in women with systemic lupus erythematosus: a systematic review and meta-analysis. Autoimmun Rev 2022; 21:103038. [PMID: 34995765 DOI: 10.1016/j.autrev.2022.103038] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fertility is thought to be not affected in women with systemic lupus erythematosus (SLE), however disease-related factors, psychosocial effects of chronic disease, as well as medications exposure might impair gonadal function. OBJECTIVE This systematic literature review (SLR) aimed to explore clinical, hormonal, serological and treatment factors associated with fertility outcomes in women of childbearing age with SLE. METHODS This SLR was conducted following the Preferred Reporting Items for systematic reviews and Meta-analysis (PRISMA) statement. All articles available in English (1972 - 30th April 2021) in Pubmed, EMBASE, Scopus and Cochrane Library were screened. Study selection and data collection were performed by two independent reviewers. All data were extracted using a standardized template. The risk of bias of the included studies was assessed using the NIH risk-of-bias tool. RESULTS Of 789 abstracts evaluated, we included in this review 46 studies, of which 1 SLR, 16 cross-sectional studies, 18 cohort studies, 10 observational studies and 1 case-series, with data pertaining to 4704 patients (mean age 31.5 ± 3.7 years, disease duration 83.27 ± 38.3 months). Definitions of premature ovarian failure (POF) adopted in the studies varied in terms of the number of months of amenorrhea considered and the age of onset of amenorrhea. Clinical factors associated with the development of POF were older age at the time of initiation of therapy, and older age at the onset of SLE disease. Cyclophosphamide exposure (CYC) and its cumulative dose influenced gonadal function in SLE women, leading to amenorrhoea and POF, as reported in 19 studies. Mycophenolate, azathioprine, calcineurin inhibitors and steroids associated with a lower risk of POF compared to CYC. POF was less frequent in patients co-treated with CYC and gonadotropin-releasing hormone analogues (GnRH-a) compared with patients not receiving GnRH-a (risk ratio 0.798, 95%-CI [0.1417; 0.5525]). 11 studies evaluated the impact of damage accrual and disease activity on ovarian reserve with conflicting evidence. Finally, 18 studies investigated exposure to hormonal and serological factors and, among others, neither Anti-Müllerian Hormone nor anti-corpus luteum antibodies were associated with POF. CONCLUSION The strongest evidence regarding management factors associated with fertility in SLE women of childbearing age remains the treatment with CYC, as well as its cumulative dosage. Hormonal and serological factors appeared not to impact fertility outcomes, but they might be used as a surrogate of fertility, especially during the treatment with disease-specific drugs.
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Affiliation(s)
- S Giambalvo
- Unit of Rheumatology, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliera-Universitaria Sant'Anna of Ferrara, Italy
| | - C Garaffoni
- Unit of Rheumatology, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliera-Universitaria Sant'Anna of Ferrara, Italy
| | - E Silvagni
- Unit of Rheumatology, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliera-Universitaria Sant'Anna of Ferrara, Italy
| | - F Furini
- Unit of Rheumatology, Ospedale Maggiore, Bologna, Italy
| | - R Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, Italy
| | - M Govoni
- Unit of Rheumatology, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliera-Universitaria Sant'Anna of Ferrara, Italy
| | - A Bortoluzzi
- Unit of Rheumatology, Department of Medical Sciences, University of Ferrara, Azienda Ospedaliera-Universitaria Sant'Anna of Ferrara, Italy.
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Tsaliki M, Koelsch KA, Chambers A, Talsania M, Scofield RH, Chakravarty EF. Ovarian antibodies among SLE women with premature menopause after cyclophosphamide. Int J Rheum Dis 2020; 24:120-124. [PMID: 33300669 DOI: 10.1111/1756-185x.14022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/21/2020] [Accepted: 10/17/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Women with systemic lupus erythematosus (SLE) are at risk of premature ovarian failure when treated with cyclophosphamide. This risk is increased when autoimmune thyroid disease is present. We undertook this study to determine whether the presence of ovarian autoimmunity also increased the risk of early ovarian failure among women receiving cyclophosphamide. METHODS We examined the records of women enrolled in the Lupus Family Registry and Repository, a cross-sectional study of ~3300 SLE subjects, for treatment with cyclophosphamide as well as menopausal status. We defined premature menopause as permanent, spontaneous cessation of menstruation before age 45. We measured anti-ovarian antibodies by enzyme-linked immunosorbent assay using stored sera. RESULTS There were 258 women treated with cyclophosphamide in whom presence of absence or premature menopause could by defined. A total of 169 (65.6%) had premature ovarian failure, while 89 (34.6%) did not. While anti-ovarian antibodies were present in a small percentage of patients, there was no association of premature menopause to either level of these antibodies (16.2 ± 20.3 units vs 17.4 ± 21.7 units, P = NS by Fisher's exact test), or positivity on this testing (11 of 169 [6.5%] positive vs 8 of 89 [8.9%], χ2 = 0.53, P = .46, 95% CI 0.95-1.1). Neither renal disease nor hypothyroidism increased the risk of premature ovarian failure in these women receiving cyclophosphamide. CONCLUSION Anti-ovarian antibodies among women with SLE are not associated with premature ovarian failure after treatment with cyclophosphamide.
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Affiliation(s)
- Martha Tsaliki
- Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.,Department of Medicine and Pathology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Oklahoma City US Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA
| | - Kristi A Koelsch
- Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.,Department of Medicine and Pathology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Oklahoma City US Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA
| | - Ambre Chambers
- Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.,Department of Medicine and Pathology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Oklahoma City US Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA
| | - Mitali Talsania
- Section of Endocrinology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - R Hal Scofield
- Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.,Department of Medicine and Pathology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Oklahoma City US Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA
| | - Eliza F Chakravarty
- Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.,Department of Medicine and Pathology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Michala L, Stefanaki K, Loutradis D. Premature ovarian insufficiency in adolescence: a chance for early diagnosis? Hormones (Athens) 2020; 19:277-283. [PMID: 31828604 DOI: 10.1007/s42000-019-00141-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/11/2019] [Indexed: 10/25/2022]
Abstract
Premature ovarian insufficiency (POI) is typically diagnosed when amenorrhea is combined with high gonadotrophins and hypoestrogenemia in a woman under 40 years of age, although, more rarely, POI can develop in adolescence and present with delayed puberty or amenorrhea, depending on the timing of follicular depletion or insult to the ovary. In a proportion of girls, the diagnosis may be made at an early stage of POI, presenting with abnormal uterine bleeding, when some follicular function is still retained. The natural history of POI in this group of patients is not clear; however, they could represent a subgroup with a unique opportunity for early intervention and thus the provision of fertility preservation options. While the etiology of POI in a large number of girls remains unknown, a growing number will be identified as carriers of genetic mutations, offering clinicians a yet greater opportunity to provide genetic counseling to other female family members. The aim of this review is to provide information regarding the etiology, diagnosis, and treatment of POI in adolescents while detailing the new options for fertility preservation when POI is diagnosed at an early stage.
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Affiliation(s)
- Lina Michala
- 1st Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vassilissis Sofias Avenue, 115 28, Athens, Greece.
| | - Katerina Stefanaki
- Department of Therapeutics, Medical School, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Dimitris Loutradis
- 1st Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vassilissis Sofias Avenue, 115 28, Athens, Greece
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Abdelaziz MM, Goma SH, Sayed SK, El-Hammady DH, Gamal RM, Sayed DS. Influence of prolactin and estrogen on disease activity in patients with systemic lupus erythematosus. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2018. [DOI: 10.4103/err.err_18_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Kokic V, Martinovic Kaliterna D, Radic M, Tandara L, Perkovic D. Association between vitamin D, oestradiol and interferon-gamma in female patients with inactive systemic lupus erythematosus: A cross-sectional study. J Int Med Res 2017; 46:1162-1171. [PMID: 29235391 PMCID: PMC5972245 DOI: 10.1177/0300060517734686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objectives To investigate possible associations between 25-hydroxyvitamin D3 (25(OH)D3), oestradiol (E2) and IFN-gamma (IFNγ) in female patients with inactive systemic lupus erythematosus (SLE). Methods Female patients with inactive SLE and age-matched healthy controls were recruited into this cross-sectional study. Serum concentrations of 25(OH)D3, E2 and IFNγ were measured by radioimmunoassay with gamma-counters and enzyme-linked immunosorbent assay. Results 36 patients and 37 controls were enrolled. In patients with SLE, the concentration of 25(OH)D3 was lower and E2 was higher compared with controls. In vitamin D deficient (i.e., 25(OH)D3≤20 ng/ml) patients, IFNγ was 150% higher compared with patients with 25(OH)D3>20 ng/ml and controls. The concentration of E2 was higher in all patients compared with controls independently of the vitamin D level. A difference was found between patients and controls in the correlation of 25(OH)D3 with E2 and a positive correlation was found between E2 and IFNγ in all participants. Conclusions Our results suggest that E2 may have a strong modulating effect on vitamin D function which is significant only at low concentration of E2.
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Affiliation(s)
- Visnja Kokic
- 1 Division of Endocrinology, Diabetes and Metabolic Disease, University Hospital of Split, School of Medicine, Split, Croatia
| | | | - Mislav Radic
- 2 Division of Rheumatology and Clinical Immunology, University Hospital of Split, Split, Croatia
| | - Leida Tandara
- 3 Department of Medical Laboratory Diagnostic, University Hospital of Split, Split, Croatia
| | - Dijana Perkovic
- 2 Division of Rheumatology and Clinical Immunology, University Hospital of Split, Split, Croatia
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Oktem O, Yagmur H, Bengisu H, Urman B. Reproductive aspects of systemic lupus erythematosus. J Reprod Immunol 2016; 117:57-65. [DOI: 10.1016/j.jri.2016.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 05/27/2016] [Accepted: 07/04/2016] [Indexed: 12/23/2022]
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Silva CAA, Brunner HI. Review: Gonadal functioning and preservation of reproductive fitness with juvenile systemic lupus erythematosus. Lupus 2016; 16:593-9. [PMID: 17711894 DOI: 10.1177/0961203307077538] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increased survival of children with juvenile systemic lupus erythematosus (jSLE) and improved prognosis have led to a change in the long-term health issues arising for jSLE patients. Preservation of gonadal functioning and fertility are of increasing importance for young adults with jSLE. Events during childhood, such as exposure to alkylating agents, may compromise the reproductive potential. Even in the absence of gonadotoxic therapies, fertility may be decreased through organs specific involvement with jSLE. Strategies to preserve the reproductive potential of girl and boys with jSLE are discussed. Lupus (2007) 16, 593—599.
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Affiliation(s)
- C A A Silva
- Pediatric Rheumatology Unit, Children's Hospital, and Division of Rheumatology of University of São Paulo, São Paulo, Brazil
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Mayorga J, Alpízar-Rodríguez D, Prieto-Padilla J, Romero-Díaz J, Cravioto MC. Prevalence of premature ovarian failure in patients with systemic lupus erythematosus. Lupus 2015; 25:675-83. [PMID: 26678443 DOI: 10.1177/0961203315622824] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/24/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To estimate the prevalence of premature ovarian failure (POF) and its associated factors in patients with systemic lupus erythematosus (SLE). METHODS Cross-sectional study including consecutive SLE women <60 years of age attending a rheumatology clinic. A face-to-face interview was undertaken to obtain demographic, gynaecological and lupus characteristics. Additional rheumatologic and endocrine data were retrieved from patients' medical records. POF prevalence was estimated in the study sample and in a subgroup of patients aged <40 years at interview. Associations between POF and selected variables were assessed by logistic regression analyses. RESULTS A total of 961 patients were analysed. Prevalence of POF, secondary amenorrhea of known cause, menopause and hysterectomy were 5.4%, 0.8%, 7.8% and 4.4%, respectively. In 674 (70%) patients who had not been exposed to cyclophosphamide (CYC) the prevalence of POF was 0.6%. Disease activity over time (OR 1.4 (CI 95% 1.0-1.8, p < 0.05)) and CYC treatment (OR 5.9 (CI 95% 1.8-18.8, p < 0.01)) were associated with higher prevalence. Association between POF and endocrine autoimmune diseases was not found. CONCLUSIONS In the absence of CYC treatment, the prevalence of POF in lupus patients is consistent with that reported in the general population. The existence of autoimmune processes at the ovary seems unlikely in most lupus patients.
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Affiliation(s)
- J Mayorga
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | - D Alpízar-Rodríguez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland
| | - J Prieto-Padilla
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | - J Romero-Díaz
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | - M C Cravioto
- Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
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de Araujo DB, Yamakami LYS, Aikawa NE, Bonfá E, Viana VST, Pasoto SG, Pereira RMR, Serafin PC, Borba EF, Silva CA. Ovarian reserve in adult patients with childhood-onset lupus: a possible deleterious effect of methotrexate? Scand J Rheumatol 2014; 43:503-11. [DOI: 10.3109/03009742.2014.908237] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Silva CA, Yamakami LYS, Aikawa NE, Araujo DB, Carvalho JF, Bonfá E. Autoimmune primary ovarian insufficiency. Autoimmun Rev 2014; 13:427-30. [PMID: 24418305 DOI: 10.1016/j.autrev.2014.01.003] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2013] [Indexed: 12/30/2022]
Abstract
Primary ovarian insufficiency (POI) is defined as sustained amenorrhea, increased follicle-stimulating hormone and low estrogen levels, whereas diminished ovarian reserve (DOR) is characterized as regular menses and alterations of ovarian reserve tests. POI of autoimmune origin may be associated with adrenal autoimmunity, non-adrenal autoimmunity or isolated. This autoimmune disease is characterized by serum ovarian, adrenocortical or steroidogenic cell autoantibodies. POI of adrenal autoimmune origin is the most frequent type observed in 60-80% of patients. Clinically, amenorrhea is the hallmark of POI, however before menstruation stops completely, irregular cycles occur. Infertility, hot flushes, vaginal atrophy, and dyspareunia are also common. Autoimmune oophoritis is characterized by mononuclear inflammatory cell infiltrate in the theca cells of growing follicles, with early stage follicles without lymphocytic infiltration. This infiltrate includes plasma, B and T-cells. A novel classification criterion for autoimmune POI/DOR is proposed subdividing in three distinct categories (possible, probable and confirmed) according to autoantibodies, autoimmune disease and ovarian histology. Unfortunately, up to date guidelines for the treatment of autoimmune oophoritis are not available. Strategies to POI treatment include hormone replacement and infertility therapy. Assisted conception with donated oocytes has been proven to achieve pregnancy by intra cytoplasmic sperm injection in POI women.
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Affiliation(s)
- C A Silva
- Pediatric Rheumatology Unit, Department of Pediatric, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - L Y S Yamakami
- Division of Gynecology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - N E Aikawa
- Pediatric Rheumatology Unit, Department of Pediatric, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - D B Araujo
- Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Division of Rheumatology, Faculdade de Medicina da Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - J F Carvalho
- Division of Rheumatology, Faculdade de Medicina da Universidade da Bahia, Bahia, Brazil
| | - E Bonfá
- Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Chang YS, Lai CC, Chen WS, Wang SH, Chou CT, Tsai CY. Protein-losing enteropathy and premature ovarian failure in a young woman with systemic lupus erythematosus. Lupus 2012; 21:1237-9. [PMID: 22627066 DOI: 10.1177/0961203312449492] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Protein-losing enteropathy (PLE) and autoimmune oophoritis are unusual manifestations of systemic lupus erythematosus (SLE). Autoimmune oophoritis may result in menstrual disturbance and spontaneous premature ovarian failure. However, there is no validated examination to confirm the diagnosis and it is easily neglected in patients with ovarian insufficiency. A 31-year-old woman with SLE presented with PLE and autoimmune oophoritis during the long course of flares and remissions in her lupus activity. The synchronism implied the association between the two. Moreover, both conditions simultaneously had a good response to cyclosporine A (CsA) therapy.
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Affiliation(s)
- Y S Chang
- Division of Allergy, Immunology and Rheumatology and, Department of Medicine, Taipei Medical University Shuang Ho Hospital, Taipei, Taiwan
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Abstract
INTRODUCTION Hashimoto's thyroiditis (HT) is a common cause of goitre and hypothyroidism in children and adolescents. Spontaneous remission may occur in up to 50% patients, but the development of hypothyroidism is possible. OBJECTIVE We investigated the clinical manifestations, course and long-term outcome of HT. METHOD We reviewed charts of 43 children (36 females) with HT, mean age at presentation 12.3 years, and mean follow-up duration 4.6 years. RESULTS HT is five times more common in females. The common complaints leading to referral were goitre in 19 children (44.3%), diffuse in 17 children (89.5%). As to the prevalence of goitre, it accounted for significantly more referrals in females (14 girls, and 5 boys; 73.7% vs 26.3%, t-test; p<0.005). Goitre was either isolated in 15 (34.4%) or associated with other complaints in 4 children: anemia in 7 (16.2%), fatigue in 5 (11.8%), increased appetite in 4 (9.7%), weight gain in 3 (7.0%), growth retardation in 2 children (4.7%), at irregular menses in 3 pubertal girls. Hypothyroidism was present in 18 patients (41.1%), 7 (38.8%) on initial admission, and 11 (61.8%) had the mean follow-up duration of 4.6 years. There were 25 euthyroid HT patients (59.9%). The family history of the thyroid disease was positive in 16 children (37.1%) and 12 of them (71.4%) had hypothyroidism. There were 6 patients (13.9%) in whom the disease was associated with some other autoimmune disease. CONCLUSION HT is five times more common in females. The usual complaints leading to referral were diffuse goitre, which accounted for significantly more referrals in females. A positive family history of autoimmune thyroid disease is associated with a higher risk of hypothyroidism in children with HT. Hypothyroid patients may appear in higher percentage of children and adolescents than previously reported.
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Euthymiopoulou K, Aletras AJ, Ravazoula P, Niarakis A, Daoussis D, Antonopoulos I, Liossis SN, Andonopoulos AP. Antiovarian antibodies in primary Sjogren's syndrome. Rheumatol Int 2007; 27:1149-55. [PMID: 17541596 DOI: 10.1007/s00296-007-0364-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Accepted: 05/07/2007] [Indexed: 10/23/2022]
Abstract
Our study aimed at screening patients with primary Sjogren's syndrome (pSs) for the presence of antiovarian antibodies (AOAs). Detection of AOAs in patients' sera was achieved by ELISA, using bovine ovarian extract for coating. Western blot analysis and immunohistochemistry were used to characterize the antibody targets in the extract and to determine their locus on the bovine ovary, respectively. Specific AOAs were detected in 27% of 37 patients (two with premature menopause) and in none of the controls. Immunoreactivity mainly resided in five proteins of the extract with molecular masses 42, 49, 55, 64 and 72 kDa, and it might be attributed to their carbohydrate components. The antibody targets were mainly located in the granulosa and theca interna cells of the follicle, and in the endothelial cells and fibroblasts of corpus luteum. The detection, for the first time, of AOAs in a significant percentage of patients with pSs may suggest autoimmune oophoritis, clinical or subclinical.
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Affiliation(s)
- Kyriaki Euthymiopoulou
- Department of Chemistry, School of Natural Sciences, University of Patras, Patras, 265 00, Greece
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