The aim of this study was to determine in pregnant women with systemic lupus erythematosus (SLE) the frequency of anti-prolactin autoantibodies and to compare the outcome of pregnancy in SLE women with and without anti-prolactin autoantibodies. Ninety-nine consecutive SLE pregnant women and 151 healthy pregnant women were studied prospectively. Patients with or without anti-prolactin autoantibodies were identified by gel filtration chromatography and affinity chromatography for IgG. Serum total and free prolactin (PRL) levels and molecular heterogeneity of PRL at each trimester of pregnancy were determined. The frequency of anti-PRL autoantibodies in SLE pregnant women was 13.1%. Serum total PRL levels were significantly higher in women with anti-PRL autoantibodies compared with SLE women without anti-PRL autoantibodies and in healthy pregnant women; and serum free PRL levels were lower in the third trimester in women with anti-PRL autoantibodies than in healthy pregnant women. In contrast, serum total and free PRL levels were significantly lower in the second and third trimester in SLE pregnant women without anti-PRL autoantibodies compared with healthy pregnant women. All adverse outcomes of pregnancy studied were more frequent in SLE women without anti-PRL autoantibodies than anti-PRL autoantibody-positive SLE women. Moreover, both maternal and fetal main complications were significantly higher in SLE women without anti-PRL autoantibodies than anti-PRL autoantibody-positive SLE women (P ≤0.03). We conclude that the frequency of anti-PRL autoantibodies in lupus pregnancy was 13.1%. SLE pregnant women with anti-PRL autoantibodies had fewer adverse outcomes of pregnancy. The presence of anti-PRL autoantibodies could be of potential use as a prognostic marker for outcomes of pregnancy in SLE. Lupus (2007) 16, 342—349.
Gimovsky ML, Montoro M., Paul RHPregnancy outcome in women with systemic lupus erythematosus. Obstet Gynecol1984; 63: 686—692.
2.
Mintz G., Niz J., Gutiérrez C.Prospective study of pregnancy in systemic lupus erythematosus. Results of a multidisciplinary approach. J Rheumatol1986; 13: 732—739.
3.
Out HJ, Derksen RH, Christiaens GCSystemic lupus erythematosus and pregnancy. Obstet Gynecol Surv1989; 44: 585—591.
4.
Petri M., Allbritton J.Fetal outcome of lupus pregnancy: a retrospective case-control study of the Hopkins Lupus Cohort. J Rheumatol1993; 20: 650—656.
5.
Ruiz-Irastorza G., Lima F., Alves J. et al. Increased rate of lupus flare during pregnancy and the puerperium: a prospective study of 78 pregnancies. Br J Rheum1996; 35: 133—138.
6.
Petri M.Hopkins lupus pregnancy center 1987 to 1996. Rheum Dis Clin North Am1997; 23: 195—212.
7.
Khamashta MA , Ruiz-Irastorza GR, Hughes Grv.Systemic lupus erythematosus flares during pregnancy. Rheum Dis Clin North Am1997; 23: 15—30.
8.
Georgiou PE, Politi EN, Katsimbri P. et al. Outcome of lupus pregnancy: a controlled study. Rheumatology2000; 39: 1014—1019.
9.
Yasmeen S., Wilkins EE, Field NT et al. Pregnancy outcomes in women with systemic lupus erythematosus . J Matern Fetal Med2001; 10: 91—96.
10.
Kiss E., Bhattoa HP, Bettembuk P. et al. Pregnancy in women with systemic lupus erythematosus. Eur J Obstet Gynecol Reprod Biol2002; 101: 129—134.
11.
Cortés-Henrández J., Ordi-Ros J., Paredes F. et al. Clinical predictors of fetal and maternal outcome in systemic lupus erytheamrosus: a prospective study of 103 pregnancies . Rheumatology2002; 41: 643—650.
12.
Blanco-Favela F., Quintal-Alvarez G., Leaños-Miranda A.Association between prolactin and disease activity in systemic lupus erythematosus. Influence of statistical power. J Rheumatol1999; 26: 55—59.
13.
Pacilio M., Migliaresi S., Meli R. et al. Elevated bioactive prolactin in systemic lupus erythematosus=association with disease activity. J Rheumatol2001; 28: 2216—2221.
14.
Jacobi AM, Rhode W., Ventz M. et al. Enhanced serum prolactin (PRL) in patients with systemic lupus erythematosus: PRL levels are related to the disease activity. Lupus2001; 10: 554—561.
15.
McMurray R. , Keisler D., Kanuekel K. et al. Prolactin influences autoimmune disease activity in the female B/W mouse. J Immunol1991; 147: 780—787.
16.
Fraser IS, Lung ZGPolymers of prolactin and their clinical significance. Obstet Gynecol Surv1990; 45: 515—520.
17.
Hattori N.The frequency of macroprolactinemia in pregnant women and heterogeneity of its etiologies. J Clin Endocrinol Metab1996 ; 81: 586—590.
18.
Pascoe-Lira D., Duran-Reyes G., Contreras-Hernández I. et al. Frequency of macroprolactinemia due to autoantibodies against prolactin in pregnant women. J Clin Endocrinol Metab2001; 86: 924—929.
19.
Sinha YNStructural variants of prolactin: occurrence and physiological significance . Endocr Rev1989; 16: 354—364.
20.
Whittaker PG , Wilcox T., Lind T.Maintained fertility in a patient with hyperprolactinemia due to big, big prolactin. J Clin Endocrinol Metab1981; 53: 863—866.
21.
Andersen AN , Pedersen H., Djursin H. et al. Bioactivity of prolactin in a woman with an excess of large molecular size prolactin, persistent hyperprolactinemia and spontaneous conception. Fertil Steril1982; 38: 625—628.
22.
Jackson RD, Wortsman J., Malarkey WBCharacterization of a large molecular weight prolactin in women with idiopathic hyperprolactinemia and normal menses. J Clin Endocrinol Metab1985; 61: 258—264.
23.
De Schepper J., Schiettecatte J., Velkeniers B. et al. Clinical and biological characterization of macroprolactinemia with and without prolactin-IgG complexes. Eur J Endcorinol2003; 149: 201—207.
24.
Amadori P., Dilberis C., Marcolla A. et al. Identification of IgGimmunocomplex macroprolactin with an immunometric `sandwich' system: technical and clinical considerations. J Endocrinol Invest2004; 27: 1022—1028.
25.
Leaños A., Pascoe D., Fraga A. et al. Anti-prolactin autoantibodies in systemic lupus erythematosus patients with associated hyperprolactinemia. Lupus1998; 7: 398—403.
26.
Leaños-Miranda A., Chávez-Rueda KA, Blanco-Favela F.Biologic activity and clearance of prolactin—IgG complex in patients with systemic lupus erythematosus. Arthritis Rheum2001; 44: 866—875.
27.
Leaños-Miranda A., Pascoe-Lira D., Chávez-Rueda KA et al. Persistence of macroprolactinemia due to antiprolactin autoantibody before, during, and after pregnancy in a woman with systemic lupus erythematosus. J Clin Endocrinol Metab2001; 86: 2619—2624.
28.
Tan EM, Cohen AS, Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum1982; 25: 1272—1277.
29.
Hochberg MCUpdating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum1997; 40: 1725.
30.
Bombardier C., Gladman D., Urowitz M. et al. The Committee on Prognosis Studies in SLE: derivation of the SLEDAI. A disease activity index for lupus patients . Arthritis Rheum1992; 35: 630—640.
31.
Leaños-Miranda A., Pascoe-Lira D., Blanco-Favela F.Prolactin and systemic lupus erythematosus (Letter). Br J Rheumatol1998; 37: 1029—1030.
32.
Leaños-Miranda A., Pascoe-Lira D., Chávez-Rueda KA et al. Antiprolactin autoantibodies in systemic lupus erythematosus: frequency and correlation with prolactinemia and disease activity. J Rheumatol2001; 28: 1546—1553.
33.
Leaños-Miranda A., Pascoe-Lira D., Chávez-Rueda KA et al. Detection of macroprolactinemia with the polyethylene glycol precipitation test in systemic lupus erythematosus patients with hyperprolactinemia. Lupus2001 ; 10: 340—345.
34.
Leaños-Miranda A., Contreras-Hernández I.Anti-prolactin autoantibodies are associated with hyperprolactinemic status in men infected with human immunodeficiency virus. Endocrine2002; 19: 139—146.
35.
Sibai BMDiagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol2003; 102: 181—192.
36.
Wilson WA, Gharavi AE, Koike T. et al. International consensus statement on preliminary classification criteria for the definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum1999; 42: 1309—1311.
37.
Muñoz-Valle JF , Vázquez-Del Mercado M., García-Iglesias T. et al. Th1/Th2 cytokine profile, metalloprotease-9 activity and hormonal status in pregnant rheumatoid arthritis and systemic lupus erythematosus. Clin Exp Immunol2003; 131: 377—384.
38.
Lynch A., Marlar R., Murphy J. et al. Antiphospholipid antibodies in predicting adverse pregnancy outcome. A prospective study. Ann Intern Med1994; 120: 470—476.
39.
Bole-Feysot C., Goffin V., Edery M. et al. Prolactin (PRL) and its receptor: actions, signal transduction pathways and phenotypes observed in PRL receptor knockout mice. Endocr Rev1998; 19: 225—268.
40.
Yu-Lee LYProlactin modulation of immune and inflammatory responses. Recent Prog Horm Res2002; 57: 435—455.
41.
Peeva E., Michael D., James C. et al. Prolactin modulates the naive B cell repertoire. J Clin Invest2003; 111: 275—283.
42.
Glezer A., Soares CR, Vieira JG et al. Human macroprolactin display low biological activity via its homologous receptor in a new sensitive bioassay. J Clin Endocrinol Metab2006; 91: 1048—1055.
43.
Leaños-Miranda A., Cárdenas-Mondragón G., Rivera-Leaños Roxana et al. Application of new homologous in vitro bioassays for human lactogens to asses the actual bioactivity of human prolactin isoforms in hyperprolactinemic patients . Clin Endocrinol2006; 65: 146—153.
