Antiphospholipid and antioangiogenic activity in females with recurrent miscarriage and antiphospholipid syndrome

Background: Antiphospholipid syndrome is an autoimmune disease characterized by thrombosis, fetal losses and thrombocytopenia associated to antiphospholipid antibodies. They are directed to phospholipids, such as cardiolipins (anticardiolipin) and lupus anticoagulant or to complexes formed by phospholipids and protein cofactors, such as b2 glycoprotein 1 (a-b2GP1) and annexin V (a-annexin V). These auto-antibodies may be considered as a family of antibodies involved in thrombotic events and antiphospholipid activity. On the other hand, some proangiogenic factors are involved in the normal development of placental vasculature, such as the vascular endothelial growth factor. Overexpression of vascular endothelial growth factor receptor in its soluble form (sVEGFR-1) has been associated to a higher antiangiogenic activity. Our aim was to analyse the association between anticardiolipin, lupus anticoagulant, a-b2GP1, a-annexin V and sVEGFR-1 with recurrent miscarriage before week 10 of gestation in females with antiphospholipid syndrome. Methods: We studied 24 females (primary or secondary antiphospholipid syndrome), who were divided into two groups: females with recurrent miscarriage before week 10 of gestation (M; n=12) and females with no history of fetal loss (NM; n=12). Anticardiolipin, a-b2GP1, a-annexin V and sVEGF-R1 concentrations were assessed by ELISA, while lupus anticoagulant was assessed by screening and confirmatory tests. Results: A significant association was observed between the number of positive biomarkers and the belonging group (P<0.05). Besides, a positive result for lupus anticoagulant and a-b2GP1 was found to be significantly associated to the M group (P<0.05). Conclusions: Lupus anticoagulant and a-b2GP1 may be implicated in pregnancies complicated by recurrent miscarriage in females with antiphospholipid syndrome.