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Previous Volume 350:134-142 January 8, 2004 Number 2 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by Wald, N. J. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background In the absence of clinical folate deficiency, periconceptional supplementation with folic acid reduces a woman's risk of having an infant with a neural-tube defect. Since antiserum to folate receptors induces embryo resorption and malformations in rats, we hypothesized that autoantibodies against folate receptors in women may be associated with pregnancy complicated by a neural-tube defect.

Methods Serum from 12 women who were or had been pregnant with a fetus with a neural-tube defect and from 24 control women (20 with current or prior normal pregnancies and 4 who were nulligravid) was analyzed for autoantibodies by incubation with human placental folate receptors radiolabeled with [³H]folic acid. The properties of these autoantibodies were characterized by incubating serum and the autoantibodies isolated from serum with placental membranes, ED27 cells, and KB cells, which express the folate receptors.

Results Serum from 9 of 12 women with a current or previous affected pregnancy (index subjects) and 2 of 20 control subjects contained autoantibodies against folate receptors (P<0.001). The autoantibodies blocked the binding of [³H]folic acid to folate receptors on placental membranes and on ED27 and KB cells incubated at 4°C and blocked the uptake of [³H]folic acid by KB cells when incubated at 37°C.

Conclusions Serum from women with a pregnancy complicated by a neural-tube defect contains autoantibodies that bind to folate receptors and can block the cellular uptake of folate. Further study is warranted to assess whether the observed association between maternal autoantibodies against folate receptors and neural-tube defects reflects a causal relation.

Source Information

From the Departments of Medicine (S.P.R., M.P.C., J.M.S., E.V.Q.) and Obstetrics and Gynecology (J.L.R.), the Division of Pediatric Neurology (J.C.), and the Scientific Computing Center (J.W.), State University of New York Downstate Medical Center, Brooklyn.

Address reprint requests to Dr. Rothenberg at SUNY Downstate Medical Center, 450 Clarkson Ave., Box 20, Brooklyn, NY 11203, or at srothenberg{at}downstate.edu.

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