Clinical implications of the thyroid peroxidase antibody (TPOAb) IgG subclasses and Th1, Th17 related factors in maternal blood and umbilical cord blood
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Background The positive rate of TPOAb in pregnant women range 2.8%-19.6% in worldwide. For recent decades, the relationship between TPOAb positive and adverse pregnancy outcomes has been concerned. Objective We aim to analyze the levels of TPOAb subclasses in maternal and umbilical cord blood and clarify the relationship between TPOAb and Th1 and Th17 related inflammatory cytokines. Methods Twelve TPOAb positive (observation group) and twenty-two case-controlled TPOAb negative health pregnant women (control group) were enrolled. The levels of TPOAb, TSH, FT 4 , FT 3 , TPOAb IgG subclasses, TNF-α, IFN-γ, IL-17 and IL-22 in maternal blood (before delivery) and umbilical cord blood were measured and analyzed. Results In maternal blood, the levels of total TPOAb IgG, IgG1, TNF-α, IFN-γ, IL-17 and IL-22 in the observation group were significantly higher than control group. Compared with the control group, the levels of TSH and TPOAb in the umbilical cord blood of the observation group increased, while the level of FT 3 decreased. TPOAb IgG1 and IgG3 mainly pass through the placenta in TPOAb positive pregnant women, while TPOAb IgG1 and IgG4 in TPOAb negative counterparts. In the observation group, correlation analysis showed that maternal blood TPOAb was positively correlated with cord blood TPOAb level ( r = 0.923). The levels of TPOAb in maternal blood were positively correlated with IFN-γ, IL-17 and IL-22 ( r = 0.627, 0.748 and 0.738, respectively). Meanwhile, the TPOAb IgG1 subclass were positively correlated with IFN-γ, IL-22, and IL-17 ( r = 0.599, 0.776 and 0.650 respectively). Conclusion For TPOAb positive, the TPOAb IgG1 and IgG3 subclasses can cross the placenta more efficiently. It (especially TPOAb IgG1 subclass) may mediate maternal and infant immune microenvironment via inducing cytokines secreted by Th1 and Th17 cells and may ultimately affect fetal thyroid function.
