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Open Access Research article

Mannose-binding lectin does not explain the course and outcome of pregnancy in rheumatoid arthritis

Fleur E van de Geijn1*, Yaël A de Man1, Manfred Wuhrer2, Sten P Willemsen3, André M Deelder2, Johanna MW Hazes1 and Radboud JEM Dolhain1

Author affiliations

1 Department of Rheumatology, Erasmus University Medical Center Rotterdam, Dr. Molewaterplein 50, NL-3015 GE, Rotterdam, The Netherlands

2 Biomolecular Mass Spectrometry Unit, Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands

3 Department of Biostatistics, Erasmus University Medical Center Rotterdam, Dr. Molewaterplein 50, NL-3015 GE, Rotterdam, The Netherlands

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Citation and License

Arthritis Research & Therapy 2011, 13:R10  doi:10.1186/ar3231

Published: 31 January 2011

Abstract

Introduction

Rheumatoid arthritis (RA) improves during pregnancy and flares after delivery. It has been hypothesized that high levels of the complement factor mannose-binding lectin (MBL) are associated with a favourable disease course of RA by facilitating the clearance of pathogenic immunoglobulin G (IgG) lacking galactose sugar moieties. During pregnancy, increased galactosylation of IgG and simultaneously increased MBL levels can be observed, with the latter being strictly related to maternal MBL genotypes. Therefore, increased MBL levels in concert with increased IgG galactosylation may be associated with pregnancy-induced improvement of RA. The objective of this study was to investigate whether MBL genotypes are associated with changes in RA disease activity and with changes in IgG galactosylation during pregnancy and in the postpartum period. We also studied the association between MBL genotypes and pregnancy outcomes in RA.

Methods

Serum from 216 patients with RA and 31 healthy controls participating in the Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) Study was collected before, during and after pregnancy. IgG galactosylation was determined by performing matrix-assisted laser desorption/ionization time of flight mass spectrometry. Disease activity was determined using the internationally recognized Disease Activity Score 28 (DAS28). MBL genotypes were determined. The pregnancy outcome measures studied were gestational age, birth weight, miscarriage and hypertensive disorders.

Results

No association was found between the MBL genotype groups and changes in RA disease activity (P = 0.89) or changes in IgG galactosylation (patients, P = 0.75, and controls, P = 0.54) during pregnancy and in the postpartum period. Furthermore, MBL genotype groups were not related to the studied pregnancy outcome measures.

Conclusions

This study does not provide evidence for a role for MBL in the improvement of RA during pregnancy or for a role for MBL in pregnancy outcome.