Fourteen patients with rheumatoid arthritis were studied during pregnancy and clinical disease activity and serum concentrations of pregnancy associated alpha 2-glycoprotein (PAG) measured at monthly intervals until parturition. Disease activity diminished during pregnancy in 10 patients (group 1) and increased or remained unchanged in four (group 2). The mean PAG concentration produced by group 1 was 1250 +/- 737 mg/1, which was significantly higher than the mean of 470 +/- 304 mg/1 produced by group 2. Furthermore, there was a highly significant negative correlation coefficient (r = -0.41; p less than 0.001) between disease activity and PAG concentrations during gestation. Since there was no significant difference between the two groups of patients in any of the other serum factors measured, and since PAG has immunosuppressive properties in vitro, the results suggest that this protein may play an important part in inducing the remissions of rheumatoid arthritis which frequently occur during pregnancy
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