Association of autoantibodies against the phosphatidylserine-prothrombin complex with manifestations of the antiphospholipid syndrome and with the presence of lupus anticoagulant
Association of autoantibodies against the phosphatidylserine-prothrombin complex with manifestations of the antiphospholipid syndrome and with the presence of lupus anticoagulant
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DOI：
10.1002/1529-0131(200009)43:9
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发表时间：
2000-09-01
影响因子：
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通讯作者：
Koike, T
中科院分区：
文献类型：
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作者：
Atsumi, T;Ieko, M;Koike, T
Objective.目的探讨抗凝血酶原自身抗体与抗磷脂综合征（APS）临床表现及狼疮抗凝物（LAC）的关系。我们检查了265名访问我们自身免疫性疾病诊所的患者。IgG和IgM抗凝血酶原抗体通过酶联免疫吸附试验（ELISA）作为抗磷脂酰丝氨酸-凝血酶原复合物（aPS/PT）抗体或作为抗凝血酶原抗体包被在辐照ELISA板上（作为抗原）（aPT）进行检测。还通过ELISA评价IgG、IgM和伊加抗心磷脂（aCL）抗体及其β（2）-糖蛋白I（β（2）GPI）依赖性。采用3种不同的方法检测LAC。存在aPS/PT而非aPT与APS的临床表现显著相关（比值比[OR] 4.39，95%置信区间[95% CI] 2.06-9.38），aPS/PT抗体与APS的β 2 GPI依赖性aCL一样具有特异性（两者均为93.1%）。IgG aPS/PT与使用稀释罗素蝰蛇毒时间试验检测到的LAC的存在强相关（OR 38.2，95%CI 13.4-109.1）。抗凝血酶原抗体是异质性的，其临床相关性取决于所应用的检测方法。aPS/PT试验的阳性结果可作为自身免疫性疾病患者血栓形成事件的标志。
Objective. To clarify the association of autoantibodies against prothrombin with the clinical manifestations of the antiphospholipid syndrome (APS) and with the presence of lupus anticoagulant (LAC).Methods. We examined 265 patients who visited our autoimmune disease clinic. IgG and IgM antiprothrombin antibodies were tested by enzyme-linked immunosorbent assay (ELISA) as either antiphosphatidylserine-prothrombin complex (aPS/PT) antibodies or as antibodies against prothrombin coated on irradiated ELISA plates (as antigen) (aPT). IgG, IgM, and IgA anticardiolipin (aCL) antibodies and their beta(2)-glycoprotein I (beta(2)GPI) dependency were also evaluated by ELISA. LAC was tested by 3 different methods.Results. The presence of aPS/PT, but not of aPT, significantly correlated with the clinical manifestations of APS (odds ratio [OR] 4.39, 95% confidence interval [95% CI] 2.06-9.38), and aPS/PT antibodies were as specific as beta(2)GPI-dependent aCL for APS (93.1% for both). IgG aPS/PT strongly correlated with the presence of LAC as detected using the dilute Russell viper venom time test (OR 38.2, 95% CI 13.4-109.1).Conclusion. Antiprothrombin antibodies are heterogeneous and their clinical relevance depends on the method of detection applied. Positive results on the aPS/PT test can serve as a marker of thrombotic events in patients with autoimmune diseases.