Anti-prothrombin antibodies and the lupus anticoagulant.
Anti-prothrombin antibodies and the lupus anticoagulant.
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DOI：
10.1182/blood.v72.2.512.bloodjournal722512
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发表时间：
1988-08
期刊：
影响因子：
20.3
通讯作者：
Rebecca A. Fleck;S. Rapaport;Vijaya Mohan Rao
中科院分区：
文献类型：
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作者：
Rebecca A. Fleck;S. Rapaport;Vijaya Mohan Rao
研究者评估了狼疮抗凝患者抗凝血酶原抗体的频率和表现。42例狼疮抗凝剂患者中有31例（74%）与各种基础疾病相关，有抗凝血酶原抗体交叉免疫电泳的证据。活化部分凝血活酶时间超过50秒的25例患者中有24例，凝血酶原时间超过对照组2秒以上的15例患者中有14例具有可证实的抗凝血酶原抗体。31例抗凝血酶原抗体患者中有3例基本上没有可测量的血浆凝血酶原，这是凝血酶原/凝血酶原抗体复合物加速清除的推测结果。这些患者均出现异常流血的。剩余的抗凝血酶原抗体患者既没有显著的低凝血酶原血症，也没有出血表现，这证实了与狼疮抗凝剂相关的抗凝血酶原抗体的非中和性质。由于已知狼疮抗凝免疫球蛋白与磷脂反应，结合凝血酶原的抗体的高流行率使我们测试抗体多反应性的假设。三个狼疮抗凝血浆与不溶性凝血酶原的吸附显着减少凝血酶原/凝血酶原抗体复合物和抗凝活性的证据。不溶性凝血酶原的洗脱液中含有IgG，不仅结合凝血酶原，但具有狼疮抗凝活性。
The investigators have evaluated the frequency and manifestations of anti-prothrombin antibodies in patients with the lupus anticoagulant. Thirty-one of 42 patients with lupus anticoagulants associated with a variety of underlying conditions (74%) had evidence on crossed immunoelectrophoresis of anti-prothrombin antibodies. Twenty-four of 25 patients with an activated partial thromboplastin time exceeding 50 seconds and 14 of 15 patients with a prothrombin time exceeding control by more than two seconds had demonstrable anti-prothrombin antibodies. Three of the 31 patients with anti-prothrombin antibodies had essentially no measurable plasma prothrombin, a presumed result of accelerated clearance of prothrombin/prothrombin antibody complexes. Each of these patients had bled abnormally. The remaining patients with anti-prothrombin antibodies had neither substantial hypoprothrombinemia nor hemorrhagic manifestations, which confirms the non-neutralizing property of anti-prothrombin antibodies associated with the lupus anticoagulant. Since lupus anticoagulant immunoglobulins are known to react with phospholipids, the high prevalence of antibodies binding prothrombin led us to test the hypothesis of antibody polyreactivity. Adsorption of three lupus anticoagulant plasmas with insolubilized prothrombin markedly diminished evidence of both prothrombin/prothrombin antibody complexes and anticoagulant activity. Eluates of the insolubilized prothrombin contained IgG that not only bound prothrombin but possessed lupus anticoagulant activity.