Ulcová-Gallová Z, Bouse V, Krizanovská K, Balvín M, Rokyta Z, Netrvalová L
Department of Obstetrics and Gynecology, Charles University, Pilsen, Czech Republic.
Int J Fertil Womens Med. 2001 Nov-Dec;46(6):304-8.
To compare levels of beta2-glycoprotein I antibodies with six different antiphospholipid antibodies (aPL) in sera from patients with certain adverse pregnancy conditions.
aPL levels were examined in pregnant women with anti-phospholipid syndrome (26), pre-eclampsia (32), autoimmune disease (12), or diabetes mellitus (23) and in a group with physiological pregnancy (38). A commercial ELISA was used to determine the serum levels of anti-beta2-GPI (Immunotech) in isotypes IgG and IgA, and anti-cardiolipin levels (Milenia) in IgG and IgM. aPL screening also included L-alpha-phosphatidic acid, L-alpha-phosphatidylethanolamine, L-alpha-phosphatidyl-DL-glycerol, L-alpha-phosphatidylinositol, and L-alpha-phosphatidyl-serine (Sigma, U.S.A.) in IgG and IgM. Statistical analysis of all aPL levels was made by cut-off levels for Ig isotypes by using 3 SD or 95th percentile calculated using STATGRAPHICS.
Positive levels of antibodies against beta2-GPI in IgA are more frequently associated with a diagnosis of anti-phospholipid syndrome, pre-eclampsia, and autoimmune disease in pregnant women than with diabetes mellitus in pregnancy. Very high interindividual differences in aPLs (against inositol, L-serine, cardiolipin, and beta2-glycoprotein in IgG and IgA) were found in serum from women with pregnancy complicated by anti-phospholipid syndrome, pre-eclampsia, and autoimmune disease. Pregnant patients with diabetes mellitus had higher serum levels in aPLs to DL-glycerol, inositol, L-serine, and beta2-glycoprotein. Positive aPL levels predominate in isotype IgG. Very low levels of aPLs to phosphatidic acid and phosphatidyl-ethanolamine were detected in all groups studied.
Serum levels of anti-beta2-GPI could serve as a better prognostic marker in complicated pregnancy than the panel of seven different anti-phospholipid antibodies. Detection of anti-beta2-GPI is proposed as a first step of the screening for aPLs.
比较患有特定不良妊娠状况患者血清中β2-糖蛋白I抗体与六种不同抗磷脂抗体（aPL）的水平。
检测患有抗磷脂综合征（26例）、先兆子痫（32例）、自身免疫性疾病（12例）或糖尿病（23例）的孕妇以及生理妊娠组（38例）的aPL水平。采用商用酶联免疫吸附测定法（ELISA）来测定IgG和IgA同种型中抗β2-GPI（Immunotech）的血清水平，以及IgG和IgM中抗心磷脂水平（Milenia）。aPL筛查还包括IgG和IgM中的L-α-磷脂酸、L-α-磷脂酰乙醇胺、L-α-磷脂酰-DL-甘油、L-α-磷脂酰肌醇和L-α-磷脂酰丝氨酸（美国Sigma公司）。使用STATGRAPHICS通过Ig同种型的临界值对所有aPL水平进行统计分析，临界值采用3个标准差或第95百分位数计算得出。
与妊娠糖尿病相比，IgA中抗β2-GPI抗体阳性水平在孕妇中更常与抗磷脂综合征、先兆子痫和自身免疫性疾病的诊断相关。在患有抗磷脂综合征、先兆子痫和自身免疫性疾病的妊娠女性血清中，发现aPL（针对IgG和IgA中的肌醇、L-丝氨酸、心磷脂和β2-糖蛋白）存在非常大的个体差异。患有糖尿病的妊娠患者aPL对DL-甘油、肌醇、L-丝氨酸和β2-糖蛋白的血清水平较高。aPL阳性水平在IgG同种型中占主导。在所有研究组中，检测到aPL对磷脂酸和磷脂酰乙醇胺的水平非常低。
与七种不同抗磷脂抗体组合相比，抗β2-GPI血清水平可作为复杂妊娠中更好的预后标志物。建议将抗β2-GPI的检测作为aPL筛查的第一步。
