Martinuzzo M E, de Larrañaga G F, Forastiero R R, Pelegri Y, Fariña M H, Alonso B S, Kordich L C, Carreras L O
Division of Haematology, Favaloro University, Favaloro Foundation, Buenos Aires, Argentina.
Clin Exp Rheumatol. 2002 Jul-Aug;20(4):477-83.
To evaluate plasma levels of markers of platelet, endothelial cell and blood coagulation activation in leprosy patients with or without antiphospholipid antibodies (aPL) and to compare them to those found in patients with antiphospholipid syndrome (APS).
42 patients with leprosy (35 lepromatous and 7 borderline): 29 aPL(+) and 13 aPL(-), as well as 26 healthy subjects as normal controls (NC) and 79 control aPL patients without leprosy (59 with and 20 without APS) were included in the study. Plasma soluble P and E selectin (sPsel and sEsel), and VCAM-1 (sVCAM-1), prothrombin F1 + 2 fragment (F1 + 2), thrombin-antithrombin complexes (TAT) and D dimer (DD) were measured by ELISA. The protein C pathway was assessed by the ProC global test.
Leprosy patients with aPL presented increased median levels of sPsel [ng/ml (82.0 vs 36.0, p < 0.001)] and sVCAM-1 [ng/ml (495 vs 335, p < 0.001)] compared to NC, as observed in control aPL patients without leprosy. Levels of sPsel in aPL(+) patients with leprosy were significantly higher than in aPL(-) ones (52.5 ng/ml), p = 0.005. However, plasma markers of thrombin generation were increased in control aPL patients without leprosy but not in those with leprosy. ProcC global test was abnormal in 24.1% of leprosy patients with aPL compared to 4.4% of NC (p < 0.024), and to 57.2% of control patients with aPL without leprosy (p = 0.005).
We demonstrated that although patients with leprosy present a high prevalence of aPL, and platelet and endothelial cell activation in vivo to the same extent than patients with APS, they do not show a procoagulant state.
评估有无抗磷脂抗体（aPL）的麻风患者血浆中血小板、内皮细胞及凝血激活标志物水平，并与抗磷脂综合征（APS）患者的相应水平进行比较。
纳入42例麻风患者（35例瘤型和7例界线类）：29例aPL阳性和13例aPL阴性，以及26例健康受试者作为正常对照（NC）和79例无麻风的aPL对照患者（59例有APS和20例无APS）。采用酶联免疫吸附测定法检测血浆可溶性P选择素和E选择素（sPsel和sEsel）、血管细胞黏附分子-1（sVCAM-1）、凝血酶原F1 + 2片段（F1 + 2）、凝血酶-抗凝血酶复合物（TAT）和D-二聚体（DD）。通过蛋白C整体检测评估蛋白C途径。
与NC相比，有aPL的麻风患者sPsel[ng/ml（82.0对36.0，p < 0.001）]和sVCAM-1[ng/ml（495对335，p < 0.001）]的中位数水平升高，无麻风的aPL对照患者也有此现象。有麻风的aPL阳性患者的sPsel水平显著高于aPL阴性患者（52.5 ng/ml），p = 0.005。然而，无麻风的aPL对照患者血浆凝血酶生成标志物升高，而有麻风的患者则未升高。24.1%有aPL的麻风患者蛋白C整体检测异常，相比之下，NC为4.4%（p < 0.024），无麻风的aPL对照患者为57.2%（p = 0.005）。
我们证明，尽管麻风患者aPL的患病率较高，且体内血小板和内皮细胞激活程度与APS患者相同，但他们并未表现出促凝状态。
