Galeazzi M, Sebastiani G D, Passiu G, Bellucci A M, Porzio F
Divisione di Reumatologia, Ospedale S. Camillo, Roma.
Medicina (Firenze). 1990 Oct-Dec;10(4):403-5.
Antiphospholipid antibodies (aPL) have been linked to various clinical manifestations in systemic lupus erythematosus (SLE), mainly thrombosis, repeated abortions and thrombocytopenia. Despite the large number of studies which have been published in the recent years, there is still some debate on this matter, and no firm conclusion has been reached as yet. Among the various aPL, anticardiolipin antibodies (aCL) have received more attention, mostly because they can be easily detected by means of immunoenzymatic assays. The main objective of the present study was to determine the prevalence of IgG and IgM aCL isotypes in SLE in order to compare their possible association with the clinical manifestations of the disease. Clinical features of 40 consecutive and unselected SLE patients (35 female and 5 male) were prospectively studied. Sera from the same patients were tested for the presence of aCL, using a standardised ELISA assay, and the presence of aCL was correlated with the various clinical events. Results showed that the prevalence of aCL was 42.5% for the IgG isotype and 10% for the IgM isotype. Regarding the clinical associations of aCL, we found a strong linkage between the presence of these antibodies and the occurrence of both thrombosis and abortions; a weaker association with neurological events was also demonstrated. These results, if confirmed on larger series, suggest that aCL should be searched in patients with SLE in order to identify those who are at greater risk of developing some severe clinical problems and could benefit by prophylactic treatment.
抗磷脂抗体(aPL)与系统性红斑狼疮(SLE)的多种临床表现相关,主要包括血栓形成、反复流产和血小板减少。尽管近年来发表了大量研究,但关于此事仍存在一些争议,尚未得出确凿结论。在各种aPL中,抗心磷脂抗体(aCL)受到了更多关注,主要是因为它们可以通过免疫酶测定法轻松检测到。本研究的主要目的是确定SLE中IgG和IgM aCL同种型的患病率,以便比较它们与该疾病临床表现的可能关联。对40例连续且未经选择的SLE患者(35例女性和5例男性)的临床特征进行了前瞻性研究。使用标准化ELISA检测法检测同一患者血清中aCL的存在,并将aCL的存在与各种临床事件相关联。结果显示,IgG同种型aCL的患病率为42.5%,IgM同种型为10%。关于aCL的临床关联,我们发现这些抗体的存在与血栓形成和流产的发生之间存在密切联系;还证实与神经学事件的关联较弱。如果在更大规模的系列研究中得到证实,这些结果表明,应该在SLE患者中检测aCL,以便识别那些发生某些严重临床问题风险更高且可能从预防性治疗中获益的患者。