Staub H L, Harris E N, Khamashta M A, Savidge G, Chahade W H, Hughes G R
Lupus Research Unit, Rayne Institute, St Thomas's Hospital, London, UK.
Ann Rheum Dis. 1989 Feb;48(2):166-9. doi: 10.1136/ard.48.2.166.
Most patients with lupus anticoagulant (LA) activity have coincident antibodies to a group of negatively charged phospholipids, and its is suggested that LA and anticardiolipin tests detect antibodies with overlapping specificities. Some discordance between the two assays has been described, however. One patient presenting with severe thrombotic disease (recurrent deep vein thrombosis, pulmonary embolism, inferior venocaval obstruction, myocardial infarction, and digital gangrene) showed strong LA activity in February 1987. An enzyme linked immunosorbent assay (ELISA) showed no binding to the negatively charged phospholipids cardiolipin, phosphatidylserine, and phosphatidic acid, but binding to zwitterionic phosphatidylethanolamine (PE) was demonstrated. Inhibition studies and affinity purification confirmed this finding. Interestingly, the serum did not bind to the kaolin cephalin clotting time reagent when used as antigen in an ELISA. The pathogenic significance of anti-PE antibodies and their relation to LA remains to be clarified. Further studies of the occurrence of anti-PE antibodies in patients with LA activity who have negative anticardiolipin tests are suggested.
大多数具有狼疮抗凝物（LA）活性的患者同时存在针对一组带负电荷磷脂的抗体，有人提出LA检测和抗心磷脂检测所检测的抗体具有重叠的特异性。然而，已有人描述这两种检测之间存在一些不一致的情况。一名患有严重血栓性疾病（复发性深静脉血栓形成、肺栓塞、下腔静脉阻塞、心肌梗死和指端坏疽）的患者在1987年2月显示出较强的LA活性。酶联免疫吸附测定（ELISA）显示该患者血清不与带负电荷的磷脂心磷脂、磷脂酰丝氨酸和磷脂酸结合，但与两性离子磷脂酰乙醇胺（PE）结合。抑制研究和亲和纯化证实了这一发现。有趣的是，当用作ELISA中的抗原时，该血清不与高岭土脑磷脂凝血时间试剂结合。抗PE抗体的致病意义及其与LA的关系仍有待阐明。建议对LA活性且抗心磷脂检测为阴性的患者中抗PE抗体的出现情况进行进一步研究。
