Klaassen R J, van der Lelie J, Vlekke A B, Weigel H M, Eeftinck Schattenkerk J K, Reiss P, von dem Borne A E
Department of Immunohaematology, The Netherlands Red Cross Blood Transfusion Service, Amsterdam.
Blut. 1989 Jul;59(1):75-81. doi: 10.1007/BF00320253.
A study was carried out on the presence of platelet-bound immunoglobulins, platelet-bound complement and serum immunoglobulin reactive with platelets in the blood of persons infected with HIV and those at risk of HIV infection. Platelet-bound immunoglobulins, predominantly IgG and IgM, but not complement, were demonstrated by immunofluorescence in 16 out of 16 patients with AIDS, in 5 out of 7 with AIDS-related complex/persistent generalized lymphadenopathy and in 7 out of 10 apparently healthy sexually active homosexual men, of whom 2 were anti-HIV1 seropositive. There was no correlation between the presence of platelet-bound immunoglobulins and either the platelet count or the level of circulating immune complexes. The specificity of the platelet-bound immunoglobulins and platelet-reactive immunoglobulins in the corresponding sera was studied. Platelet-bound immunoglobulins were eluted and then investigated for cross-reactivity with HIV. Both sera and eluates were tested for reactivity with cardiolipin and reactivity with the major target antigen in classical autoimmune thrombocytopenia, the GP IIb/IIIa complex. Of 17 eluates containing platelet-reactive immunoglobulins, 5 reacted with HIV-determinants but 2 out of 5 eluates that did not contain platelet-reactive immunoglobulins also reacted. Although anti-cardiolipin antibodies were detected in all sera, none of the 17 eluates reacted with cardiolipin. Moreover, sera and eluates, reactive with normal platelets, did not react with type-1-Glanzmann disease platelets. This indicates that the antibodies are directed against the glycoprotein IIb/IIIa complex of platelets. This could not be confirmed by immunoprecipitation or by immunoblotting, however. We conclude that the presence of platelet-bound immunoglobulins is common in HIV-infection but may also occur in persons at risk and that the nature of the auto-antibodies is not different from that of the auto-antibodies observed in classical ITP.
对感染HIV者及有HIV感染风险者血液中的血小板结合免疫球蛋白、血小板结合补体和与血小板反应的血清免疫球蛋白进行了研究。通过免疫荧光法在16例艾滋病患者中的16例、7例艾滋病相关综合征/持续性全身性淋巴结病患者中的5例以及10例明显健康的性活跃同性恋男性中的7例（其中2例抗HIV1血清阳性）中检测到血小板结合免疫球蛋白，主要为IgG和IgM，但未检测到补体。血小板结合免疫球蛋白的存在与血小板计数或循环免疫复合物水平之间无相关性。研究了相应血清中血小板结合免疫球蛋白和血小板反应性免疫球蛋白的特异性。洗脱血小板结合免疫球蛋白，然后研究其与HIV的交叉反应性。检测血清和洗脱液与心磷脂的反应性以及与经典自身免疫性血小板减少症中的主要靶抗原GP IIb/IIIa复合物的反应性。在17份含有血小板反应性免疫球蛋白的洗脱液中，5份与HIV决定簇反应，但在5份不含血小板反应性免疫球蛋白的洗脱液中有2份也发生反应。尽管在所有血清中均检测到抗心磷脂抗体，但17份洗脱液中无一与心磷脂反应。此外，与正常血小板反应的血清和洗脱液不与1型Glanzmann病血小板反应。这表明抗体是针对血小板糖蛋白IIb/IIIa复合物的。然而，这一点无法通过免疫沉淀或免疫印迹法得到证实。我们得出结论，血小板结合免疫球蛋白在HIV感染中很常见，但也可能发生在有感染风险的人群中，并且自身抗体的性质与经典免疫性血小板减少性紫癜中观察到的自身抗体没有差异。
