Walker T S, Triplett D A, Javed N, Musgrave K
Muncie Center for Medical Education, Indiana University School of Medicine.
Thromb Res. 1988 Aug 1;51(3):267-81. doi: 10.1016/0049-3848(88)90104-1.
Plasma samples from nineteen patients with well characterized lupus anticoagulants (LA) were evaluated using a series of test systems. An ELISA was used to determine if the plasmas contained antiphospholipid antibodies (APA); fifteen of nineteen LA plasmas contained APA, with five exhibiting IgG only, two exhibiting IgM, and eight plasmas containing both IgG and IgM. Anti-phosphatidyl serine (PS) was the predominant IgG specificity and all IgM APA-containing plasmas reacted with phosphatidyl inositol (PI). An ELISA was developed to determine if LA plasmas contained immunoglobulin which would associate with cultured human umbilical cord vein-derived endothelial cells (HUV); ten of nineteen plasmas contained endothelium associated immunoglobulin (EAI). There was significant concordance between the occurrence of EAI and IgM anti-PI. The occurrence of EAI or APA, either singly or in combination, did not correlate with a past history of thrombosis. Patient plasmas were incubated with HUV and examined for effects on HUV prostacyclin (PGI2) secretion; six plasmas significantly stimulated PGI2 secretion and one plasma was inhibitory. Finally, plasma levels of free and total antigenic protein S were determined by EID. Five plasmas contained significantly reduced levels of free antigenic protein S, and total antigenic protein S was reduced in ten plasmas. Patient histories were examined for evidence of thrombotic episodes; six patients had a history of either arterial or venous thrombosis, with five of these six patients having drug-induced LA. Thus, unlike previous studies, drug-induced LA were associated with thrombosis.
使用一系列检测系统对19例具有明确特征的狼疮抗凝物（LA）患者的血浆样本进行了评估。采用酶联免疫吸附测定（ELISA）来确定血浆中是否含有抗磷脂抗体（APA）；19份LA血浆中有15份含有APA，其中5份仅表现为IgG，2份表现为IgM，8份血浆同时含有IgG和IgM。抗磷脂酰丝氨酸（PS）是主要的IgG特异性抗体，所有含有IgM APA的血浆均与磷脂酰肌醇（PI）反应。开发了一种ELISA来确定LA血浆中是否含有可与培养的人脐静脉来源的内皮细胞（HUV）结合的免疫球蛋白；19份血浆中有10份含有内皮相关免疫球蛋白（EAI）。EAI的出现与IgM抗PI之间存在显著的一致性。EAI或APA单独或联合出现与既往血栓形成史无关。将患者血浆与HUV孵育，并检测其对HUV前列环素（PGI2）分泌的影响；6份血浆显著刺激PGI2分泌，1份血浆具有抑制作用。最后，通过酶免疫扩散法（EID）测定游离和总抗原性蛋白S的血浆水平。5份血浆中游离抗原性蛋白S水平显著降低，10份血浆中总抗原性蛋白S水平降低。检查患者病史以寻找血栓形成发作的证据；6例患者有动脉或静脉血栓形成史，这6例患者中有5例患有药物诱导的LA。因此，与以往的研究不同，药物诱导的LA与血栓形成有关。
