Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, China; Zhongshan Hospital, Fujian Medical University, Xiamen, China.
Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, China.
Int Immunopharmacol. 2018 Sep;62:132-138. doi: 10.1016/j.intimp.2018.05.033. Epub 2018 Jul 10.
Anticardiolipin antibody (ACA) includes beta2-glycoprotein I-dependent (β2-GPI-dependent) and β2-GPI-independent forms. The appearance of β2-GPI-dependent ACA and its association with blood coagulation have never been investigated in subjects with classical biological false-positive syphilis reactions (CBFP). In total, 146 CBFP subjects, 465 syphilis patients and 64 presumed antiphospholipid antibody syndrome (pAPS) patients were enrolled, and β2-GPI-dependent ACA IgA/IgG/IgM and anti-β2-GPI IgA/IgG/IgM antibodies were detected via chemiluminescence assay. Conventional blood coagulation indices were measured to analyze their associations with these autoantibodies. In current study, the positive rate of β2-GPI-dependent ACA in CBFP subjects was 22.60%, which was significantly higher than that in syphilis patients (3.87%) (P < 0.001) and similar to that in pAPS patients (32.81%) (P = 0.119). The predominant autoantibody isotypes were IgG in CBFP subjects and pAPS patients and IgM in syphilis patients. Positive autoantibody rates were independent of rapid plasma reagin titers. CBFP and pAPS subjects had longer prothrombin times (P < 0.001) and activated partial thromboplastin times (APTTs, P < 0.001) but lower fibrinogen concentrations (P = 0.022) and platelet counts (P < 0.001) than syphilis patients. APTTs were prolonged in CBFP, syphilis and pAPS subjects with positive autoantibodies compared with those in subjects with negative autoantibodies (P < 0.05). In conclusion, ACAs in CBFP and syphilis subjects are heterogeneous; β2-GPI-dependent ACA constitutes a significant proportion of ACAs in CBFP subjects, while β2-GPI-independent ACA predominates in syphilis patients. CBFP subjects are more prone to blood coagulation disorders than syphilis patients, and these autoantibodies may impact the intrinsic coagulation cascade in CBFP subjects, similar to pAPS patients.
抗心磷脂抗体（ACA）包括β2-糖蛋白 I 依赖性（β2-GPI 依赖性）和β2-GPI 非依赖性形式。β2-GPI 依赖性 ACA 的出现及其与血液凝固的关系从未在经典生物学假阳性梅毒反应（CBFP）的受试者中进行过研究。共纳入 146 例 CBFP 受试者、465 例梅毒患者和 64 例拟诊抗磷脂抗体综合征（pAPS）患者，采用化学发光法检测β2-GPI 依赖性 ACA IgA/IgG/IgM 和抗β2-GPI IgA/IgG/IgM 抗体。检测常规凝血指数，分析其与这些自身抗体的关系。在本研究中，CBFP 受试者β2-GPI 依赖性 ACA 的阳性率为 22.60%，明显高于梅毒患者（3.87%）（P<0.001），与 pAPS 患者（32.81%）相似（P=0.119）。CBFP 受试者和 pAPS 患者的主要自身抗体同种型为 IgG，而梅毒患者为 IgM。阳性自身抗体率与快速血浆反应素滴度无关。CBFP 和 pAPS 受试者的凝血酶原时间（P<0.001）和活化部分凝血活酶时间（APTT，P<0.001）较长，纤维蛋白原浓度（P=0.022）和血小板计数（P<0.001）较低，与梅毒患者相比。与自身抗体阴性者相比，自身抗体阳性的 CBFP、梅毒和 pAPS 受试者的 APTT 延长（P<0.05）。总之，CBFP 和梅毒患者的 ACA 存在异质性；β2-GPI 依赖性 ACA 构成 CBFP 患者 ACA 的重要组成部分，而β2-GPI 非依赖性 ACA 在梅毒患者中占优势。CBFP 受试者比梅毒患者更容易发生凝血功能障碍，这些自身抗体可能影响 CBFP 受试者的内源性凝血级联反应，与 pAPS 患者相似。
