Laperche S, Abuaf N, Meyer O, Carsique R, Deschamps A, Rajoely B, Johanet C, Homberg J C
Service d'Hématologie et d'Immunologie biologiques, Hôpital Rothschild, Paris, France.
J Rheumatol. 1994 Sep;21(9):1678-83.
To evaluate if antimitochondrial type 5 antibodies (AMA5) might be included among antiphospholipid syndrome (APS) markers.
In a retrospective study, blood variables of 48 patients with AMA5 were analyzed in relationship with clinical and biological markers of APS and systemic lupus erythematosus (SLE).
We observed a high prevalence of false biological test for syphilis (95%), lupus anticoagulant (LAC) (71%), anticardiolipin antibodies (aCL) of IgG (71%) and IgM (75%) isotype, positive direct Coombs' test (54%), thrombocytopenia (52%), anti-B2 glycoprotein I antibodies (38%). Twenty-nine patients (61%) had at least one clinical manifestation of APS; 42% had recurrent arterial and/or venous deep thrombosis and 21% had recurrent fetal loss. But, for 2 patients, AMA5 were the sole detected immunological marker. Moreover, SLE was observed in 35% of the patients. These were different from 100 control patients with SLE with the respect to skin involvement and dsDNA antibodies which were less frequent (p < 0.01) and aCL, LAC, false biological test for syphilis (p < 0.001), positive direct Coombs' test and thrombocytopenia (p < 0.05) which were more frequent.
Our data suggests (1) AMA5 is another marker of the APS (2) in patients with SLE, AMA5 seems to be a marker of a subset of SLE. This appears to justify the routine detection of these antibodies.
评估抗线粒体5型抗体（AMA5）是否可能包含在抗磷脂综合征（APS）标志物之中。
在一项回顾性研究中，分析了48例AMA5患者的血液变量，并将其与APS和系统性红斑狼疮（SLE）的临床及生物学标志物进行关联分析。
我们观察到梅毒生物学假阳性检测的高患病率（95%）、狼疮抗凝物（LAC）（71%）、IgG（71%）和IgM（75%）亚型的抗心磷脂抗体（aCL）、直接抗人球蛋白试验阳性（54%）、血小板减少症（52%）、抗β2糖蛋白I抗体（38%）。29例患者（61%）至少有一项APS临床表现；42%有反复的动脉和/或静脉深静脉血栓形成，21%有反复的胎儿丢失。但是，对于2例患者，AMA5是唯一检测到的免疫标志物。此外，35%的患者观察到SLE。这些患者在皮肤受累和双链DNA抗体方面与100例SLE对照患者不同，皮肤受累和双链DNA抗体较少见（p<0.01），而aCL、LAC、梅毒生物学假阳性检测（p<0.001）、直接抗人球蛋白试验阳性和血小板减少症（p<0.05）更常见。
我们的数据表明（1）AMA5是APS的另一种标志物（2）在SLE患者中，AMA5似乎是SLE一个亚组的标志物。这似乎证明了常规检测这些抗体的合理性。
