Aoki K, Dudkiewicz A B, Matsuura E, Novotny M, Kaberlein G, Gleicher N
Center for Human Reproduction, Chicago, IL 60610.
Am J Obstet Gynecol. 1995 Mar;172(3):926-31. doi: 10.1016/0002-9378(95)90023-3.
Our purpose was to determine whether beta 2-glycoprotein I-dependent anticardiolipin antibodies may represent a superior marker of reproductive risk than do conventional antiphospholipid antibodies.
The incidence of beta 2-glycoprotein I-dependent and beta 2-glycoprotein I-independent anticardiolipin antibodies and of six conventional antiphospholipid antibodies was statistically compared between study groups with and without autoantibody-associated features of reproductive failure. Sera from 356 women were randomly selected from the frozen sera bank at the Center for Human Reproduction, Chicago. They included sera from 259 patients with autoantibody-associated features of reproductive failure such as unexplained infertility, endometriosis, and repeated pregnancy loss and 97 infertile controls. Autoantibody levels by a modified enzyme-linked immunosorbent assay for beta 2-glycoprotein I-dependent and beta 2-glycoprotein I-independent anticardiolipin antibodies and a standard enzyme-linked immunosorbent assay for anticardiolipin antibody and five other antiphospholipid antibodies were then compared.
Patients demonstrated a significantly higher incidence of beta 2-glycoprotein I-dependent anticardiolipin antibodies (5.4%) than did controls (0%) in a modified enzyme-linked immunosorbent assay (p = 0.01). No such difference was, however, noted for beta 2-glycoprotein I-independent anticardiolipin antibodies or any one of six antiphospholipid antibodies. Two or more among six antiphospholipid antibodies, especially if involving anticardiolipin antibodies, antiphosphatidylserine and antiphosphatidylinositol, as assayed by standard enzyme-linked immunosorbent assay, were significantly more often (p = 0.02) positive in the patients (5.0%) than in the controls (0%). Moreover, positivity in two of those three antiphospholipid antibodies correlated in 59% of cases to positivity in the beta 2-glycoprotein I-dependent anticardiolipin antibody.
As a single test beta 2-glycoprotein I-dependent anticardiolipin antibody appears to be superior to cofactor-independent anticardiolipin antibody or any other single conventional antiphospholipid antibody for the detection of autoantibody-associated conditions of reproductive failure. A broadly based panel of conventional antiphospholipid antibodies, especially if inclusive of anticardiolipid antibody, antiphosphatidylserine, and antiphosphatidylinositol, may, however, achieve similar results.
我们的目的是确定β2-糖蛋白I依赖性抗心磷脂抗体是否比传统抗磷脂抗体更能代表生殖风险的指标。
在有和没有与自身抗体相关的生殖功能衰竭特征的研究组之间，对β2-糖蛋白I依赖性和β2-糖蛋白I非依赖性抗心磷脂抗体以及六种传统抗磷脂抗体的发生率进行了统计学比较。从芝加哥人类生殖中心的冷冻血清库中随机选取356名女性的血清。其中包括259例具有与自身抗体相关的生殖功能衰竭特征的患者的血清，如不明原因的不孕症、子宫内膜异位症和反复流产，以及97例不孕对照者的血清。然后比较了通过改良酶联免疫吸附测定法检测β2-糖蛋白I依赖性和β2-糖蛋白I非依赖性抗心磷脂抗体的自身抗体水平，以及通过标准酶联免疫吸附测定法检测抗心磷脂抗体和其他五种抗磷脂抗体的自身抗体水平。
在改良酶联免疫吸附测定中，患者的β2-糖蛋白I依赖性抗心磷脂抗体发生率（5.4%）显著高于对照组（0%）（p = 0.01）。然而，β2-糖蛋白I非依赖性抗心磷脂抗体或六种抗磷脂抗体中的任何一种均未观察到这种差异。通过标准酶联免疫吸附测定法检测，六种抗磷脂抗体中有两种或更多种，特别是如果涉及抗心磷脂抗体、抗磷脂酰丝氨酸和抗磷脂酰肌醇，患者（5.0%）呈阳性的频率显著高于对照组（0%）（p = 0.02）。此外，在这三种抗磷脂抗体中，有两种呈阳性的情况在59%的病例中与β2-糖蛋白I依赖性抗心磷脂抗体呈阳性相关。
作为单一检测指标，β2-糖蛋白I依赖性抗心磷脂抗体在检测与自身抗体相关的生殖功能衰竭情况方面似乎优于不依赖辅因子的抗心磷脂抗体或任何其他单一传统抗磷脂抗体。然而，一组广泛的传统抗磷脂抗体，特别是如果包括抗心磷脂抗体、抗磷脂酰丝氨酸和抗磷脂酰肌醇，可能会取得类似的结果。
