Ogasawara M, Aoki K, Matsuura E, Sasa H, Yagami Y
Department of Obstetrics and Gynecology, Nagoya City University Medical School, Japan.
Lupus. 1996 Dec;5(6):587-92. doi: 10.1177/096120339600500605.
Anticardiolipin antibodies (aCL) were found to recognize beta 2glycoprotein I (beta 2GPI) structure altered by its interaction with an oxygen modified solid phase surface by gamma-ray radiation. Lupus anticoagulant (LA) has been reported to comprise anti prothrombin antibodies, anti factor X antibodies and anti beta 2GPI antibodies. The present study focuses on the possible association between antibodies against the altered beta 2GPI structure (anti beta 2GPI antibodies) and LA in patients with recurrent pregnancy loss. Moreover, the clinical significance of both subgroups of so-called antiphospholipid antibodies were investigated to cast light on the controversy of whether aCL and LA are risk factors for pregnancy losses. One hundred and ninety five women with a history of two or more unexplained consecutive miscarriages and 100 control pregnant women were tested. Lupus anticoagulant was detected by the dilute phospholipid activated partial thromboplastin time. Anti beta 2GPI antibodies were measured by the ELISA method using commercially oxygenated microtiter plates. Twenty two (11.3%) and 19 (9.7%) of the 195 recurrent aborters were, respectively, positive for LA and anti beta 2GPI antibodies. Seven (3.6%) of the aborters had both of them. None of the control pregnant women had LA. Three of the control pregnant women had anti beta 2GPI antibodies. Nine (40.9%) of 22 aborters with positive-LA had a history of miscarriages in the second trimester as compared to 8 (4.6%) of 173 aborters with negative-LA. (P = 0.000007, Odds ratio = 14.3). None of the 12 aborters with anti beta 2GPI antibodies but no LA had a history of second trimester-fetal loss. These results support the hypothesis that aCL and LA define two distinct but partly related populations and that aCL include two subtypes of antibodies, with and without LA activity. LA and anti beta 2GPI antibodies appear to be associated with pregnancy loss, with LA being linked not only to abortions in the first trimester but also to miscarriages in the second trimester.
抗心磷脂抗体（aCL）被发现可识别因β2糖蛋白I（β2GPI）与经γ射线辐射的氧修饰固相表面相互作用而改变的结构。狼疮抗凝物（LA）据报道包括抗凝血酶原抗体、抗X因子抗体和抗β2GPI抗体。本研究聚焦于复发性流产患者中针对改变的β2GPI结构的抗体（抗β2GPI抗体）与LA之间的可能关联。此外，对这两种所谓抗磷脂抗体亚组的临床意义进行了研究，以阐明aCL和LA是否为流产风险因素这一争议。对195名有两次或更多次不明原因连续流产史的女性和100名对照孕妇进行了检测。采用稀释磷脂激活部分凝血活酶时间检测狼疮抗凝物。使用商业氧化微量滴定板通过ELISA法检测抗β2GPI抗体。195名复发性流产者中分别有22名（11.3%）和19名（9.7%）LA和抗β2GPI抗体呈阳性。其中7名（3.6%）流产者两者均呈阳性。对照孕妇中无LA阳性者。3名对照孕妇抗β2GPI抗体呈阳性。LA阳性的22名流产者中有9名（40.9%）有孕中期流产史，而LA阴性的173名流产者中有8名（4.6%）有孕中期流产史。（P = 0.000007，优势比 = 14.3）。12名抗β2GPI抗体阳性但无LA的流产者中无一例有孕中期胎儿丢失史。这些结果支持以下假说：aCL和LA界定了两个不同但部分相关的群体，且aCL包括有和无LA活性的两种抗体亚型。LA和抗β2GPI抗体似乎与流产有关，LA不仅与孕早期流产有关，还与孕中期流产有关。
