Macchi L, Rispal P, Clofent-Sanchez G, Pellegrin J L, Nurden P, Leng B, Nurden A T
UMR 5533 CNRS, Hôpital Cardiologique, Pessac, France.
Br J Haematol. 1997 Aug;98(2):336-41. doi: 10.1046/j.1365-2141.1997.2243038.x.
The role of antiphospholipid antibodies in the pathogenesis of the thrombocytopenia observed during primary antiphospholipid antibody syndrome (APAS) and systemic lupus erythematosus (SLE) remains controversial. We have used the MAIPA test to examine the frequency and specificity of anti-platelet antibodies directed against the major platelet membrane glycoproteins (GP IIb-IIIa, GP Ib-IX, GP Ia-IIa and GP IV) in patients where SLE and APAS were associated or not with thrombocytopenia. Results were compared with a series of 26 ITP patients, 46% of whom were shown to possess anti-platelet antibodies directed against one or more of the platelet surface glycoproteins. When APAS was associated with thrombocytopenia, 7/10 patients possessed antibodies against GP IIb-IIIa and/or GP Ib-IX. For SLE patients with thrombocytopenia, 6/10 patients were shown to have antiplatelet antibodies against GP IIb-IIIa, GP Ib-IX or GP IV. In contrast, for APAS (n=11) and SLE patients (n=11) without thrombocytopenia, only one patient had an antibody directed against GP IIb-IIIa and one patient had an antibody to GP IV. Our results suggest that antibodies directed against major platelet membrane glycoproteins may play a role in the thrombocytopenia that is seen during SLE and APAS.
抗磷脂抗体在原发性抗磷脂抗体综合征（APAS）和系统性红斑狼疮（SLE）期间观察到的血小板减少症发病机制中的作用仍存在争议。我们使用单克隆抗体固相血小板抗原分析法（MAIPA）检测了SLE和APAS患者中抗血小板抗体针对主要血小板膜糖蛋白（GP IIb-IIIa、GP Ib-IX、GP Ia-IIa和GP IV）的频率和特异性，这些患者伴有或不伴有血小板减少症。结果与26例免疫性血小板减少性紫癜（ITP）患者进行了比较，其中46%的患者被证明拥有针对一种或多种血小板表面糖蛋白抗原的抗血小板抗体。当APAS与血小板减少症相关时，10例患者中有7例拥有针对GP IIb-IIIa和/或GP Ib-IX的抗体。对于血小板减少症的SLE患者，10例患者中有6例被证明具有针对GP IIb-IIIa、GP Ib-IX或GP IV的抗血小板抗体。相比之下，对于无血小板减少症的APAS患者（n = 11）和SLE患者（n = 11），只有1例患者拥有针对GP IIb-IIIa的抗体，1例患者拥有针对GP IV的抗体。我们的结果表明，针对主要血小板膜糖蛋白的抗体可能在SLE和APAS期间出现的血小板减少症中起作用。
