Inanç M, Donohoe S, Ravirajan C T, Radway-Bright E L, Mackie I, Machin S, Isenberg D A
Department of Medicine, University College London.
Br J Rheumatol. 1998 Oct;37(10):1089-94.
To determine anti-beta2 glycoprotein-I (anti-beta2GPI) and anti-prothrombin (anti-ProT) antibody levels, and the IgG subclass distribution of anti-beta2GPI antibodies, in serial samples from patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) having initial or recurrent thrombotic/neurological (T/N) events during the study period. To investigate the correlations between these antibodies and beta2GPI antigen, anticardiolipin antibody (aCL), anti-double-stranded (ds) DNA, C3 levels and disease activity.
Fifty serum samples were identified from seven patients with SLE who had had T/N events during the follow-up from a cohort under long-term follow-up. IgG anti-beta2GPI, anti-ProT, aCL, IgG subclasses of anti-beta2GPI and beta2GPI antigen levels were determined by ELISA. Corresponding disease activity [British Isles Lupus Assessment Group (BILAG)], anti-dsDNA and C3 levels were compared.
IgG anti-beta2GPI antibody levels were elevated in six of the patients before and after the T/N events with less marked fluctuations than aCL antibody levels. The predominant subclass of anti-beta2GPI antibodies was IgG2 before and after the T/N events. IgG anti-ProT antibodies were negative in all cases. There was a significant but weak correlation between anti-beta2GPI and aCL antibodies. No correlation was found between disease activity and IgG anti-beta2GPI antibody and beta2GPI antigen levels. There were fluctuations in beta2GPI antigen levels and a trend to increase after T/N events was observed in some patients.
Most of the patients with a T/N event during the study period had IgG anti-beta2GPI, but not IgG anti-ProT antibodies. Many IgG aCL-negative samples were found to have IgG anti-beta2GPI activity during the follow-up period. The predominant subclass of IgG anti-beta2GPI was IgG2, which may have importance in the pathogenesis of APS. beta2GPI antigen levels were found to be increased in some patients with SLE after T/N events. IgG anti-beta2GPI antibodies may be used as an adjunctive marker of future T/N events in patients with SLE and APS with aCL antibodies and lupus anticoagulant.
测定系统性红斑狼疮（SLE）和抗磷脂综合征（APS）患者在研究期间发生初始或复发性血栓形成/神经系统（T/N）事件的系列样本中抗β2糖蛋白-I（抗β2GPI）和抗凝血酶原（抗ProT）抗体水平，以及抗β2GPI抗体的IgG亚类分布。研究这些抗体与β2GPI抗原、抗心磷脂抗体（aCL）、抗双链（ds）DNA、C3水平及疾病活动度之间的相关性。
从长期随访队列中选取7例在随访期间发生T/N事件的SLE患者的50份血清样本。采用酶联免疫吸附测定法（ELISA）测定IgG抗β2GPI、抗ProT、aCL、抗β2GPI的IgG亚类及β2GPI抗原水平。比较相应的疾病活动度[英伦狼疮评估组（BILAG）]、抗dsDNA及C3水平。
6例患者在T/N事件前后IgG抗β2GPI抗体水平升高，其波动程度小于aCL抗体水平。T/N事件前后抗β2GPI抗体的主要亚类均为IgG2。所有病例中IgG抗ProT抗体均为阴性。抗β2GPI与aCL抗体之间存在显著但较弱的相关性。未发现疾病活动度与IgG抗β2GPI抗体及β2GPI抗原水平之间存在相关性。β2GPI抗原水平存在波动，部分患者在T/N事件后有升高趋势。
研究期间发生T/N事件的大多数患者有IgG抗β2GPI，但无IgG抗ProT抗体。随访期间发现许多IgG aCL阴性样本具有IgG抗β2GPI活性。IgG抗β2GPI的主要亚类为IgG2，这可能在APS的发病机制中具有重要意义。发现部分SLE患者在T/N事件后β2GPI抗原水平升高。IgG抗β2GPI抗体可作为伴有aCL抗体和狼疮抗凝物的SLE和APS患者未来发生T/N事件的辅助标志物。
