Testing for and clinical significance of anticardiolipin antibodies.
نویسندگان
چکیده
The disputed nomenclature of the antibodies associated with the antiphospholipid syndrome (APS) can easily confuse the reader. In this paper we use the historical terms; thus, “antiphospholipid antibodies” (aPL) refers to antibodies associated with the clinical syndrome of venous and arterial thrombosis, recurrent fetal loss, livido reticularis, thrombocytopenia, and other, less common manifestations, termed APS. This syndrome may be primary or secondary in association with other autoimmune conditions such as systemic lupus erythaematosus (SLE). aPL can be divided into the lupus anticoagulants (LA), detected by in vitro clotting tests, and antibodies detected by solid-phase enzyme-linked immunosorbent assays (ELISA), which include anticardiolipin antibodies (aCL). This review covers the solid-phase assays for aPL, but not the LA tests usually performed in a hematology laboratory. These terms are used to maintain historical and keyword search consistency. Clinically significant aCL detected in the aCL ELISA and also in some cases of LA are in fact largely directed to a plasma protein, b2-glycoprotein I (B2GPI) (48, 50, 62), with the B2GPI itself binding to phospholipid in the assay. True aPL, although detected in the aCL ELISA, are false positive and are usually not associated with the APS. In addition, cardiolipin may not necessarily be the best phospholipid for detecting aCL, and phosphatidylserine, phosphatidylethanolamine, and phospholipid mixtures have also been used; some of these may also detect different antibodies (82, 86). The reader will see the terms “antiphospholipid/cofactors syndrome,” “antiphospholipid-protein syndrome,” and “Hughes’ syndrome” used elsewhere referring to APS; no doubt, further terms will be introduced when the physiologic mechanism of the antibodies becomes clear.
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ورودعنوان ژورنال:
- Clinical and diagnostic laboratory immunology
دوره 6 6 شماره
صفحات -
تاریخ انتشار 1999