Reactivity Profiles of Autoantibodies to Different Phospholipids and the Phospholipid-binding Protein ß2-Glycoprotein I in Patients with Clinical Symptoms Related to Thromboembolic and/or Vasculopathic Events with or without Connective Tissue Diseases

H.-Jaekel, P.; Schmid, D.; E.-W. Müller; V.Ziutelis; Trabandt, A.; N.Grobe; Kaskel, S.-Paul; H. Höh; Bauer, B.; Sudik, R.; Baldauf, A.; Werle, E.

Clinical Laboratory 49(7-8): 345-355

2003


ISSN/ISBN: 1433-6510
PMID: 12908734
Document Number: 9759
To study the antigenic and epitope specificities of anti-phospholipid Ab in detail, we investigated 177 patients without (62 with APS-related systemic clinical symptoms, 115 with microangiopathies) and 164 patients with connective tissue diseases (CTD). Ab associated with primary APS (pAPS) seem to show a restricted specificity (phospholipid/β2-GPI-complexes), whereas those in secondary APS (sAPS) react additionaly with pure β2-GPI. Simultaneously, β2-GPI-independent Ab were also frequently present in both conditions (50% of all Ab-positive sera). In CTD patients. the reactivity profile "pure β2-GPI + phospholipid/β2-GPI-complexes" is significantly associated with clinically manifest sAPS. Comparing cardiolipin and phosphatidylserine as antigenic target, the overall concordance (crossreactivity?) between both assays was lower than expected (52%), being highest in pAPS (87%) and sAPS (65%). Based on these results, a two-step procedure for reliable serological diagnosis of APS could be recommended: Ab-screening using a mix of phospholipids complexed with β2-GPI (sensitivity > 90% for Ab concentrations above 20 U/ml) followed by an assay allowing the simultaneous detection of all relevant antigenic and epitope specificities.

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Reactivity Profiles of Autoantibodies to Different Phospholipids and the Phospholipid-binding Protein ß2-Glycoprotein I in Patients with Clinical Symptoms Related to Thromboembolic and/or Vasculopathic Events with or without Connective Tissue Diseases