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Clinical significance of IgA anticardiolipin and anti-β2-GP1 antibodies in patients with systemic lupus erythematosus and primary antiphospholipid syndrome

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Abstract

The objectives of this study were to estimate the prevalence of IgA anticardiolipin antibodies (aCL) and anti-β2-glycoprotein 1 antibodies (aβ2-GPl) in a large number of patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (PAPS) and to examine possible associations between the clinical manifestations of the APS and the levels of IgA aCL and aβ2-GPl. We also assessed the operative characteristics of IgA aCL and aβ2-GP1. We retrospectively studied 130 patients with SLE and 35 patients with PAPS. In all patients we measured IgG, IgM, and IgA aCL and aβ2-GP1 and recorded any of the clinical manifestations of the APS. IgA aCL were positive in 8.5% of patients with SLE and in 40% of patients with PAPS. Positive IgA aβ2-GP1 were found in 17.7% of patients with SLE and in 25.7% of patients with PAPS. IgA aCL were associated with a history of venous thrombosis, thrombocytopenia, and recurrent fetal loss. In contrast, we could not establish significant associations between IgA aβ2-GP1 and any of the clinical manifestations of the APS. Measurement of the IgA in addition to IgG and IgM aCL hardly changed the operative characteristics of aCL testing, while measurement of the IgA in addition to IgG and IgM aβ2-GP1 increased sensitivity but with a greater loss in specificity. IgA aCL is significantly associated with more than one of the clinical manifestations of the APS in contrast to the IgA aβ2-GP1. Routine measurement of the IgA isotype of both aCL and aβ2-GP1 does not improve the operative characteristics of aCL and aβ2-GP1 and therefore is not recommended at present.

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References

  1. Asherson RA, Cervera R (1993) Anticardiolipin antibodies, chronic biologic false-positive tests for syphilis and other antiphospholipid antibodies. In: Wallace DJ, Hahn BH (eds) Dubois’ lupus erythematosus. Lea ⇐p; Febiger, Philadelphia, pp 233–245

    Google Scholar 

  2. Feinstein DI, Francis RB (1993) The lupus anticoagulant and anticardiolipin antibodies. In: Wallace DJ, Hahn BH (eds) Dubois’ lupus erythematosus. Lea & Febiger, Philadelphia, pp 246–253

    Google Scholar 

  3. Arvieux J, Roussel B, Jacob MC, Colomb MG (1991) Measurement of anti-phospholipid antibodies by ELISA using beta 2-glycoprotein I as an antigen. J Immunol Methods 143:223–229

    Article  PubMed  CAS  Google Scholar 

  4. Alarcon-Segovia D, Deleze M, Oria CV et al (1989) Anti-phospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosus. Medicine 68:353–365

    PubMed  CAS  Google Scholar 

  5. Weidmann CE, Wallace DJ, Peter JB, Knight PJ, Bear MB, Klinenberg JR (1988) Studies of IgG, IgM and IgA antiphospholipid antibody isotypes in systemic lupus erythematosus. J Rheumatol 15:74–79

    PubMed  CAS  Google Scholar 

  6. Molina JF, Gutierrez-Urena S, Molina J et al (1997) Variability of anticardiolipin antibody isotype distribution in 3 geographic populations of patients with systemic lupus erythematosus. J Rheumatol 24:291–296

    PubMed  CAS  Google Scholar 

  7. Loizou S, Cofiner C, Weetman AP, Walport MJ (1992) Immunoglobulin class and IgG subclass distribution of anticardiolipin antibodies in patients with systemic lupus erythematosus and associated disorders. Clin Exp Immunol 90:434–439

    PubMed  CAS  Google Scholar 

  8. Selva-O’Callaghan A, Ordi-Ros J, Monegal-Ferran F, Martinez N, Cortes-Hernandez F, Vilardell-Tarres M (1998) IgA anticardiolipin antibodies—relation with other antiphospholipid antibodies and clinical significance. Thromb Haemost 79:282–285

    PubMed  CAS  Google Scholar 

  9. Lakos G, Kiss E, Regeczy N et al (1999) Isotype distribution and clinical relevance of anti-beta2-glycoprotein I (beta2-GPI) antibodies: importance of IgA isotype. Clin Exp Immunol 117:574–579

    Article  PubMed  CAS  Google Scholar 

  10. Fanopoulos D, Teodorescu MR, Varga J, Teodorescu M (1998) High frequency of abnormal levels of IgA anti-beta2-glycoprotein I antibodies in patients with systemic lupus erythematosus: relationship with antiphospholipid syndrome. J Rheumatol 25:675–680

    PubMed  CAS  Google Scholar 

  11. Galeazzi M, Sebastiani GD, Tincani A, Piette JC, Allegri F, Morozzi G et al (2000) HLA class II alleles associations of anticardiolipin and anti-beta2GPI antibodies in a large series of European patients with systemic lupus erythematosus. Lupus 9:47–55

    Article  PubMed  CAS  Google Scholar 

  12. Spadaro A, Riccieri V, Terracina S, Rinaldi T, Taccari E, Zoppini A (2000) Class specific rheumatoid factors and antiphospholipid syndrome in systemic lupus erythematosus. Lupus 9:56–60

    Article  PubMed  CAS  Google Scholar 

  13. Gharavi AE, Harris EN, Asherson RA, Hughes GR (1987) Anticardiolipin antibodies: isotype distribution and phospholipid specificity. Ann Rheum Dis 46:1–6

    Article  PubMed  CAS  Google Scholar 

  14. Lopez LR, Santos ME, Espinoza LR, La Rosa FG (1992) Clinical significance of immunoglobulin A versus immunoglobulins G and M anti-cardiolipin antibodies in patients with systemic lupus erythematosus. Correlation with thrombosis, thrombocytopenia, and recurrent abortion. Am J Clin Pathol 98:449–454

    PubMed  CAS  Google Scholar 

  15. Tsutsumi A, Matsuura E, Ichikawa K, Fujisaku A, Mukai M, Koike T (1998) IgA class anti-beta2-glycoprotein I in patients with systemic lupus erythematosus. J Rheumatol 25:74–78

    PubMed  CAS  Google Scholar 

  16. Guerin J, Casey E, Feighery C, Jackson J (1999) Anti-beta 2-glycoprotein I antibody isotype and IgG subclass in antiphospholipid syndrome patients. Autoimmunity 31:109–116

    Article  PubMed  CAS  Google Scholar 

  17. Lakos G, Kiss E, Regeczy N et al (1999) Isotype distribution and clinical relevance of anti-b2-glycoprotein I antibodies: importance of IgA isotype. Clin Exp Immunol 117:574–579

    Article  PubMed  CAS  Google Scholar 

  18. Lee SS, Cho ML, Joo YS, Kim WU, Hong YS, Min JK et al (2001) Isotypes of anti-beta2-glycoprotein I antibodies: association with thrombosis in patients with systemic lupus erythematosus. J Rheumatol 28:520–524

    PubMed  CAS  Google Scholar 

  19. Bertolaccini ML, Atsumi T, Escudero CA, Khamashta MA, Hughes GR (2001) The value of IgA antiphospholipid testing for diagnosis of antiphospholipid (Hughes) syndrome in systemic lupus erythematosus. J Rheumatol 28:2637–2643

    PubMed  CAS  Google Scholar 

  20. Samarkos M, Asherson RA, Loizou S (2001) The clinical significance of IgA antiphospholipid antibodies. J Rheumatol 28:694–697

    PubMed  CAS  Google Scholar 

  21. Samarkos M, Davies KA, Gordon C, Walport MJ, Loizou S (2001) IgG subclass distribution of antibodies against beta(2)-GP1 and cardiolipin in patients with systemic lupus erythematosus and primary antiphospholipid syndrome, and their clinical associations. Rheumatology (Oxford) 40:1026–1032

    Article  CAS  Google Scholar 

  22. Tan EM, Cohen AS, Fries JF (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277

    Article  PubMed  CAS  Google Scholar 

  23. Loizou S, Samarkos M, Norsworthy PJ, Cazabon JK, Walport MJ, Davies KA (2000) Significance of anticardiolipin and anti-beta(2)-glycoprotein I antibodies in lupus nephritis. Rheumatology (Oxford) 39:962–968

    Article  CAS  Google Scholar 

  24. Polz E, Wurm H, Kostner GM (1981) Studies on the composition of the protein part of triglyceride rich lipoproteins of human serum: isolation of polymorphic forms of beta 2-glycoprotein-I. Artery 9:305–315

    PubMed  CAS  Google Scholar 

  25. Cucurull E, Espinoza LR, Mendez E et al (1999) Anticardiolipin and anti-beta2glycoprotein-I antibodies in patients with systemic lupus erythematosus: comparison between Colombians and Spaniards. Lupus 8:134–141

    Article  PubMed  CAS  Google Scholar 

  26. Cucurull E, Gharavi AE, Diri E, Mendez E, Kapoor D, Espinoza LR (1999) IgA anticardiolipin and anti-beta2-glycopro-tein I are the most prevalent isotypes in African American patients with systemic lupus erythematosus. Am J Med Sci 318:55–60

    Article  PubMed  CAS  Google Scholar 

  27. Kalunian KC, Peter JB, Middlekauff HR et al (1988) Clinical significance of a single test for anti-cardiolipin antibodies in patients with systemic lupus erythematosus. Am J Med 85:602–608

    Article  PubMed  CAS  Google Scholar 

  28. Tajima C, Suzuki Y, Mizushima Y, Ichikawa Y (1998) Clinical significance of immunoglobulin A antiphospholipid antibodies: possible association with skin manifestations and small vessel vasculitis. J Rheumatol 25:1730–1736

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. 5th Department of Internal Medicine, Evangelismos Hospital, 45-47 Ipsilantou street, 106 76, Athens, Greece

    M. Samarkos

  2. Brighton and Sussex Medical School, University of Sussex, Brighton, UK

    K. A. Davies

  3. Department of Rheumatology, Division of Immunity and Infection, Birmingham University Medical School, UK

    C. Gordon

  4. Rheumatology Section, Division of Medicine, Hammersmith Hospital, Imperial College School of Medicine, London, UK

    S. Loizou

Authors
  1. M. Samarkos
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  2. K. A. Davies
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  3. C. Gordon
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  4. S. Loizou
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Correspondence to M. Samarkos.

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Published online: 10 August 2005

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Samarkos, M., Davies, K.A., Gordon, C. et al. Clinical significance of IgA anticardiolipin and anti-β2-GP1 antibodies in patients with systemic lupus erythematosus and primary antiphospholipid syndrome. Clin Rheumatol 25, 199–204 (2006). https://doi.org/10.1007/s10067-005-1156-z

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  • DOI: https://doi.org/10.1007/s10067-005-1156-z

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