Henoch–Schönlein purpura and stroke: Antiphosphatidyl-ethanolamine antibody in CSF and serum

Sokol, Deborah K.; McIntyre, John A.; Short, Rodney A.; Gutt, J.; Wagenknecht, Dawn R.; Biller, José; Garg, Bhuwan P.

doi:10.1212/wnl.55.9.1379

Cited by 48 publications

(19 citation statements)

References 9 publications

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“…Direct binding of monoclonal aPS to human trophoblast, inhibition of hCG production and blocking trophoblast invasiveness have been observed for plasma protein independent aPS (Katsuragawa et al, 1997;Di Simone et al, 2000). The aPE we observed in the CSF of a 15-year-old stroke patient was plasma protein independent (Sokol et al, 2000), and we have shown that certain aPL associated with early rejection of solid organ grafts were independent of plasma proteins (McIntyre and Wagenknecht, 2003). Indeed, the majority of CSF aPL described in this report 10/12 were classified as plasma protein independent.…”

Section: Discussionsupporting

confidence: 61%

“…Indeed, there is evidence that some aPL detected in the central nervous system (CNS) may be synthesized in situ and not result from extravasation through the CNS-associated vasculature (MartinezCordero, 1997;Sokol et al, 2000;Baraczka et al, 2002). Although there are no published reports to confirm that intrathecally-produced aPL, do not escape into the systemic circulation and vice versa, locally produced aPL in the CNS might be responsible for some aPLassociated symptoms in otherwise aPL seronegative patients (Miret et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

“…A total of 24 tests were performed for each CSF sample. The ELISA was modified for CSF testing as previously published (Sokol et al, 2000). Briefly, the modifications included: (1) Dilution of CSF, 1:4; (2) each dilution was tested in duplicate and (3) to ensure detection the ELISA plate wells containing CSF were developed for 2 h in the presence of substrate.…”

Section: Methodsmentioning

confidence: 99%

“…To our knowledge only one report included testing for IgG and IgM antiphosphatidylserine (aPS) and antiphosphatidylethanolamine (aPE) in CSF; the results were negative (Gallo et al, 1994). Our finding of IgA aPE in the CSF of a young stroke victim (Sokol et al, 2000), together with our intent to continue testing additional CSF samples, prompted us to undertake and establish "normal" aPL values for CSF. Our findings form the basis of this report.…”

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confidence: 99%

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Testing for Antiphospholipid Antibody (aPL) Specificities in Retrospective “Normal” Cerebral Spinal Fluid (CSF)

Sokol

Wagenknecht

McIntyre

2004

Journal of Immunology Research

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Antiphospholipid antibodies (aPL) have been found in the blood of patients with systemic and neurological disease. The rare reports of aPL in cerebral spinal fluid (CSF) have been limited mostly to IgG and IgM anticardiolipin (aCL). Our published finding of IgA aPE in the CSF of a young stroke victim prompted us to establish "normal" CSF aPL values for a panel of aPL, which included aCL, antiphosphatidylserine (aPS), antiphosphatidylethanolamine (aPE) and antiphosphatidylcholine (aPC). CSF samples were tested by ELISA for IgG, IgM and IgA aPL. In addition, the CSF samples were tested for activity in the presence and absence of phospholipid (PL) binding plasma-proteins. A total of 24 data points were obtained for each CSF sample. We tested 59 CSF samples obtained from 59 patients who were undergoing evaluation for systemic or neurologic diseases. All CSF samples had normal protein, glucose and cell counts. Ten of the 59 CSF samples (17%) had elevated aPL optical density (OD) values an order of magnitude higher than the other 49 CSF samples for one or more aPL specificity and/or isotype. One CSF sample had both PL-binding protein dependent and independent IgG aPE activity. Another CSF sample showed both IgG aPE and aPC reactivity. The remaining eight CSF samples showed single aPL findings; IgG aPE (5), IgG aPC (1), IgG aCL (1) and IgM aPC (1). Seven of 10 patients with elevated CSF values were females. As expected, most "normal" aPL OD values were substantially lower in CSF than those we have reported in blood samples from volunteer blood donors. Jacobson et al., 1999). The associations of aPL with neurologic conditions other than thromboocclusive events have been considered "weak" and attributable to an "epiphenomenon" rather than to pathophysiologic mechanisms (Brey, 2000). A stronger association between aPL and neurological disorders might be easier to establish if aPL are sought and detected in the cerebral spinal fluid (CSF) of patients experiencing neurologic symptoms. Historically, scarce reports of aPL in CSF are limited mostly to IgG and IgM anticardiolipin (aCL) detection (Marchiorri, 1990;Lolli et al., 1991;Wang et al., 1992;Gallo et al., 1994;Yeh et al., 1994;Martinez-Cordero, 1997;Jedryka-Goral et al., 2000;Lai and Lan, 2000;Baraczka et al., 2002). Rarely are IgA aCL sought (Wang et al., 1992). To our knowledge only one report included testing for IgG and IgM antiphosphatidylserine (aPS) and antiphosphatidylethanolamine (aPE) in CSF; the results were negative (Gallo et al., 1994). Our finding of IgA aPE in the CSF of a young stroke victim (Sokol et al., 2000), together with our intent to continue testing additional CSF samples, prompted us to undertake and establish "normal" aPL values for CSF. Our findings form the basis of this report. PATIENTS AND METHODSBecause of the potential risks associated with spinal taps to healthy individuals we were unable to obtain CSF samples from random donors. We opted to perform a retrospective analysis using residual CSF that was collected for diagnostic purposes a...

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Testing for Antiphospholipid Antibody (aPL) Specificities in Retrospective “Normal” Cerebral Spinal Fluid (CSF)

Sokol

Wagenknecht

McIntyre

2004

Journal of Immunology Research

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“…In addition, the finding of aPE in the cerebral spinal fluid of patient with a documented ischemic stroke may suggest a possibility of an intrathecal production of aPL in the course of central nervous system disorders. However, this observation needs to be confirmed by further investigations (Sokol et al, 2000). A number of reports confirmed also an association between aPE and atherosclerosis.…”

Section: Selected Non-criteria Antiphospholipid Antibodies and Their mentioning

confidence: 88%

Antiphospholipid Antibodies and Their Association with Atherosclerotic Changes in Patients with Systemic Lupus Erythematosus – Review of Literature and Own Experiences

Fischer¹,

Flicinnski²,

Brzosko³

2012

Antiphospholipid Syndrome

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Unusual Causes of Ischaemic Stroke and Transient Ischaemic Attack

Warlow¹,

Gijn²,

Dennis³

et al. 2008

Stroke

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Henoch–Schönlein purpura and stroke: Antiphosphatidyl-ethanolamine antibody in CSF and serum

Cited by 48 publications

References 9 publications

Testing for Antiphospholipid Antibody (aPL) Specificities in Retrospective “Normal” Cerebral Spinal Fluid (CSF)

Testing for Antiphospholipid Antibody (aPL) Specificities in Retrospective “Normal” Cerebral Spinal Fluid (CSF)

Antiphospholipid Antibodies and Their Association with Atherosclerotic Changes in Patients with Systemic Lupus Erythematosus – Review of Literature and Own Experiences

Unusual Causes of Ischaemic Stroke and Transient Ischaemic Attack

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