Immunology and Clinical Importance of Antiphospholipid Antibodies

McNeil, H. Patrick; Chesterman, C N; Krilis, SA

doi:10.1016/s0065-2776(08)60777-4

Cited by 459 publications

(283 citation statements)

References 241 publications

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“…Antiphospholipid antibodies (aPL) are associated with poor obstetric outcome, such as recurrent abortions, fetal death, growth retardation, and early preeclampsia (1). Passive transfer of whole immunoglobulin fractions from aPL-positive sera has been found to induce fetal loss and growth retardation in pregnant naive mice, suggesting a direct pathogenetic role (2)(3)(4).…”

mentioning

confidence: 99%

Antiphospholipid antibodies affect trophoblast gonadotropin secretion and invasiveness by binding directly and through adhered β2-glycoprotein I

Simone

Meroni

Papa

et al. 2000

Arthritis & Rheumatism

295

179

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Objective. To investigate the in vitro ability of antiphospholipid antibodies (aPL) to bind human trophoblast cells and to affect gonadotropin secretion and invasiveness.Methods. Antiphospholipid antibody IgG from women with recurrent miscarriages, ␤ 2 -glycoprotein I (␤ 2 GPI)-independent IgG aPL human monoclonal antibody (mAb) (519), and IgM anti-␤ 2 GPI human mAb (TM1G2) were investigated for their binding to trophoblasts cultured for various amounts of time, their ability to affect invasiveness of Matrigel-coated filters, and their release of human chorionic gonadotropin (hCG).Results. Polyclonal IgG aPL, as well as mAb 519 and TM1G2, bound to trophoblasts, the highest binding being found when cells displayed the greatest amount of syncytium formation. TM1G2 binding was found to be ␤ 2 GPI dependent. Both polyclonal and monoclonal aPL, but not the controls, significantly reduced hCG release and Matrigel invasiveness.Conclusion. These findings suggest that aPL recognition of both anionic PL and adhered ␤ 2 GPI on trophoblast cell structures might represent a potential pathogenetic mechanism for defective placentation in women with the antiphospholipid syndrome.

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confidence: 99%

Antiphospholipid antibodies affect trophoblast gonadotropin secretion and invasiveness by binding directly and through adhered β2-glycoprotein I

Simone

Meroni

Papa

et al. 2000

Arthritis & Rheumatism

295

179

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“…Antiphospholipid antibodies (aPL) are frequently present in patients with systemic rheumatic diseases such as systemic lupus erythematosus (SLE), and even in persons with no apparent autoimmune disease (1)(2)(3). Patients with high titers of aPL are prone to a variety of thrombotic episodes and to fetal loss (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

Tsutsumi

Matsuura

Ichikawa

et al. 1996

Arthritis & Rheumatism

212

109

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Objective. To investigate whether anticardiolipin antibodies (aCL) in patients with systemic lupus erythematosus (SLE) bind to β2‐glycoprotein I (β2GPI), and to search for a relationship between the presence of IgG and/or IgM anti‐β2GPI antibody and clinical manifestations in SLE patients. Methods. IgG and IgM anti‐β2GPI in 308 Japanese SLE patients were measured using phospholipid‐independent enzyme immunoassays. Relationships to clinical histories and to various laboratory data were examined. Results. The values of anti‐β2GPI and aCL, as measured by conventional enzyme immunoassay, showed a strong correlation, but the anti‐β2GPI assay was more useful in distinguishing β2GPI‐dependent aCL from β2GPI‐independent aCL. The presence of IgG anti‐β2GPI was associated with an increased frequency of a history of thrombosis. Comparisons of various laboratory data suggested that the titer of anti‐β2GPI may fluctuate with disease activity. Conclusion. The results suggest that pathogenic aCL is directed against structurally altered β2GPI and that enzyme immunoassay for anti‐β2GPI may prove useful in evaluating the risk of thrombosis and monitoring the clinical course in patients with SLE.

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“…Durante muitos anos, a idéia prevalente quanto a patogênese dessa síndrome era a de que os anticorpos dirigidos contra fosfolípides da membrana de células do endotélio vascular seriam responsáveis pelos eventos trombóticos 15 . Dados recentes sugerem que esses anticorpos sejam específicos para proteínas plasmáticas, que se ligam a fosfolípi-des do endotélio, atuando como verdadeiros antígenos, uma vez que a cardiolipina e os fosfolípides, de um modo geral, são pouco antigênicos 13 .…”

Section: Discussionunclassified

“…Em um estudo de 147 pacientes, adolescentes e adultos, o anticoagulante foi utilizado com boa Trombose da artéria renal e síndrome... -Macedo CS, et alii resposta, o que sugere que a anticoagulação parece ser a medida mais eficaz de mudança na história natural da doença 33 . É sugerido o tratamento anticoagulante com heparina na fase aguda e o uso profilático de antiagregantes plaquetários até a negativação do anticorpo anticardiolipina 15 . No presente caso, no momento do diagnóstico da trombose arterial renal, o paciente não tinha o diagnóstico da síndrome do anticorpo antifosfolípide; posteriormente, quando da obtenção da positividade deste anticorpo, o paciente estava assintomático, optando-se por não medicar.…”

Section: Discussionunclassified

Trombose da artéria renal e síndrome do anticorpo antifosfolípide: um relato de caso

Macedo¹,

Martinez²,

Riyuzo³

et al. 2001

J. Pediatr. (Rio J.)

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ResumoObjetivo: descrever um caso clínico raro na infância, com achados clínicos da síndrome do anticorpo antifosfolípide.Descrição: criança, sexo masculino, com 2 anos e 6 meses de idade, com insuficiência renal, trombose da artéria renal e diagnós-tico de síndrome do anticorpo antifosfolípide, foi internada com dor abdominal, palidez, letargia e anúria há 36 horas. Ao exame físico, apresentava-se desnutrida, com hipertensão arterial severa, edema moderado e dor em hipocôndrio. Os achados laboratoriais incluíram: uréia=112mg/dl; creatinina plasmática=4,5 mg/dl; pH sangüí-neo=7,47; bicarbonato sangüíneo=12,8 mmol/L; K=7,2 mEq/L. A diálise peritoneal foi iniciada e mantida por 11 dias. Após 7 semanas de evolução, o paciente ainda necessitava de droga anti-hipertensiva e a função renal estava anormal. A biópsia renal revelou infarto renal anêmico; ultra-sonografia renal com doppler, fluxo sangüíneo renal ausente no lado direito, e a arteriografia mostrou oclusão total da artéria renal direita. A pesquisa de doenças do colágeno foi negativa. Foi realizada nefrectomia à direita obtendo-se normalização da pressão arterial. Aos 5 anos e 8 meses, foi novamente hospitalizada com quadro de crises de ausência e dores abdominais e precordiais. A dosagem do anticorpo anticardiolipina foi positiva. Atualmente aos 7 anos, está em seguimento ambulatorial, assintomática e com dosagens negativas do anticorpo anticardiolipina.Comentários: as observações deste caso mostram que crianças com quadro de trombose arterial, mesmo na ausência de doenças do colágeno, devem ser investigadas para uma possível associação com a síndrome do anticorpo antifosfolípide.J Pediatr (Rio J) 2001; 77 (6): 517-21:anticorpos de anticardiolipina, doenças do colágeno, nefrectomia, diálise peritoneal. AbstractObjective: to describe an unusual case with clinical features of the antiphospholipid syndrome.Description: white child, two years and six months old, with renal failure, renal arterial thrombosis, and diagnosis of antiphospholipid syndrome was hospitalized with a history of abdominal pain, pallor, lethargy, and anuria for 36 hours. On physical examination, the patient showed malnutrition, high blood pressure, moderate edema, and hypochondrial pain. Laboratory findings included: urea=112mg/dl, serum creatinine= 4.5 mg/dl, blood pH= 7.47, blood bicarbonate= 12.8 mmol/L, K=7.2 mEq/L. Peritoneal dialysis was started and maintained for 11 days. After 7 weeks, the patient still needed anti-hypertensive drugs and the renal function was still abnormal. Renal biopsy was performed and revealed renal infarction. The result of Doppler ultrasonography revealed absent renal blood flow on the right side. Renal arteriography showed total occlusion of the right renal artery. Results for collagen diseases were negative. A right nephrectomy was performed and the blood pressure was controlled. The child was hospitalized again at 5 years and 8 months old with episodes of absence seizures and abdominal and precordial pain. Anticardiolipin antibody test was positive. The c...

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Immunology and Clinical Importance of Antiphospholipid Antibodies

Cited by 459 publications

References 241 publications

Antiphospholipid antibodies affect trophoblast gonadotropin secretion and invasiveness by binding directly and through adhered β2-glycoprotein I

Antiphospholipid antibodies affect trophoblast gonadotropin secretion and invasiveness by binding directly and through adhered β2-glycoprotein I

Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

Trombose da artéria renal e síndrome do anticorpo antifosfolípide: um relato de caso

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Immunology and Clinical Importance of Antiphospholipid Antibodies

Cited by 459 publications

References 241 publications

Antiphospholipid antibodies affect trophoblast gonadotropin secretion and invasiveness by binding directly and through adhered β2-glycoprotein I

Antiphospholipid antibodies affect trophoblast gonadotropin secretion and invasiveness by binding directly and through adhered β2-glycoprotein I

Antibodies to β2‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

Trombose da artéria renal e síndrome do anticorpo antifosfolípide: um relato de caso

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Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus