© 1996 British Society for Rheumatology
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ANTIBODIES TO ENDOTHELIAL CELLS AND TO ß2-GLYCOPROTEIN I IN THE ANTIPHOSPHOLIPID SYNDROME: PREVALENCE AND ISOTYPE DISTRIBUTION
*Department of Haemotherapy and Haemostasis, Hospital Clinic Barcelona, Catalonia, Spain
Systemic Autoimmune Diseases Unit, Hospital Clinic Barcelona, Catalonia, Spain
Correspondence to:
Correspondence to: R. Cervera, Unitat de Malalties Autoimmunes Sistemiques, Hospital Clinic, Villarroel, 170, 08036-Barcelona, Catalonia, Spain.
The aim of this study was to analyse the prevalence and isotype distribution of antibodies to endothelial cells (aEC and to ß2-glycoprotein I (aß2GPI) in the antiphospholipid syndrome (APS). Fifteen patients with an APS [nine associated with systemic lupus erythematosus (SLE) and six ‘primary’] and 15 with SLE without an APS were prospectively studied. The aEC were determined by an enzyme-linked immunosorbent assay (ELISA) using endothelial cells derived from human umbilical vein and the aß2GPI by ELISA using highly purified ß2GPI. A positive titre of aEC was detected in 20 out of 30 patients (67%), but in none of the control group. Ten patients had both IgG and IgM isotypes, five had IgG only and five had only IgM. Thirteen patients with the APS (87%) were found to have a positive titre of aEC, while only seven with SLE but without a history of APS (47%) had aEC (P < 0.05). Nine patients with the APS (60%) had a positive titre of aß2GPI (four had both IgG and IgM isotypes, one had IgG only and four had only IgM), while none of the patients without an APS (0%) had these antibodies (P < 0.001). A significant association was also found between the presence of aPL and aEC (P < 0.05), as well as between aPL and aß2GPI (P < 0.001). Both aEC and aß2GPI can be found in the APS. This reinforces the theory that APS represents a complex autoimmune disorder in which several autoantibodies co-exist with aPL.
KEY WORDS: Antiphospholipid antibodies, Anticardiolipin antibodies, Lupus anticoagulant, Endothelial cells, ß2-glycoprotein I
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