[Anti-endothelial cell antibodies in chronic leg ulcer: prevalence and significance]

Anti-endothelial cell antibodies are detected in auto-immune vasculitis and connective tissue diseases such as scleroderma, with possible pathogenic involvement. We looked for these antibodies in patients presenting chronic ulcers.

Eighty patients were tested: 35 presented vascular ulcers (27 of venous origin and 8 arterial). A control group of 14 patients with connective tissue disease and vasculitis was formed, and a third group included 31 patients without vascular or immune disease. Their sera were tested by ELISA technique on EAhy 926 cell (obtained from hybridization of human endothelial and line A 549/8 cells).

Blood tests were positive in 37.5 p. 100 of patients. Antibodies were present in 48.5 p. 100 of patients with leg ulcers (of which 59 p. 100 (16/27) venous ulcers). Fifty-seven per cent of the autoimmune group and 12 p. 100 of the third group were positive. Association with anti-phospholipid antibodies was observed twice in leg ulcers. The level of antibodies was higher in patients with leg ulcers.

The presence of high levels of anti-endothelial cells antibodies in 48.5 p. 100 of patients presenting leg ulcers shows that these antibodies are not specific to autoimmune diseases. Since they are involved in coagulation, inflammation (enhancing of adhesion molecules and tissue lysis) and apoptosis of endothelial cells, their significance in chronic ulcers, both as a consequence and/or possible cofactor merits discussion.