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Anticardiolipin and complement activation: relation to clinical symptoms
Insights
High levels of anticardiolipin antibodies are common in systemic lupus erythematosus (SLE) and linked to clotting issues and pregnancy loss. Treatment may improve outcomes by normalizing clotting times.
Area of Science:
- Immunology
- Rheumatology
- Obstetrics
Background:
- Anticardiolipin antibodies are rarely found in healthy individuals but are prevalent in systemic lupus erythematosus (SLE).
- Elevated anticardiolipin antibody levels correlate with thromboembolic events, thrombocytopenia, and recurrent pregnancy loss.
Purpose of the Study:
- To investigate the prevalence and clinical significance of anticardiolipin antibodies in SLE patients.
- To assess the impact of disease activity and therapy on anticardiolipin antibody levels and related clinical manifestations.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to detect anticardiolipin antibodies.
- Absorption studies with phospholipids were performed to confirm antibody specificity.
- Complement activation via the classical pathway was assessed in patients with high antibody levels.
Main Results:
- High anticardiolipin antibody levels were observed in SLE patients and women with unexplained recurrent abortions.
- Antibody levels remained stable despite disease activity and therapy in most cases.
- Treatment with prednisolone and salicylic acid normalized prolonged activated partial thromboplastin time, aiding successful pregnancies.
Conclusions:
- Anticardiolipin antibodies are a significant marker in SLE, associated with adverse clinical outcomes.
- Therapeutic interventions may mitigate some associated risks, improving pregnancy success.
- The role of anticardiolipin antibodies in complement activation warrants further investigation.
Abstract:
Anticardiolipin antibodies which seldom occur in healthy persons are frequently found in systemic lupus erythematosus (SLE). Their presence, especially at high levels (greater than 10 units) are often accompanied by thromboembolic manifestations as well as thrombocytopenia and recurrent abortions. The incidence of cardiolipin antibodies was as great in SLE as in women with clinically unexplained recurrent abortions. The anticardiolipin levels remained unchanged in most patients for long periods and were remarkably unaffected by disease activity and therapy. On the other hand, in several cases the activated partial thromboplastin time which was prolonged in most patients with persistently high cardiolipin antibody levels, approached normal during treatment with prednisolone and salicylic acid. This seemed to facilitate a successful outcome of pregnancy. Absorption of sera with cardiolipin and other negatively charged phospholipids but not with uncharged phospholipids abolished the anticardiolipin activity in enzyme linked immunosorbent assay. In most sera with cardiolipin antibody levels greater than 10 units complement activation by the classical pathway could be demonstrated. Whether the anticardiolipin antibodies contributed to complement activation could not be determined.