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[Anticardiolipin antibodies and Horton disease]
F Liozon1, M O Jauberteau-Marchan, F Boutros-Toni
1Service de Médecine Interne, CHU, Limoges.
Insights
Giant cell arteritis patients frequently have anticardiolipin antibodies, particularly IgG class. These antibody levels decrease with corticosteroid treatment but may indicate disease relapses.
Area of Science:
- Rheumatology
- Immunology
- Vascular Medicine
Context:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting large arteries.
- Anticardiolipin antibodies (aCL) are associated with autoimmune diseases and thrombosis.
- The role of aCL in GCA pathogenesis and disease course requires clarification.
Purpose:
- To investigate the prevalence and isotype of anticardiolipin antibodies in GCA patients.
- To determine the association between aCL and ischemic complications in GCA.
- To evaluate the evolution of aCL during corticosteroid therapy and their relation to disease activity.
Summary:
- A prospective study of 86 GCA patients found 50% had aCL (vs 8% controls), predominantly IgG-aCL (36%).
- No significant link was found between aCL levels and ischemic ocular complications.
- aCL levels, mainly IgG, decreased with corticosteroid treatment, rising with relapses after therapy cessation.
Impact:
- This study highlights the potential of IgG anticardiolipin antibodies as biomarkers for monitoring disease activity in giant cell arteritis.
- Findings suggest a distinct role for IgG and IgM antibody isotypes in GCA.
- Understanding aCL dynamics in GCA can inform treatment strategies and prognosis.
Abstract:
A prospective study, including 86 patients with giant cell arteritis proven by temporal artery biopsies, was performed to determine the prevalence of anticardiolipin antibodies, the antibody isotype, the relationship of antibodies to ischemic involvement and their evolution during corticosteroid treatment. Controls were obtained from 50 subjects without vasculitis or autoimmune disorders. Before treatment, 50% of patients' sera contained anti-cardiolipin antibodies (vs 8% in controls, p < 0.0001). These antibodies were IgG-ACL in 36% of patients and IgM-ACL in 17% of patients (vs respectively, 4% and 2% in controls). No significant association was observed between the incidence of ischemic ocular complications and the levels of anti-cardiolipin antibodies. During corticosteroid treatment, the level of anti-cardiolipin antibodies, mostly IgG class, decreased to become negative in 2 months. An increase of these antibodies was observed with the occurrence of relapses in four patients, after the end of corticosteroid therapy. The significance of IgG and IgM antibodies is different in giant cell arteritis. IgG antibodies may be markers of the course of this vasculitis.