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Specificity, isotype, and titer distribution of anticardiolipin antibodies in CNS diseases
L D'Olhaberriague1, S R Levine, L Salowich-Palm
1Center for Stroke Research, Department of Neurology, and Henry Ford Hospital, Detroit Campus of Case Western Reserve University, MI, USA.
Insights
Anticardiolipin antibodies (aCL) are specifically associated with ischemic stroke, not other central nervous system diseases. This study found IgG-aCL positivity is a marker for ischemic stroke, distinguishing it from other neurological conditions.
Area of Science:
- Neurology
- Immunology
- Cardiovascular Medicine
Background:
- Anticardiolipin antibodies (aCL) are linked to ischemic stroke.
- Reports suggest aCL may also be associated with other central nervous system (CNS) diseases, such as multiple sclerosis (MS).
Purpose of the Study:
- To investigate the specificity of anticardiolipin antibodies (aCL) in relation to ischemic stroke versus other CNS diseases (OND).
Main Methods:
- Prospective study of patients tested for aCL (IgG and IgM).
- Patients were categorized into two groups: first-ever ischemic stroke and OND (stroke-free).
- Comparison of risk factors and aCL positivity rates between groups.
Main Results:
- The ischemic stroke group had significantly higher rates of aCL positivity, particularly IgG-aCL ( > 10 GPL and > 20 GPL), compared to the OND group.
- Demographic and clinical differences included age, African American ethnicity, smoking, hypertension, and diabetes.
- While IgG-aCL positivity was not different in MS patients compared to other OND, IgM-aCL positivity was higher in MS patients.
Conclusions:
- IgG-anticardiolipin antibody positivity is a specific marker for ischemic stroke.
- aCL positivity does not appear to be a general marker for central nervous system disease.
Background And Purpose:
There is an association between anticardiolipin antibodies (aCL) and ischemic stroke. There are, however, also occasional reports linking aCL with other CNS diseases (OND), particularly with multiple sclerosis (MS). Hence, we studied the specificity of aCL for ischemic stroke.
Methods:
Prospective, consecutively identified patients evaluated for aCL (immunoglobulin G [IgG] and immunoglobulin M [IgM] isotypes) were divided into two groups: ischemic stroke (first ever) and OND (stroke-free subjects affected by OND).
Results:
The ischemic stroke group (n = 300) and the OND (n = 149) differed in the following risk factors: age (64 +/- 14 versus 58 +/- 15 years; p < 0.001) and proportions of African Americans (67% versus 29%; p < 0.001); current cigarette smoker (26% versus 17%; p = 0.028); hypertensive (69% versus 34%; p < 0.001); diabetic (18% versus 7%; p = 0.001); history of angina (16% versus 8%; p = 0.015) or myocardial infarction (15% versus 3%; p < 0.001). There were higher rates of aCL positivity (26% versus 17%; p = 0.050), IgG-aCL > 10 GPL (23% versus 11%; p = 0.003) or IgG aCL > 20 GPL (12% versus 4%; p = 0.012) among the stroke group than among the OND group. No differences in IgG-aCL positivity were found between the MS group and the rest of the OND group but the MS patients had a higher rate of IgM-aCL positivity than the other OND patients.
Conclusion:
IgG-aCL positivity does not appear to be a marker for CNS disease generally but of ischemic stroke.