title: Specificity, isotype, and titer distribution of anticardiolipin antibodies in CNS diseases.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  IgG-aCL positivity does not appear to be a marker for CNS disease generally but of ischemic stroke.
authors.affiliation: Center for Stroke Research, Department of Neurology, and Henry Ford Hospital, Detroit Campus of Case Western Reserve University, MI, USA.
authors.forename: L
authors.initials: L
authors.lastname: D'Olhaberriague
authors.forename: S R
authors.initials: SR
authors.lastname: Levine
authors.forename: L
authors.initials: L
authors.lastname: Salowich-Palm
authors.forename: D
authors.initials: D
authors.lastname: Tanne
authors.forename: K L
authors.initials: KL
authors.lastname: Sawaya
authors.forename: T K
authors.initials: TK
authors.lastname: Aurora
authors.forename: M
authors.initials: M
authors.lastname: Perry
authors.forename: M
authors.initials: M
authors.lastname: Day
authors.forename: T
authors.initials: T
authors.lastname: Spencer
authors.forename: L
authors.initials: L
authors.lastname: Schultz
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood*; D017152:Antibodies, Antiphospholipid / Q000097:blood; D000918:Antibody Specificity; D044383:Black People; D002545:Brain Ischemia / Q000097:blood / Q000276:immunology; D002493:Central Nervous System Diseases / Q000097:blood / Q000276:immunology*; D002561:Cerebrovascular Disorders / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007074:Immunoglobulin G / Q000097:blood; D007132:Immunoglobulin Isotypes / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008824:Michigan; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D012016:Reference Values; D012307:Risk Factors; D001741:Black or African American
chemical_list: D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D007074:Immunoglobulin G; D007132:Immunoglobulin Isotypes; D007075:Immunoglobulin M