Antiphospholipid antibodies in leprotic patients: a correlation with disease manifestations.
OBJECTIVE
Previous studies showed that antiphospholipid antibodies (aPL) are frequent in the sera of leprosy patients and are most probably directed against body tissue cardiolipins. Some groups have demonstrated differences between the binding specificity of "autoimmune-aPL" and "non-autoimmune-aPL". It is widely accepted that a plasma protein, beta 2-Glycoprotein I (beta 2-GPI), is required for the binding of autoimmune anticardiolipin antibodies (aCL) to cardiolipin. However, some reports suggested heterogeneity of leprosy aCL with respect to their beta 2-Glycoprotein I (beta 2GPI) dependency, although no thromboembolic complications have been reported. This study was designed to assess the specificity of aPL by investigating the prevalence of aCL, anti-phosphatidylserine (aPS), anti-phosphatidylinositol (aPI), anti-beta 2GPI and antiprothrombin (aPT) antibodies, and evaluate their clinical significance in a group of patients with lepromatous leprosy.


METHODS
35 lepromatous leprosy patients were selected randomly from an Egyptian leprosarium as a study group. 35 normal household contact controls were selected matching the study group for both sex and age. aCL, aPS, aPI, aPT, anti-beta 2GPI and beta 2-dependent aCL antibodies were investigated by ELISA in all patients and controls.


RESULTS
aCL antibodies were more frequent in leprosy patients than in controls [13/35 (37%) vs. 3/35 (9%), respectively, p = 0.02] and significantly correlated with Raynaud's phenomenon, skin nodules, chronic skin ulcers and urticarial skin rash. No association was found with hypopigmentation, hyperpigmentation and saddle nose. None of the patients presented aPS nor aPI. Only 1 subject from the control group presented aPI along with aCL. aPT were present in 2/35 (5.7%) and anti-beta 2GPI in 1/35 (2.9%) leprotic patients. None of the individuals from the control group presented aPT nor anti-beta 2GPI.


CONCLUSIONS
An association was found between the presence of aCL and certain dermatological manifestations of leprosy, such as Raynaud's phenomenon, skin nodules, chronic skin ulcers and urticarial skin rash. As in other infectious diseases, there was a lack of beta 2GPI-dependency and an absence of thrombotic complications.
Elbeialy
A
A
Lupus Research Unit, Rayne Institute, St. Thomas' Hospital, London, UK.
Strassburger-Lorna
K
K
Atsumi
T
T
Bertolaccini
M L
ML
Amengual
O
O
Hanafi
M
M
Khamashta
M A
MA
Hughes
G R
GR
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D005260:Female; D006801:Humans; D015440:Leprosy, Lepromatous / Q000453:epidemiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index
D017152:Antibodies, Antiphospholipid; D000942:Antigens, Bacterial