title: Enhanced monocyte expression of tissue factor by oxidative stress in patients with antiphospholipid antibodies: effect of antioxidant treatment.
abstract: In a first study, we performed a cross-sectional analysis of urinary excretion of isoprostanes, IPF(2alpha-III) and (VI), and monocyte tissue factor (TF) antigen and activity between 11 antiphospholipid (APL) antibody-positive patients and 13 APL negative subjects. In a second study, 11 APL positive patients were randomly supplemented either with (n = 6) or without (n = 5) antioxidants (vitamin E at 900 IU day(-1), vitamin C at 2000 mg day(-1)) for 6 weeks. In a third study, TF and superoxide anion were measured in human monocytes incubated with anti-beta(2) glycoprotein 1 (beta(2)GP(1)) or control IgG, either with or without vitamin E. APL-positive patients had higher values of isoprostanes (P < 0.05) and monocyte TF antigen (P = 0.001) and activity (P = 0.0001) than APL-negative subjects. Only in APL positive patients did monocyte TF antigen correlate significantly with IPF(2alpha-III) (rho 0.79; P < 0.003) and IPF(2alpha-VI) (rho = 0.87; P < 0.0001). In patients who received antioxidant supplementation, we found a significant decrease of isoprostanes (P < 0.05) and monocyte TF antigen (P < 0.01) and activity (P < 0.007). In vitro experiments demonstrated that anti-beta(2)GP(1) antibodies dose-dependently enhanced the monocyte production of the superoxide anion and TF, which were significantly inhibited by vitamin E. This study demonstrates that in APL-positive patients, oxidative stress contributes to activate the clotting system via over-expression of monocyte TF. We suggest that anti-beta(2)GP(1) antibodies could play a pivotal role by enhancing the monocyte production of oxygen free radicals.
authors.affiliation: Institute of Clinical Medicine I, University 'La Sapienza' Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Ferro
authors.forename: M
authors.initials: M
authors.lastname: Saliola
authors.forename: P L
authors.initials: PL
authors.lastname: Meroni
authors.forename: G
authors.initials: G
authors.lastname: Valesini
authors.forename: C
authors.initials: C
authors.lastname: Caroselli
authors.forename: D
authors.initials: D
authors.lastname: Praticò
authors.forename: G A
authors.initials: GA
authors.lastname: Fitzgerald
authors.forename: Y
authors.initials: Y
authors.lastname: Shoenfeld
authors.forename: F
authors.initials: F
authors.lastname: Violi
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid; D000975:Antioxidants / Q000494:pharmacology*; D016736:Antiphospholipid Syndrome / Q000378:metabolism; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D018384:Oxidative Stress / Q000502:physiology*; D013481:Superoxides; D013925:Thromboplastin / Q000096:biosynthesis*
chemical_list: D017152:Antibodies, Antiphospholipid; D000975:Antioxidants; D013481:Superoxides; D013925:Thromboplastin