title: Reactivity profiles of autoantibodies to different phospholipids and the phospholipid-binding protein beta2-glycoprotein I in patients with clinical symptoms related to thromboembolic and/or vasculopathic events with or without connective tissue diseases.
abstract: To study the antigenic and epitope specificities of anti-phospholipid Ab in detail, we investigated 177 patients without (62 with APS-related systemic clinical symptoms, 115 with microangiopathies) and 164 patients with connective tissue diseases (CTD). Ab associated with primary APS (pAPS) seem to show a restricted specificity (phospholipid/beta2-GPI-complexes), whereas those in secondary APS (sAPS) react additionaly with pure beta2-GPI. Simultaneously, beta2-GPI-independent Ab were also frequently present in both conditions (50% of all Ab-positive sera). In CTD patients, the reactivity profile "pure beta2-GPI + phospholipid/beta2-GPI-complexes" is significantly associated with clinically manifest sAPS. Comparing cardiolipin and phosphatidylserine as antigenic target, the overall concordance (crossreactivity?) between both assays was lower than expected (52%), being highest in pAPS (87%) and sAPS (65%). Based on these results, a two-step procedure for reliable serological diagnosis of APS could be recommended: Ab-screening using a mix of phospholipids complexed with beta2-GPI (sensitivity > 90% for Ab concentrations above 20 U/ml) followed by an assay allowing the simultaneous detection of all relevant antigenic and epitope specificities.
authors.affiliation: Institute of Laboratory Diagnostics, Microbiology and Transfusion Medicine, Dietrich Bonhoeffer Clinical Centre, Neubrandenburg, Germany. LAB@dbk-nb.de
authors.forename: H P
authors.initials: HP
authors.lastname: Jaekel
authors.forename: D
authors.initials: D
authors.lastname: Schmid
authors.forename: E W
authors.initials: EW
authors.lastname: Müller
authors.forename: V
authors.initials: V
authors.lastname: Ziutelis
authors.forename: A
authors.initials: A
authors.lastname: Trabandt
authors.forename: N
authors.initials: N
authors.lastname: Grobe
authors.forename: S
authors.initials: S
authors.lastname: Kaskel-Paul
authors.forename: H
authors.initials: H
authors.lastname: Höh
authors.forename: B
authors.initials: B
authors.lastname: Bauer
authors.forename: R
authors.initials: R
authors.lastname: Sudik
authors.forename: A
authors.initials: A
authors.lastname: Baldauf
authors.forename: E
authors.initials: E
authors.lastname: Werle
mesh_terms: D000328:Adult; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000276:immunology; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000276:immunology*; D002308:Cardiolipins / Q000276:immunology; D003240:Connective Tissue Diseases / Q000150:complications / Q000276:immunology*; D003429:Cross Reactions; D005260:Female; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010718:Phosphatidylserines / Q000276:immunology; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013923:Thromboembolism / Q000209:etiology / Q000276:immunology*; D014652:Vascular Diseases / Q000209:etiology / Q000276:immunology*; D053482:beta 2-Glycoprotein I
chemical_list: D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D002308:Cardiolipins; D006023:Glycoproteins; D010718:Phosphatidylserines; D053482:beta 2-Glycoprotein I