The course of anticardiolipin antibody levels under immunoadsorption therapy.
BACKGROUND
The emergence of anticardiolipin antibodies in patients with systemic lupus erythematosus is a serious occurrence in regard to a high risk for thrombosis and thromboembolic complications, fetal loss, and renal insufficiency. In an observational analysis, we studied anticardiolipin antibodies during immunoadsorption therapy.


METHODS
We analyzed the magnitude and time course of serum concentrations of the immunoglobulin G (IgG) and IgM subtypes of anticardiolipin antibodies (CIgG and CIgM) along with IgG and IgM, antinuclear antibodies, and antibodies to double-stranded DNA before and after single immunoadsorption sessions and their long-term course in 11 patients with systemic lupus erythematosus.


RESULTS
Single immunoadsorption sessions (n = 842) led to a rapid decline in CIgG and CIgM levels by 62.94% +/- 21.60% and 42.02% +/- 22.14%, respectively (P < 0.0001), along with a corresponding decline in serum levels of antinuclear antibodies (65.04% +/- 18.83%), antibodies to double-stranded DNA (64.67% +/- 21.20%), IgG (58.11% +/- 16.84%), and IgM (32.15% +/- 15.58%). Reduction rates of CIgG and CIgM levels were greater when high initial concentrations (P < 0.0001) and low IgG levels (P < 0.0001) were present. Mean reductions in pretreatment values of CIgG and CIgM during 6 months of immunoadsorption therapy were 42.85% +/- 39.94% and 29.39% +/- 70.41% (mean number of sessions/patient = 21.55) and for the 1-year period were 63.20% +/- 22.49% and 58.05% +/- 40.16% (mean number of sessions/patient = 30.46).


CONCLUSIONS
We observed that immunoadsorption therapy is an effective method to reduce anticardiolipin antibody levels rapidly and keep them at a low level in the long term.
Hauser
Anna-Christine
AC
Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Austria. anna-christine.hauser@meduniwien.ac.at
Hauser
Lorenz
L
Pabinger-Fasching
Ingrid
I
Quehenberger
Peter
P
Derfler
Kurt
K
Hörl
Walter Hermann
WH
D000026:Abortion, Habitual / Q000209:etiology; D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D000974:Antibodies, Antinuclear / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D001781:Blood Component Removal; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007163:Immunosorbent Techniques; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D008181:Lupus Nephritis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000628:therapy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011507:Proteinuria / Q000209:etiology; D019851:Thrombophilia / Q000209:etiology; D016896:Treatment Outcome; D014427:Twins
D017153:Antibodies, Anticardiolipin; D000974:Antibodies, Antinuclear; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007166:Immunosuppressive Agents; D011241:Prednisone