The significance of anticardiolipin antibody and immunologic abnormality in livedoid vasculitis

SummaryThe high prevalence of free protein S deficiency in human immunodeficiency virus (HlV)-infected patients is poorly understood. We studied 38 HIV seropositive patients. Free protein S antigen values assayed using the polyethylene-glycol precipitation technique (PEG-fS) were statistically lower in patients than in controls. These values using a specific monoclonal antibody-based ELISA (MoAb-fS) and the values of protein S activity (S-act) were not statistically different between patients and controls. C4b-binding protein values were not different from control values. In patients, PEG-fS values were lower than MoAb-fS values. Ten patients had a PEG-fS deficiency, 4 patients had a MoAb-fS deficiency and 8 had a S-act deficiency. Protein S activity and MoAb-fS were lower in clinical groups with poor prognosis and in patients with AIDS but PEG-fS was not. A trend for reduced S-act/MoAb-fS ratios was observed in patients. PEG-fS was negatively correlated with anticardiolipin antibody titers whereas MoAb-fS was not. The plasma of PEG-fS deficient HIV-patients contained high amounts of flow cytometry detectable microparticles which were depleted from plasma by PEG precipitation. The microparticles were partly CD42b and CD4 positive but CD8 negative. These microparticles were labelled by an anti free protein S monoclonal antibody. The observed differences between MoAb-fS and PEG-fS values were correlated with the amount of detectable plasma microparticles, just like the differences between MoAb-fS and S-act. Plasma microparticles correlated with anticardiolipin antibody titers.In summary, free protein S antigen in HIV infected patients is underestimated when the PEG precipitation technique is used due to the presence of elevated levels of microparticles that bind protein S. The activity of free protein S is also impaired by high levels of microparticles. The prevalence of free protein S deficiency in HIV positive patients is lower than previously published (4/38, -10%) and is correlated with poor prognosis. By implication, use of a PEG precipitation technique might give artefactually low free protein S antigen values in other patient groups if high numbers of microparticles are present. In HIV patients, high titers of anticardiolipin antibodies are associated with high concentrations of cell-derived plasma microparticles.

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No Association of Homocysteine, Anticardiolipin Antibody, and Anti-β2 Glycoprotein I Antibody With Portal Venous System Thrombosis in Liver Cirrhosis

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211010969 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110109

Author(s):

Le Wang ◽

Xiaozhong Guo ◽

Xiangbo Xu ◽

Shixue Xu ◽

Juqiang Han ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Vein ◽

Anticardiolipin Antibody ◽

Venous System ◽

Common Complication ◽

Portal Venous System ◽

Main Portal Vein ◽

Glycoprotein I ◽

Cirrhotic Patients ◽

Clinically Significant

Portal venous system thrombosis (PVST), a common complication of liver cirrhosis, is closely associated with thrombophilia. To explore the association of homocysteine (Hcy), anticardiolipin antibody (aCL), and anti-β2 glycoprotein I antibody (aβ2GPI), which are possible thrombophilic factors, with PVST in liver cirrhosis. Overall, 654 non-malignant patients (219 with and 435 without liver cirrhosis) admitted between January 2016 and June 2020 were retrospectively evaluated. Presence of PVST, degree of main portal vein (MPV) thrombosis, and clinically significant PVST were identified. Hcy level, hyperhomocysteinemia (HHcy), aCL positivity, and aβ2GPI positivity were compared according to the presence of liver cirrhosis and PVST. Positive aβ2GPI was significantly more frequent in patients with liver cirrhosis than those without, but Hcy level and proportions of HHcy and positive aCL were not significantly different between them. PVST could be evaluated in 136 cirrhotic patients. Hcy level [10.57 μmol/L (2.71-56.82) versus 9.97 μmol/L (2.05-53.44); P = 0.796] and proportions of HHcy [4/44 (9.1%) versus 13/81 (16.0%); P = 0.413] and positive aCL [1/23 (4.3%) versus 10/52 (19.2%); P = 0.185] and aβ2GPI [9/23 (39.1%) versus 21/52 (40.4%); P = 0.919] were not significantly different between cirrhotic patients with and without PVST. There was still no significant association of Hcy level, HHcy, aCL, or aβ2GPI with PVST based on Child-Pugh classification, MPV thrombosis >50%, and clinically significant PVST. Hcy, aCL, and aβ2GPI may not be associated with PVST in liver cirrhosis, suggesting that routine screening for Hcy, aCL, and aβ2GPI should be unnecessary in such patients.

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Protein S deficiency in men with long-term human immunodeficiency virus infection [see comments]

Blood ◽

10.1182/blood.v81.7.1801.1801 ◽

1993 ◽

Vol 81 (7) ◽

pp. 1801-1807 ◽

Cited By ~ 96

Author(s):

CP Stahl ◽

CS Wideman ◽

TJ Spira ◽

EC Haff ◽

GJ Hixon ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Pneumocystis Carinii ◽

Anticardiolipin Antibody ◽

Protein S ◽

Protein S Deficiency ◽

Free Protein ◽

Long Term Study ◽

S Deficiency ◽

Immunodeficiency Virus

Abstract Decreases in protein S levels have recently been reported in some human immunodeficiency virus (HIV)-infected patients. To examine predisposing factors, 25 men randomly selected from a long-term study of HIV- infected patients were studied. The minimum mean duration of HIV seropositivity in this group was 106.6 months (range 15 to 143 months). No patients were anticoagulated at the time of the study. Three of the 25 randomly selected patients gave a history of thrombosis, in each instance occurring after the onset of HIV positivity. Two of the 3 patients with thrombosis had more than one episode. Coagulation studies showed that 3 of 3 (100%) of the patients with thrombosis and 16 of 22 (72.7%) of those without previous thrombosis had decreased free protein S. Mean-free and total protein S levels were statistically lower for HIV-infected patients with and without previous thrombosis compared with healthy male controls. C4b-binding protein was not increased in study patients with decreased protein S levels. Decreases in protein S levels did not correlate with CD4+ cell levels, CDC class, p24 antigen positivity, zidovudine (AZT) use, or Pneumocystis carinii prophylaxis. The duration of disease statistically correlated with decreases in protein S levels (r = .37, P < .05). A linear correlation existed between increasing IgG anticardiolipin antibody levels and decreasing free protein S antigen (r = .67, P < .005). This study shows that protein S deficiency is common in long-term HIV-infected patients and is caused by a decrease in the free protein, rather than by changes in the bound complex. The data suggest that protein S deficiency is not correlated with HIV disease severity but may predispose patients to thromboembolic complications.

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Variability in Anticardiolipin Antibody Detection: Role of Nonspecific IgG Binding and Different Microtiter Plates

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029607303540 ◽

2007 ◽

Vol 13 (4) ◽

pp. 404-409 ◽

Cited By ~ 3

Author(s):

Nelly M. Pellegrino ◽

Domenico Caccavo

Keyword(s):

Specific Binding ◽

Anticardiolipin Antibody ◽

Anticardiolipin Antibodies ◽

Antibody Detection ◽

Categorical Variables ◽

Enzyme Linked Immunosorbent Assay ◽

Microtiter Plates ◽

Igg Binding ◽

Coefficient Of Concordance

There are many studies that are available on the Internet that attempt to standardize the assay for anticardiolipin antibody evaluation because of the variability of results. The aim of this study was to evaluate simultaneously the role of different microplates and the importance of sample nonspecific binding in determining different results in anticardiolipin antibody detection. Sera from 8 patients with raised levels of IgG anticardiolipin antibodies and 10 control sera were assayed by enzyme-linked immunosorbent assay in the presence (specific binding) or in the absence of cardiolipin (sample blank) with four different microplates, that is, NUNC PolySorp, FALCON ProBIND, Greiner 655061 (high binding), and Greiner 655001 (medium binding). Results were expressed as optical densities or net-optical densities (following sample blank subtraction) as well as international IgG anticardiolipin units (GPL) or net-GPL. A wide interplate variability of optical densities was found. When results were expressed as GPL, significant differences were only found between Greiner 655061, FALCON ProBIND, and NUNC PolySorp ( P < .05 and P < .001, respectively) whereas differences were not statistically significant if interplate variability was analyzed as net-GPL. Results expressed as categorical variables (ie, positive/negative, according to a GPL cut-off and net-GPL cut-off, obtained with sera from 100 apparently healthy blood donors) showed a good or excellent Cohen's κ coefficient of concordance among plates when positivity was evaluated on net-GPL. Our data strongly suggest that quantification and subtraction of sample blank may improve both interlaboratory agreement and reliability of anticardiolipin assay and minimize false-positive results.

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Primary Adrenal Failure due to Antiphospholipid Syndrome

Case Reports in Endocrinology ◽

10.1155/2015/161497 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Murat Sahin ◽

Ayten Oguz ◽

Dilek Tuzun ◽

Serife Nur Boysan ◽

Bülent Mese ◽

...

Keyword(s):

Venous Thrombosis ◽

Antiphospholipid Syndrome ◽

Anticardiolipin Antibody ◽

Adrenal Crisis ◽

Adrenal Failure ◽

Primary Adrenal Insufficiency ◽

Warfarin Sodium ◽

Laboratory Examinations ◽

Case Presentations ◽

Antibody Levels

Background. Antiphospholipid syndrome (APS) characterized by thrombosis and abortus may rarely cause primary adrenal failure.Case Presentations. A 34-year-old male presented with hypotension, hypoglycemia, hyperpigmentation on his skin and oral mucosa, scars on both legs, and loss of consciousness. In laboratory examinations, hyponatremia (135 mmol/L), hyperpotassemia (6 mmol/L), and thrombocytopenia (83 K/µL) were determined. Cortisol (1.91 µg/dL) and adrenocorticotropic (550 pg/mL) hormone levels were also evaluated. The patient was hospitalized with a diagnosis of acute adrenal crisis due to primary adrenal insufficiency. A Doppler ultrasound revealed venous thrombosis. The patient was diagnosed with antiphospholipid syndrome after the detection of venous thrombosis, thrombocytopenia, elevated aPTT, and anticardiolipin antibody levels. Anticoagulation treatment was started for antiphospholipid syndrome. The patient is now following up with hydrocortisone, fludrocortisone, and warfarin sodium.Conclusion. Antiphospholipid syndrome is a rare reason for adrenal failure. Antiphospholipid syndrome should be suspected if patients have morbidity secondary to venous-arterial thrombosis.

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Serum TNF-α, IL-6, lupus anticoagulant and anticardiolipin antibody in women with and without a past history of recurrent miscarriage

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-003-0547-0 ◽

2004 ◽

Vol 270 (4) ◽

pp. 227-229 ◽

Cited By ~ 25

Author(s):

Emine Arslan ◽

Mehmet Çolakoğlu ◽

Çetin Çelik ◽

Kazim Gezginç ◽

Ali Acar ◽

...

Keyword(s):

Lupus Anticoagulant ◽

Recurrent Miscarriage ◽

Past History ◽

Anticardiolipin Antibody ◽

Tnf Α ◽

History Of

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Parvovirus B19 infection associated with the production of antineutrophil cytoplasmic antibody (ANCA) and anticardiolipin antibody (aCL)

Lupus ◽

10.1177/096120330000900714 ◽

2000 ◽

Vol 9 (7) ◽

pp. 551-554 ◽

Cited By ~ 33

Author(s):

T-N K Chou ◽

T-C Hsu ◽

R-M Chen ◽

L-I Lin ◽

G J Tsay

Keyword(s):

Parvovirus B19 ◽

Anticardiolipin Antibody ◽

Antineutrophil Cytoplasmic Antibody ◽

Parvovirus B19 Infection

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PHA Responsiveness and Subpopulations of Circulating Lymphocytes in Pernicious Anemia

Blood ◽

10.1182/blood.v44.6.849.849 ◽

1974 ◽

Vol 44 (6) ◽

pp. 849-855 ◽

Cited By ~ 18

Author(s):

A. C. MacCuish ◽

S. J. Urbaniak ◽

A. H. Goldstone ◽

W. J. Irvine

Keyword(s):

Pernicious Anemia ◽

Lymphocyte Transformation ◽

Cell Subpopulation ◽

Significant Difference ◽

Beta Counting ◽

Significant Depression ◽

Circulating Lymphocytes ◽

Immunologic Abnormality ◽

The Difference ◽

Cell Subpopulations

Abstract Lymphocyte transformation responses to the mitogen phytohemagglutinin (PHA) were measured in 20 patients with proven pernicious anemia (PA) and 20 matched controls using 3H-thymidine label. The patients with PA showed significant depression of lymphocyte transformation to the three doses of PHA employed, as judged by beta counting; however, radioautographic examination of PHA-stimulated cells indicated that the results were due to a failure of intranuclear incorporation of 3H-thymidine by PA lymphocytes, rather than a failure of PHA to induce blastogenesis. The percentages and numbers of T and B lymphocytes in peripheral blood were measured in 30 patients and controls by rosette and immunofluorescence techniques, respectively. There was no significant difference in the B cell subpopulations between patients and controls; the T cell subpopulation was slightly lower in the PA patients (mean 62.4%) than in the controls (mean 65.5%), but the difference was not statistically significant. The depressed uptake of 3H-thymidine by stimulated lymphocytes in PA would seem to reflect a chemical defect rather than inherent immunologic abnormality.

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