scholarly journals Antiinflammatory therapy of neurotrophic corneal diseases

2019 ◽  
Vol 12 (4) ◽  
pp. 77-82
Author(s):  
E. V. Yani ◽  
E. N. Orlova ◽  
V. A. Golikova
Keyword(s):  
Combined Treatment ◽  
Eye Drops ◽  
Test Results ◽  
Antiinflammatory Therapy ◽  
Group Iii ◽  
Group I ◽  
New Directions ◽  
Neurotrophic Keratitis ◽  
Anti Inflammatory ◽  
Group Ii

Clinical data on new directions in combined treatment of neurotrophic keratitis, including anti-inflammatory therapy are presented.Purpose. To compare the effectiveness of bromfenac 0.09 %, nepafenac 0.1 % and indomethacin 0.1 % eye drops in the treatment of neurotrophic keratitis (NK).Materials and methods. 22 NK patients, aged 34 to 78, were divided into three groups. Group I received bromfenac 0.09 %, group II, nepafenac 0.1 %, and group III, indomethacin 0.1 %. Ophthalmic tests included visometry, biomicroscopy, corneal sensitivity determination, as well as diagnostic tests to determine indicators of tear production (Schirmer test, Norn test, LIPCOF test), and measuring lacrimal meniscus height.Results. Between visits V2 and V3, patients of group III showed an increase in conjunctival irritation to an average of 2.3 points, while groups I and II revealed the condition of the conjunctiva at 0.9 and 1.1 points, respectively. The lesion area was evaluated in points (max = 20) and averaged on V1 6.8 points in group I, 5.9 points in group II and 7.2 points in group III. Keratopathy in group I which was estimated at 3.8 points before V2, dropped to 1.4 points by V3. In group III it was 1.7 points by V3. In group II, keratopathy showed only 4.1 points by V3. The average Norn test on the day of treatment showed 2.7 seconds in group I, 2.5 seconds in group II, and 3.1 seconds in group III. No significant increase in Schirmer's test results in all groups was recorded.Conclusion. The use of non-steroidal anti-inflammatory eye drops of various groups — bromfenac 0.09%, nepafenac 0.1 % and indomethacin 0.1 % — gave a positive result in NK therapy. However, bromfenac 0.09% instillations administered once a day produce a higher anti-inflammatory effect then the same quantity of nepafenac 0.1% and indomethacin 0.1 % instillations.

scholarly journals THE EFFECT OF SILODOSIN AND SODIUM DICLOFENAC TO REDUCE PAIN AFTER DJ STENT REMOVAL IN SOETOMO HOSPITAL: DOUBLE-BLINDED RANDOMIZED-CONTROLLED TRIAL

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Hasroni Fathurrahman ◽  
Doddy M Soebadi ◽  
Lukman Hakim
Keyword(s):  
Controlled Trial ◽  
Diclofenac Sodium ◽  
Pain Scale ◽  
Test Results ◽  
Group Iii ◽  
Stent Removal ◽  
Group I ◽  
Dj Stent ◽  
Group Ii ◽  
Double Blinded

Objective: To analyze, measure, compare, prove, and evaluate effectiveness of silodosin, diclofenac sodium, and the combination of both drugs in pain management after stent removal. Materials & Methods: Thirty-three patients were divided into three groups. Group I was given diclofenac Sodium 50 mg, group II was given silodosin 8 mg and group III was given the combination of diclofenac sodium 50 mg and silodosin 8 mg. The Wong Baker Pain Scale (WBPS) was assessed serially: two hours before the DJ stent removal, during DJ stent removal, and after the DJ stent removal (2 hours and 24 hours after). The data was analyzed by ANOVA and Kruskal-Wallis test. Results: In this study, 33 patients who underwent DJ stent removal were obtained. Wong Baker was presented in median (min-max) form. The WBPS study in each group did not differ statistically significant. Lowest WBPS during DJ stent removal was found in group III. Group III was better and statistically significant in reducing pain compared to group I and group II (p<0.05). WBPS two hours after removal in each group decreased and group III was better and statistically significant in reducing pain compared to group II, whereas group III compared to group I had an equivalent effectiveness. While the WBPS 24 hours after removal had the same value and did not differ significantly. No side effects or adverse events were found in the use of diclofenac sodium, silodosin, and their combinations. Conclusion: Single oral dose of diclofenac sodium combined with silodosin is effective to reduce pain after DJ stent removal.

MYOCARDIAL SALVAGE BY COMBINED TREATMENT WITH RECOMBINANT SINGLE-CHAIN UROKINASE-TYPE PLASMINOGEN ACTIVATOR AND RECOMBINANT HUMAN SUPEROXIDE DISMUTASE IN A CANINE CORONARY THROMBOSIS MODEL*

1987 ◽  
Author(s):  
U Finke ◽  
J Schneider ◽  
E Friderichs ◽  
L Flohé ◽  
H Giertz
Keyword(s):  
Combined Treatment ◽  
Myocardial Salvage ◽  
Single Chain ◽  
Reperfusion Arrhythmias ◽  
Group Iii ◽  
Thrombosis Model ◽  
Group I ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Group Ii

Recanalization of thrombotic coronary occlusion with fibrinolytic treatment is a promising approach to salvage jeopardized ischemic myocardium. However, the success of thrombolytic treatment of myocardial infarction may be curtailed by the risk inherent to reperfusion. Cell damage upon reoxygenation after an ischemic period is tentatively attributed to the formation of oxygen-derived free radicals. Improved myocardial salvage is therefore expected from coadministration of a free radical scavenger and fibrinolytic treatment. We tested this hypothesis in a canine model of left anterior circumflex coronary artery (LCX) thrombosis. Thrombolysis was achieved with the fibrin- selective single-chain urokinase-type plasminogen activator of recombinant origin (r-scu-PA). As enzymatic scavenger of oxygen radicals recombinant human superoxide dismu-tase (r-HSOD) was used. The three experimental groups were: group I (n=4) did not receive any treatment after LCX thrombosis; in group II (n=9) at 100 min after LCX thrombosis r-scu-PA (20 μg/kg/min i.v. for 30 min) was infused; dogs in group III (n=8) received concomitant treatment with r-scu-PA and r-HSOD (10 mg/kg i.v. for 60 min). Infarct size as percent of the risk zone was 38.2 ± 4.1 in group I, 25.3 ± 3.7 in group II (p ≤ 0.05 vs group I) and 14.9 ± 3.2 in group III (p ≤ 0.05 vs group II). Incidence of reperfusion arrhythmias and increase in plasma CK were significantly diminished by r-HSOD when compared to dogs receiving r-scu-PA only. There were no significant differences in hemodynamic parameters between the groups. In conclusion, in terms of infarct size reduction, suppression of reperfusion arrhythmias and attenuation of intracellular enzyme release the combined treatment with r-scu-PA and r-HSOD yielded a significant higher myocardial salvage versus thrombolytic treatment alone in a canine LCX thrombosis model.* This work is part of the doctoral dissertation of Miss U. Fincke

scholarly journals GAMBARAN HISTOPATOLOGIK LAMBUNG TIKUS WISTAR SETELAH DIINDUKSI DENGAN ASPIRIN

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Poppy M Lintong ◽  
Lily L. Loho ◽  
Herman Anggran
Keyword(s):  
Lamina Propria ◽  
Food Pellet ◽  
Wistar Rat ◽  
Control Group ◽  
Group Iii ◽  
Group I ◽  
Microscopic Features ◽  
Anti Inflammatory ◽  
Group Ii ◽  
Normal Stomach

Abstract: Aspirin is one of the non-steroid-anti-inflammatory drugs. Its pharmacodynamic effects are as an analgesic, antipyretic, anti-inflammatory, anti-thrombotic, and uricosuric agent. The side effects of aspirin are on the respiratory tract, the gastrointestinal tract, blood, metabolic processes, endocrine functions, pregnancy, hypersensitivity, and drug interaction. The purpose of this study was to evaluate the macroscopic and microscopic features of wistar rat stomachs after the administration of aspirin. This was an experimental study, using nine wistar rats divided into three groups equally. Group I, the control group, was given a food pellet only. Group II was given the pellet, added with aspirin 21 mg daily for 10 days. Group I and Group II were terminated on day 11. Group III was given the pellet, added with aspirin 21 mg/day for 10 days, and was terminated on day 14. All the wistar rat stomachs were examined macroscopically and microscopically. The results showed that the control group had a macroscopically normal stomach architecture, and the mucosa layers and rugae were intact and looked pinkish white. The groups treated with aspirin still showed normal stomach architecture, and the mucosa layers and rugae were intact but looked more palid than that of the control group. Microscopically, the stomach walls of the control group were normal, but groups treated with aspirin for 10 days revealed edema of the lamina propria, dilatation of capillaries; and predominantly neutrophilic infiltration in the lamina propria. Ceasing of aspirin administration showed a resolution of the inflammatory process, marked by diminished infiltration of PMN cells and tisuue edema. Conclusion: Aspirin treatment of 21 mg a day for 10 days revealed histopathologically acute gastritis of the wistar rat stomach walls. The inflammatory reaction was diminished after the cessation of aspirin. Keywords: aspirin, histopathology, stomach.   Abstrak: Aspirin tergolong obat anti-inflamasi non-steroid (AINS) yang secara farmakodinamika mempunyai efek analgesik, anti-piretik, anti-inflamasi, anti-trombotik, dan urikosurik, namun mempunyai efek samping pada saluran  cerna terutama lambung. Penelitian ini bertujuan untuk mendapatkan gambaran histopatologik (makroskopik dan mikroskopik) lambung tikus Wistar setelah pemberian aspirin. Penelitian ini bersifat eksperimental dengan menggunakan sampel sembilan ekor tikus Wistar yang dibagi atas tiga kelompok. Kelompok I (kontrol) terdiri dari tiga ekor tikus yang diberi pelet biasa dan air minum. Kelompok II terdiri dari tiga ekor tikus yang diberi pelet biasa, air minum, dan aspirin dosis 21 mg/hari  selama 10 hari. Pada hari ke-11 kelompok I dan II diterminasi. Kelompok III terdiri dari tiga ekor tikus yang diberikan pelet biasa, air minum, dan aspirin dosis 21 mg/hari selama 10 hari, kemudian aspirin dihentikan dan tikus diterminasi pada hari ke-14. Setelah diterminasi, kelompok I-III diotopsi, diambil organ lambungnya, kemudian dilakukan pemeriksaan histopatologik. Hasil penelitian memperlihatkan makroskopik mukosa lambung tampak lebih pucat sedangkan mikroskopik menunjukkan tanda-tanda radang akut. Penghentian pemberian aspirin diikuti dengan resolusi reaksi inflamasi yang ditandai oleh penurunan infiltrasi sel-sel radang PMN dan edema jaringan. Sinpulan: Pemberian aspirin 21 mg/hari selama 10 hari mengakibatkan terjadinya gambaran histopatologik gastritis akut pada lambung tikus Wistar. Reaksi inflamasi menurun setelah penghentian pemberian aspirin. Kata kunci: aspirin, histopatologi, lambung.

scholarly journals Prevention of inflammation, pain and loss of height of marginal bone tissue at the stage of dental implantation and direct prosthetics

2020 ◽  
Vol 104 (5) ◽  
pp. 36-43
Author(s):  
P. Leonenko ◽  
◽  
Yu. Kokoieva ◽  
Keyword(s):  
Bone Resorption ◽  
Bone Tissue ◽  
Dental Implant ◽  
Group Iii ◽  
Dental Implantation ◽  
Analgesic Therapy ◽  
Group I ◽  
Cox 2 ◽  
Anti Inflammatory ◽  
Group Ii

Summary. Inflammation and pain can lead not only to a deterioration in the patient’s condition, but also to such local consequences as: bone resorption, loss of soft tissue volume, an increase in the wound healing time and patient rehabilitation in general. Inflammation-induced bone resorption in the area of implantation with direct prosthetics, caused by the activity of cytokines and prostaglandins, negatively affects the entire result of treatment of dentition defects in general. This is because the quality and quantity of bone tissue is one of the key points in the success of prosthetics on dental implants, therefore, pharmacological support of dental implantation and direct prosthetics is an important component of treatment. Purpose: to investigate the effect of inflammation and pain on peri-implant bone tissue at the stages of dental implantation and direct prosthetics and scientifically substantiate pharmacological support in order to prevent inflammatory bone resorption. Materials and methods. A clinical prospective study of 57 patients was carried out at the stage of dental implantation and direct prosthetics with randomization according to the type of pharmacological accompaniment: 1) group I received anti-inflammatory therapy in the form of a balanced inhibitor of COX-1, COX-2 and 5-LOG – nimesulide and analgesic therapy – dexketaprofen trometamol; 2) group II received anti-inflammatory therapy – a selective COX-2 inhibitor – meloxicam and analgesic therapy – ibuprofen; 3) group III did not receive anti-inflammatory and analgesic therapy due to contraindications to the use of non-steroidal anti-inflammatory drugs. Patients of groups I, II, III underwent: clinical, radiological and functional research methods by monitoring the state in dynamics. Results. According to the data obtained, the indices of pain intensity in group I were significantly lower (p < 0.05) as of 1 and 2-d days, compared with groups II and III. The stabilization of inflammatory processes in group I was recorded on the 2-d day. There was a significant decrease (p < 0.05) in the signs of the inflammatory process in patients of group I on the 3rd day (3.01±0.11 units), and on the 7-th day – their complete absence (1.12±0.23 units). In group II, significant regression of inflammation was noted on the 4th day (3.14±0.12 units), and on the 7-th day, minimal signs were observed (2.04±0.17 units). A decrease in signs of inflammation in group III occurred from the 5th day (3.31±0.28 units), and inflammatory phenomena were observed on the 7th day of the study (2.65±0.27 units). In group I, there was a significant stop in the loss of stability of the connection between the bone tissue and the dental implant on the 20-th day (65.08±1.03 points). As of the 25-th day, in patients of group I of the study, there was significantly higher (p < 0.05) indicators of the coefficient of stability of the implant (66.21±1.40 points) in relation to group II of patients (62.93±0.94 points), in who used selective COX-2 inhibitors, and group III (62.90±0.75 points), where NSAID’s were not used. The loss of marginal bone around the dental implant during the study period in group I was 0.5±0.23 mm CI, in group II – 1.1±0.34 mm, in group III – 1.3±0.28 mm. Side effects in group I of the study were recorded in 5.3 % of patients taking drugs nimesulide and dexketoprofen, and in 15.8 % of those in group II who took drugs meloxicam and ibuprofen. Conclusions. Complex pharmacological support of dental implantation and direct prosthetics on implants in the treatment of dentition defects, consisting of perioperative analgesia – dexketoprofen trometamol, as well as nimesulide for anti-inflammatory therapy, made it possible to influence the trauma-induced bone resorption in the implantation area by controlling inflammation. As a result, on the 20-th day in the patients of the group I of the study, a significant stop was noted in the loss of stability of the connection of the bone tissue and the dental implant (65.08±1.03 units), and on the 25-th day of the study in the group I it was found significantly higher (p < 0.05) indicators of the coefficient of stability of the implant and less loss of height of marginal bone tissue in relation to groups II and III of patients. This pharmacological complex made it possible to achieve stabilization of pathological processes in soft tissues – stopping the formation of edema on the 2-d day, a significant decrease (p < 0.05) of signs of the inflammatory process on the 3-d day (3.01±0.11 points) and to implement effective pain prevention at the stages of dental implantation and direct prosthetics.

Meloxicam induced toxicopathology studies in Wistar rats

2019 ◽  
Author(s):  
S. Pramod Bharani ◽  
A. K. Naik ◽  
S. C. Parija ◽  
S. K. Panda
Keyword(s):  
Wistar Rats ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
High Dose ◽  
Dependent Manner ◽  
Group Iii ◽  
Group I ◽  
Anti Inflammatory ◽  
Group Ii ◽  
Dose Dependent

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used class of drugs for treating inflammation and pain. Meloxicam has analgesic, anti-inflammatory and antipyretic properties and is a commonly used NSAID in veterinary practice. The present study was done to evaluate effect of meloxicam on toxico-pathological and hematological parameters in Wistar rats. Eighteen Wistar rats were equally divided into three groups i.e. Group I, Group II and Group III. Group I (negative control) rats received only Normal saline (0.9%) @ 1ml/kg. Group II (Low dose) received meloxicam@ 4 mg/kg B.W. and Group III (High dose) rats received meloxicam@8 mg/kg B.W. orally by gavage for 28 days. Dose-dependent clinical signs and lesions were observed after meloxicam treatment. Kidneys and liver were severely hemorrhagic at the high dose, while intestine and stomach had ulcers and erosions. Hematological values were altered after 28 days of administration. Total Erythrocyte Count (TEC), Packed Cell Volume (PCV), Haemoglobin values were decreased and TLC count was significantly increased in both doses of meloxicam treated groups in a dose-dependent manner. It was concluded that meloxicam caused GIT lesions, nephrotoxicity, hepatotoxicity and variation in the hematological parameters at selected dose and duration.

scholarly journals Effect of hyaluronate and splinting alone versus combined treatment (splinting and hyaluronate) on thumb carpometacarpal osteoarthritis

2020 ◽  
Vol 2 (1) ◽  
pp. 35-40
Author(s):  
Salvatore Denaro ◽  
Salvatore Boccaccio ◽  
Antonino Zocco
Keyword(s):  
Grip Strength ◽  
Rating Scale ◽  
Combined Treatment ◽  
Numeric Rating Scale ◽  
Group Iii ◽  
Pain Disability ◽  
Group I ◽  
Group Ii ◽  
Thumb Carpometacarpal ◽  
Carpometacarpal Osteoarthritis

Thumb carpometacarpal osteoarthritis can lead to global hand dysfunctions and its symptoms are pain and inability. The purpose of this study is to determine the effectiveness of hyaluronate in relieving these symptoms, and to compare it to orthosis and combined treatment (orthosis and hyaluronate). We enrolled 39 patients, evaluated at the baseline by using numeric rating scale (NRS) for pain, Disability of the Arm, Shoulder and Hand (DASH) and Dreiser Scale for disability degree, and Digital Hydraulic Pinch Gauge for grip strength. Eligible participants were randomly assigned to one of the three treatments: injection of hyaluronate (group I), combined treatment (hyaluronate and orthosis, Group II) and orthosis (hard-resting splint, Group III). Patients of Group I and Group II were injected by low molecular weight Hyaluronate once a week for three consecutive weeks. Injections were performed by means of the so-called blind technique. The data analysis indicated a significant decrease (P<0.01) of pain at week 4, further manifested at week 26 by all groups treated. The same occurred for functional symptoms, and grip strength. This improvement appears more evident in group I that received HA.

scholarly journals The Comparison of the Effects of Ellagic Acid and Diclofenac Sodium on Intra-Abdominal Adhesion: An In Vivo Study in the Rat Model

2014 ◽  
Vol 99 (5) ◽  
pp. 543-550 ◽  
Author(s):  
Tulay Diken Allahverdi ◽  
Ertuğrul Allahverdi ◽  
Sadık Yayla ◽  
Turgay Deprem ◽  
Oğuz Merhan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Ellagic Acid ◽  
Diclofenac Sodium ◽  
Peritoneal Adhesion ◽  
Peritoneal Adhesions ◽  
Group Iii ◽  
Group I ◽  
Anti Inflammatory ◽  
Group Ii

Abstract Peritoneal adhesions are seen frequently after abdominal surgery and can cause serious complications. We aimed to evaluate the effects of the oral use of diclofenac sodium and ellagic acid on formation of postoperative adhesions in rats Studies have shown that agents with anti-inflammatory properties and antioxidant substances can prevent adhesion by decreasing oxidative stress. We compared and evaluated the effects of ellagic acid that has strong antioxidant and anti-inflammatory properties and the nonsteroidal anti-inflammatory diclofenac sodium on peritoneal adhesion development in our experimental study. Laparotomy was performed with a midline incision under general anesthesia and an adhesion model was created on the antimesenteric side of the cecum in Groups I, II, and III. Group I received 85 mg/kg ellagic acid and Group II, 50 mg/kg diclofenac sodium through the nasogastric catheter while Group III received no medication. Only laparotomy was performed in Group IV. The rats were sacrificed at the end of the 14th day. Following macroscopic scoring, tissue samples were removed and subjected to biochemical and histopathologic evaluation. The degree of adhesion and the malondialdehyde level were decreased (P &lt; 0.05), and glutathione level increased (P &lt; 0.05) in Group I compared to Group II and Group III. The effects of ellagic acid on the prevention of peritoneal adhesion were found to be stronger than diclofenac sodium. This can be explained by the fact that ellagic acid is a strong antioxidant and decreases oxidative stress with anti-inflammatory and anti-angiogenic effects.

scholarly journals Evaluation of Anti-Inflammatory Effect of Moringa oleifera Lam. and Cyanthillium cinereum (Less) H. Rob. Lozenges in Volunteer Smokers

Plants ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Thitiya Luetragoon ◽  
Rungnapa Pankla Sranujit ◽  
Chanai Noysang ◽  
Yordhathai Thongsri ◽  
Pachuen Potup ◽  
...  
Keyword(s):  
Oral Health ◽  
Moringa Oleifera ◽  
Group Iii ◽  
Percentage Decrease ◽  
Group I ◽  
Oral Inflammation ◽  
Anti Inflammatory ◽  
Group Ii ◽  
Moringa Oleifera Lam ◽  
Inflammatory Effect

Smokers have high plaque accumulation that initiates gingival inflammation and progresses to periodontitis. Thus, oral hygiene to control microbial plaque formation is an effective method of preventing gingivitis. Medicinal plants such as Moringa oleifera Lam. (MO) and Cyanthillium cinereum (Less.) H. Rob. (CC) have an anti-inflammatory effect that might improve oral health in smokers. This study evaluated the effect of MO leaf and CC extracts using MO lozenges and a combination of MO + CC lozenges on oral inflammation and gingivitis in volunteer smokers. Lozenges consisting of MO and CC extracts were developed and studied in vivo. The results showed that lozenges significantly reduced oral inflammation and gingivitis in volunteers. The gingival index (GI) of group III (MO + CC lozenges) significantly decreased, while the percentage decrease of oral inflammation in group II (MO lozenges) was significantly higher than the other groups. The percentage decrease of GI values in group II (MO lozenges) and group III (MO + CC lozenges) were significantly higher than the placebo group I. Our findings indicated that MO and MO + CC lozenges reduced oral inflammation and gingivitis and showed potential to improve oral health in smokers.

Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

1970 ◽  
Vol 28 ◽  
pp. 208-209
Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA
Keyword(s):  
Osmium Tetroxide ◽  
Male Mice ◽  
Alcohol Group ◽  
Group Iii ◽  
Group I ◽  
C57bl Mice ◽  
Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

Heterogeneity and Immunochemical Properties of Anti-β2-glycoprotein I Autoantibodies

1998 ◽  
Vol 80 (09) ◽  
pp. 393-398 ◽  
Author(s):  
V. Regnault ◽  
E. Hachulla ◽  
L. Darnige ◽  
B. Roussel ◽  
J. C. Bensa ◽  
...  
Keyword(s):  
Fluid Phase ◽  
Anticardiolipin Antibodies ◽  
Dual Reactivity ◽  
Group Iii ◽  
Important Group ◽  
Epitope Specificity ◽  
Glycoprotein I ◽  
Group I ◽  
Group Ii ◽  
Sufficient Concentration

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.

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