[Antiphospholipid antibodies: new data in the pathogenesis of collagenosis]

Abstract

Antiphospholipid antibodies (APAB) were first detected as a result of the disturbances they cause in routine biological tests. These effects include lupus anticoagulant (LA) in APTT test and false serological reactions for syphilis in VDRL test. With more sensitive techniques using purified phospholipid antibodies (ELISA, RIA) antibodies directed specifically against cardiolipidin or other phospholipids can be assayed. Beside being responsible for positivity of the VDRL test in the context of syphilis, APAB (false serological reactions for syphilis, LA, anticardiolipin antibodies) have also been detected in systemic lupus erythematosus (SLE) and lupus-like syndromes, after intake of certain drugs, and, more rarely, in a number of diseases (table I). The specificity of APAB detected in syphilis (antiphosphatidylcholine) is different from that of APAB detected in SLE (antiphosphatidylserine and anticardiolipin). A given APAB can react with several phospholipids, but such crossreactions do not occur haphazardly with all phospholipids. Crossreactions are observed between APAB and polynucleotides on the one hand, and between antinuclear antibodies and phospholipids on the other. This pattern has led to speculate that APAB are directly involved in the pathogenesis of SLE; however since these crossreactions are not extensive, such speculation is controversial. The presence of APAB in the form of LA, false serological reactions for syphilis or anticardiolipin antibodies is associated with a number of problems including recurrent thrombosis, repeated abortions, thrombocytopenia and positive Coombs' tests or, more rarely, pulmonary hypertension, migraine, epilepsy, chorea, and transverse myelitis.(ABSTRACT TRUNCATED AT 250 WORDS)