Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1991 Apr;65(4):184–187. doi: 10.1136/hrt.65.4.184

Platelet aggregating activity in serum from patients with HLA-B27 associated rheumatic and cardiac disorders: a possible link to the proliferative vascular changes.

L Bergfeldt 1, O Edhag 1, G Holm 1, R Norberg 1
PMCID: PMC1024576  PMID: 2029440

Abstract

OBJECTIVE--To search for possible serum factors (immunochemical abnormalities) that reflect HLA-B27 associated inflammatory process with the proliferative endarteritis, which is an important cause of severe bradycardia and aortic valve regurgitation. PATIENTS AND METHODS--Seventy four men with pacemakers were studied: 24 were HLA-B27 positive and had associated rheumatic and cardiac disorders, 13 were B27 positive but had no clinical or radiographic signs of a related rheumatic condition, and 37 were B27 negative controls. Randomly obtained serum samples were examined for a series of serum factors. RESULTS--Thirteen (57%) of the 23 patients with HLA-B27 and associated rheumatic and cardiac conditions had platelet aggregating activity in their serum. No such activity was found in sera from patients in the other groups. None the less, immunochemical abnormalities were common among patients of all groups; 30 (41%) had antinuclear antibodies or rheumatoid factor or both. CONCLUSION--The platelet aggregating activity found in patients with HLA-B27 and associated rheumatic and cardiac conditions may reflect serum factors that increase the stickiness of platelets and increase their adhesion to the vessel wall. This suggests a link via release of platelet derived growth factor(s) with the characteristic histopathological feature of proliferative endarteritis. Immunochemical abnormalities were common in serum from all men with pacemakers.

Full text

PDF
187

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bergfeldt L., Edhag O., Rajs J. HLA-B27-associated heart disease. Clinicopathologic study of three cases. Am J Med. 1984 Nov;77(5):961–967. doi: 10.1016/0002-9343(84)90552-7. [DOI] [PubMed] [Google Scholar]
  2. Bergfeldt L., Edhag O., Vallin H. Cardiac conduction disturbances, an underestimated manifestation in ankylosing spondylitis. A 25-year follow-up study of 68 patients. Acta Med Scand. 1982;212(4):217–223. doi: 10.1111/j.0954-6820.1982.tb03203.x. [DOI] [PubMed] [Google Scholar]
  3. Bergfeldt L., Edhag O., Vedin L., Vallin H. Ankylosing spondylitis: an important cause of severe disturbances of the cardiac conduction system. Prevalence among 223 pacemaker-treated men. Am J Med. 1982 Aug;73(2):187–191. doi: 10.1016/0002-9343(82)90177-2. [DOI] [PubMed] [Google Scholar]
  4. Bergfeldt L. HLA B27-associated rheumatic diseases with severe cardiac bradyarrhythmias. Clinical features and prevalence in 223 men with permanent pacemakers. Am J Med. 1983 Aug;75(2):210–215. doi: 10.1016/0002-9343(83)91193-2. [DOI] [PubMed] [Google Scholar]
  5. Bergfeldt L., Insulander P., Lindblom D., Möller E., Edhag O. HLA-B27: an important genetic risk factor for lone aortic regurgitation and severe conduction system abnormalities. Am J Med. 1988 Jul;85(1):12–18. doi: 10.1016/0002-9343(88)90497-4. [DOI] [PubMed] [Google Scholar]
  6. Bergfeldt L., Möller E. Complete heart block--another HLA B27 associated disease manifestation. Tissue Antigens. 1983 May;21(5):385–390. doi: 10.1111/j.1399-0039.1983.tb00188.x. [DOI] [PubMed] [Google Scholar]
  7. Bergfeldt L., Möller E. Pacemaker treated women with heart block have no increase in the frequency of HLA-B27 and associated rheumatic disorders in contrast to men--a sex linked difference in disease susceptibility. J Rheumatol. 1986 Oct;13(5):941–943. [PubMed] [Google Scholar]
  8. Brewerton D. A., Gibson D. G., Goddard D. H., Jones T. J., Moore R. B., Pease C. T., Revell P. A., Shapiro L. M., Swettenham K. V. The myocardium in ankylosing spondylitis. A clinical, echocardiographic, and histopathological study. Lancet. 1987 May 2;1(8540):995–998. doi: 10.1016/s0140-6736(87)92268-9. [DOI] [PubMed] [Google Scholar]
  9. Brewerton D. A., Hart F. D., Nicholls A., Caffrey M., James D. C., Sturrock R. D. Ankylosing spondylitis and HL-A 27. Lancet. 1973 Apr 28;1(7809):904–907. doi: 10.1016/s0140-6736(73)91360-3. [DOI] [PubMed] [Google Scholar]
  10. Bulkley B. H., Roberts W. C. Ankylosing spondylitis and aortic regurgitation. Description of the characteristic cardiovascular lesion from study of eight necropsy patients. Circulation. 1973 Nov;48(5):1014–1027. doi: 10.1161/01.cir.48.5.1014. [DOI] [PubMed] [Google Scholar]
  11. Casali P., Bossus A., Carpentier N. A., Lambert P. H. Solid-phase enzyme immunoassay or radioimmunoassay for the detection of immune complexes based on their recognition by conglutinin: conglutinin-binding test. A comparative study with 125I-labelled Clq binding and Raji-cell RIA tests. Clin Exp Immunol. 1977 Aug;29(2):342–354. [PMC free article] [PubMed] [Google Scholar]
  12. Cream J. J. Clinical and immunological aspects of cutaneous vasculitis. Q J Med. 1976 Apr;45(178):255–276. [PubMed] [Google Scholar]
  13. DAVIDSON P., BAGGENSTOSS A. H., SLOCUMB C. H., DAUGHERTY G. W. CARDIAC AND AORTIC LESIONS IN RHEUMATOID SPONDYLITIS. Proc Staff Meet Mayo Clin. 1963 Sep 18;38:427–435. [PubMed] [Google Scholar]
  14. ENGFELDT B., ROMANUS R., YDEN S. Histological studies of pelvo-spondylitis ossificans (ankylosing spondylitis) correlated with clinical and radiological findings. Ann Rheum Dis. 1954 Sep;13(3):219–228. doi: 10.1136/ard.13.3.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hay F. C., Nineham L. J., Roitt I. M. Routine assay for the detection of immune complexes of known immunoglobulin class using solid phase C1q. Clin Exp Immunol. 1976 Jun;24(3):396–400. [PMC free article] [PubMed] [Google Scholar]
  16. Hedfors E., Norberg R. Evidence for circulating immune complexes in sarcoidosis. Clin Exp Immunol. 1974 Mar;16(3):493–496. [PMC free article] [PubMed] [Google Scholar]
  17. Kinsella T. D., Johnson L. G., Ian R. Cardiovascular manifestations of ankylosing spondylitis. Can Med Assoc J. 1974 Dec 21;111(12):1309–1311. [PMC free article] [PubMed] [Google Scholar]
  18. Laurell C. B. Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies. Anal Biochem. 1966 Apr;15(1):45–52. doi: 10.1016/0003-2697(66)90246-6. [DOI] [PubMed] [Google Scholar]
  19. Myllylä G. Aggregation of human blood platelets by immune complexes in the sedimentation pattern test. Scand J Haematol Suppl. 1973;19:1–56. [PubMed] [Google Scholar]
  20. Norberg R. IgG complexes in serum of rheumatoid arthritis patients. Scand J Immunol. 1974;3(3):229–236. doi: 10.1111/j.1365-3083.1974.tb01253.x. [DOI] [PubMed] [Google Scholar]
  21. Paulus H. E., Pearson C. M., Pitts W., Jr Aortic insufficiency in five patients with Reiter's syndrome. A detailed clinical and pathologic study. Am J Med. 1972 Oct;53(4):464–472. doi: 10.1016/0002-9343(72)90142-8. [DOI] [PubMed] [Google Scholar]
  22. Qaiyumi S., Hassan Z. U., Toone E. Seronegative spondyloarthropathies in lone aortic insufficiency. Arch Intern Med. 1985 May;145(5):822–824. [PubMed] [Google Scholar]
  23. Ribeiro P., Morley K. D., Shapiro L. M., Garnett R. A., Hughes G. R., Goodwin J. F. Left ventricular function in patients with ankylosing spondylitis and Reiter's disease. Eur Heart J. 1984 May;5(5):419–422. doi: 10.1093/oxfordjournals.eurheartj.a061676. [DOI] [PubMed] [Google Scholar]
  24. Roberts W. C., Hollingsworth J. F., Bulkley B. H., Jaffe R. B., Epstein S. E., Stinson E. B. Combined mitral and aortic regurgitation in ankylosing spondylitis. Angiographic and anatomic features. Am J Med. 1974 Feb;56(2):237–243. doi: 10.1016/0002-9343(74)90602-0. [DOI] [PubMed] [Google Scholar]
  25. Ross R. The pathogenesis of atherosclerosis--an update. N Engl J Med. 1986 Feb 20;314(8):488–500. doi: 10.1056/NEJM198602203140806. [DOI] [PubMed] [Google Scholar]
  26. Rubin K., Tingström A., Hansson G. K., Larsson E., Rönnstrand L., Klareskog L., Claesson-Welsh L., Heldin C. H., Fellström B., Terracio L. Induction of B-type receptors for platelet-derived growth factor in vascular inflammation: possible implications for development of vascular proliferative lesions. Lancet. 1988 Jun 18;1(8599):1353–1356. doi: 10.1016/s0140-6736(88)92177-0. [DOI] [PubMed] [Google Scholar]
  27. Schlosstein L., Terasaki P. I., Bluestone R., Pearson C. M. High association of an HL-A antigen, W27, with ankylosing spondylitis. N Engl J Med. 1973 Apr 5;288(14):704–706. doi: 10.1056/NEJM197304052881403. [DOI] [PubMed] [Google Scholar]
  28. Sharp G. C., Irvin W. S., Tan E. M., Gould R. G., Holman H. R. Mixed connective tissue disease--an apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA). Am J Med. 1972 Feb;52(2):148–159. doi: 10.1016/0002-9343(72)90064-2. [DOI] [PubMed] [Google Scholar]
  29. Tan P. L., Butler M. J., Woodfield D. G., Jacobson C., Grigor R. R., Caughey D. E. HLA antigens in isolated aortic incompetence. J Rheumatol. 1980 Sep-Oct;7(5):757–758. [PubMed] [Google Scholar]
  30. Truedsson L., Sjöholm A. G., Laurell A. B. Screening for deficiencies in the classical and alternative pathways of complement by hemolysis in gel. Acta Pathol Microbiol Scand C. 1981 Jun;89(3):161–166. doi: 10.1111/j.1699-0463.1981.tb02680.x. [DOI] [PubMed] [Google Scholar]
  31. Weed C. L., Kulander B. G., Massarella J. A., Decker J. L. Heart block in ankylosing spondylitis. Arch Intern Med. 1966 Jun;117(6):800–806. [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES