Skip to main content
NCBI home page
Journal of Clinical Laboratory Analysis logoLink to Journal of Clinical Laboratory Analysis
. 1999 Feb 11;13(2):59–64. doi: 10.1002/(SICI)1098-2825(1999)13:2<59::AID-JCLA3>3.0.CO;2-Q

Antiphosphatidylserine antibodies in patients with autoimmune diseases and HIV‐infected patients: Effects of Tween 20 and relationship with antibodies to β2‐glycoprotein I

Concepción González 1,2, Antonio Lestón 1, Belén García‐Berrocal 1, Angel Sánchez‐Rodriguez 3,5, José A Martín‐Oterino 3, Ignacio Alberca 4, Miguel Cordero 3,5, Ramón Jorge 3, José A Navajo 1, José M González‐Buitrago 1,2,✉
PMCID: PMC6807730  PMID: 10102133

Abstract

Antiphospholipid antibodies (aPL) react with negatively charged phospholipids, which may often be complexed with a protein cofactor such as β2 glycoprotein (β2GPI) and prothrombin. Cofactor requirements may be assessed by measuring antibodies to β2GPI or by adding Tween 20 to some reagents in the assays for aPL (anticardiolipin and antiphosphatidylserine). We have measured anticardiolipin antibodies (aCL), antiphosphatidylserine antibodies (aPS), and anti β2 glycoprotein antibodies (aβ2GPI) in the serum of 10 normal subjects, 20 patients with systemic autoimmune diseases (SAD) diagnosed as having systemic lupus erythematosus (SLE) or antiphospholipid syndrome (APS), and 12 patients with HIV infection. Adding Tween 20 to aPS, the assay couldn't differentiate protein cofactor dependent from independent antibodies, but this can be done by measuring aβ2GPI (P = 0.0008). There was a significant correlation between aCL and aβ2GPI in the control group and in the patients with SAD, but not in the HIV‐positive (HIV+) patients. After excluding the HIV+ patients, the best Spearman correlation was obtained between aβ2GPI and aCL (0.64, P < 0.0005). In 3 out of 7 patients with positive aβ2GPI and in 5 out of 6 patients with moderate or high positive aCL of the group of SAD, there was a history of venous thrombosis. The presence of moderate or high values of aCL either alone or together with aβ2GPI was significantly associated with a history of venous thrombosis (P < 0.05). Moderate or high aCL concentrations and their association with aβ2GPI seems to be useful for the assessment of the risk of venous thrombosis in unselected patients with SLE or APS. J. Clin. Lab. Anal. 13:59–64, 1999. © 1999 Wiley‐Liss, Inc.

Keywords: antiphosphatidylserine antibodies, anticardiolipin antibodies, anti β2 glycoprotein antibodies, autoimmune diseases, HIV infection

REFERENCES

  • 1. Asherson RA, Cervera R. Antiphospholipid syndrome. J Invest Dermatol 1993;100:21S–27S. Medline [DOI] [PubMed] [Google Scholar]
  • 2. Hughes GRV. The antiphospholipid syndrome: Ten years on. Lancet 1993;342:341–344. Medline [DOI] [PubMed] [Google Scholar]
  • 3. McNeil HP, Chesterman CN, Krilis SA. Immunology and clinical importance of antiphospholipid antibodies. Adv Immunol 1991; 49:193–280. Medline [DOI] [PubMed] [Google Scholar]
  • 4. Triplett DA. Antiphospholipid antibodies and thrombosis. A consequence, coincidence, or cause? Arch Pathol Lab Med 1993;117:78–88. Medline [PubMed] [Google Scholar]
  • 5. Puurunen M, Vaarala O, Julkunen H, Aho K, Palosuo T. Antibodies to phospholipid binding proteins and occurrence of thrombosis in patients with systemic lupus eritematosus. Clin Immunol Immunopathol 1996;80:16–22. Medline [DOI] [PubMed] [Google Scholar]
  • 6. Coll Daroka A, Gutierrez‐Cebollada J, Yazbeck H, Berges A, Rubies‐Prat J. Anticardiolipin antibodies and adquired immunodeficiency syndrome: Prognostic marker or association with HIV infection. Infection 1992;20:140–142. Medline [DOI] [PubMed] [Google Scholar]
  • 7. Capel P, Janssens A, Clumeck N, Gerard M, Feremans W, Vamdevelde D, Fondu P. Anticardiolipin antibodies (ACA) are most often not associated with lupus‐like anticoagulant (LLAC) in human immunodeficiency virus (HIV) infection. Am J Hematol 1991;37:234‐238. Medline [DOI] [PubMed] [Google Scholar]
  • 8. Tsutsumi A, Matsuura E, Ichikawa K, Fujisaku A, Mukkiu M, Kobayashi S, Koike T. Antibodies to beta‐2 glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus. Arthritis Rheum 1996;39:1466–1474, 1996. Medline [DOI] [PubMed] [Google Scholar]
  • 9. Forastiero RR, Matinuzzo M, Kordich LC, Carreras LO. Reactivity to beta‐2 glycoprotein I clearly differentiates anticardiolipin antibodies from antiphospholipid syndrome and syphilis. Thromb Haemost 1996;75:717–720. Medline [PubMed] [Google Scholar]
  • 10. McNeil HP, Simpson RJ, Chesterman CN, Krilis SA. Antiphospholipid antibodies are directed against a complex antigen that includes a lipid‐binding inhibitor of coagulation: Beta‐2 glycoprotein I (apolipoprotein H). Proc Natl Acad Sci U S A 1990;87:4120–4124. Medline [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11. Cines DB, McCrae KM. The antiphospholipid‐protein syndrome. J Clin Immunol 1995;15:86S–98S. Medline [DOI] [PubMed] [Google Scholar]
  • 12. Matsuda J, Saitoh N, Gohghi K, Gotoh M. Distinguishing beta‐2 glycoprotein I dependent (systemic lupus erythematosus type) and independent (syphilis type) anticardiolipin antibody with Tween 20. Br J Haematol 1993;85:799–802. Medline [DOI] [PubMed] [Google Scholar]
  • 13. Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982;25:1271–1277. Medline [DOI] [PubMed] [Google Scholar]
  • 14. Harris EN. Annotation: Antiphospholipid antibodies. Br J Haematol 1990;74:1–9. [DOI] [PubMed] [Google Scholar]
  • 15. Erickson E, Najmey S, Keil L, El‐Kadi H, DeBari V. Reference calibrators for IgG antibodies to β2‐glycoprotein I: Preparation, properties and availability to investigators. Clin Chem 1996;42:1–2. [PubMed] [Google Scholar]
  • 16. Reyes H, Dearing L, Peter JB. Antiphospholipid antibodies. A critique of their heterogeneity and hegemony. Sem Thromb Hemostasis 1993;20:89–100. [DOI] [PubMed] [Google Scholar]
  • 17. Yodfat O, Blank M, Krause I, Shoenfeld Y. The pathogenic role of anti‐phosphatidylserine antibodies: Active immunization with the antibodies leads to the induction of antiphospholipid syndrome. Clin Immunol Immunopathol 1996;78:14–20. Medline [DOI] [PubMed] [Google Scholar]
  • 18. Arfors L, Lefvert AK. Enrichment of antibodies against phospholipids in circulating immune complexes (CIC) in the anti‐phospholipid syndrome (APLS). Clin Exp Immunol 1997;108:47–51. Medline [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19. Roubey RAS. Immunology of the antiphospholipid antibody syndrome. Arthritis Rheum 1996;39:1444–1454. Medline [DOI] [PubMed] [Google Scholar]
  • 20. Roubey RAS, Maldonado MA, Byrd SN. Comparison of an enzyme‐linked immunosorbent assay for antibodies to β2‐glicoprotein I and a conventional anticardiolipin immunoassay. Arthritis Rheum 1996;39: 1606–1607. Medline [DOI] [PubMed] [Google Scholar]
  • 21. Pengo V, Biasiolo A, Brocco T. Autoantibodies to phospholipid‐binding proteins in patients with thrombosis and phospholipid‐reactive antibodies. Thromb Haemost 1996;75:721–724. Medline [PubMed] [Google Scholar]
  • 22. Emlen W. Antiphospholipid antibodies: New complexities and new assays. Arthritis Rheum 1996;39:1441–1443.Medline [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Laboratory Analysis are provided here courtesy of Wiley

RESOURCES