Anticardiolipin antibodies in Hashimoto's disease.

OBJECTIVE: To ascertain the presence and significance of anticardiolipin antibodies in patients with Hashimoto's disease. METHODS: We studied 19 patients (15 women and 4 men; age range, 26 to 79 years) with Hashimoto's disease. IgA, IgG, and IgM anticardiolipin antibodies were measured by enzyme-linked immunosorbent assay. RESULTS: Of the 19 study patients, 4 (21%) tested positive for anticardiolipin antibodies (IgG in 2 and IgM in 2). Patients with anticardiolipin antibodies did not exhibit a higher titer of antithyroglobulin or anti-thyroid peroxidase antibodies in comparison with patients without anticardiolipin antibodies. Moreover, no relationship was found between anticardiolipin antibody levels and thyroid hormone replacement therapy. None of the patients with high levels of IgG or IgM anticardiolipin antibodies had clinical features of the antiphospholipid syndrome. CONCLUSION: Our results showed an increased incidence of anticardiolipin antibodies in patients with Hashimoto's disease. The presence of these antibodies may be a nonspecific marker of activation of the immune system.

Hormonally-regulated proteins in breast secretions are markers of target organ sensitivity.

Anti-oestrogen therapy is being used in an attempt to prevent breast cancer but no intermediate end points of the effect of tamoxifen on the normal breast are available. Therefore, the purpose of this study was to develop a physiological measure of oestrogen action on the breast. We measured oestrogen-stimulated and -inhibited proteins in breast secretions from women on and off anti-oestrogen therapy. Two oestrogen-stimulated proteins (pS2 and cathepsin D) and oestrogen-inhibited proteins (CP15, gross cystic disease fluid protein 15; Apo,: apolipoprotein D) were measured. Premenopausal women had significantly higher pS2 and cathepsin D in association with lower Apo D and CP15 secretion levels compared to post-menopausal women. Sequential nipple aspirates from women treated with the luteinizing hormone releasing hormone agonist goserelin (n = 9), tamoxifen (n = 9) and hormone replacement therapy (HRT) (n = 26) were measured. Following treatment with goserelin, median nipple secretion levels of pS2 fell (P < 0.02) and Apo D and CP15 rose significantly (P < 0.03 and P < 0.05 respectively). Similar changes were seen on tamoxifen therapy but not in untreated control women. Treatment with HRT resulted in a rise of pS2 (P < 0.001) and a fall in Apo D (P < 0.05). Measurement of pS2 and Apo D in nipple aspirates may prove useful intermediate end point of breast responsiveness to anti-oestrogens.

Radioimmunoassay for serum apolipoprotein D, an atypical apolipoprotein: validation and clinical application.

Apolipoprotein D (apoD) is an atypical apolipoprotein in terms of its structure, synthesis and probable function. It is the most abundant protein in breast cyst fluids of patients suffering from macrocystic disease of the breast, a disease associated with an increased risk of developing breast cancer. We have developed and optimized a competitive radioimmunoassay for the measurement of apoD in human serum. The assay uses a solid phase separation method and with a 4 h incubation period, it can be completed in a single working day. The within and between run coefficients of variation were < 8.5% and < 12.2%, respectively, and quantitative recovery of apoD was obtained over the range 250-5000 micrograms/L. There was no difference in the serum concentrations of apoD between female controls, patients with benign breast disease and early breast cancer. However, serum apoD was significantly lower in breast cancer patients with bone metastasis.