ABSTRACT
OBJECTIVE: The objective of this paper is to determine which kinds of assays for antiphospholipid antibodies (aPL) should be tested for clinical practice for patients with recurrent pregnancy loss (RPL). MATERIALS AND METHODS: We studied 560 patients with a history of RPL prospectively. We determined the obstetric significance of 11 commercially available tested assays for lupus anticoagulant (LA)-aPTT StaClot, phosphatidylserine-dependent antiprothrombin (aPS/PT) IgG, IgM, classical cardiolipin (CL) IgG, IgM, CL IgG, IgM, IgA, and ß2glycoprotein I (ß2GPI) IgG, IgM, IgA Phadia. Obstetric significance was defined as the potential for anticoagulant therapy to improve the subsequent live birth rate, or a difference in the live birth rate between positive and negative untreated cases. RESULTS: The LA-aPTT StaClot assay and aPS/PT IgG assay, but not CL IgG, were found to have obstetric significance. Our conventional tests covered positive cases with the aPS/PT IgM and classical CL IgG assays. The results of the LA-aPTT StaClot, LA-aPTT and LA-RVVT assays showed different distributions, although strong or moderate correlation was observed. CONCLUSION: LA-aPTT StaClot and aPS/PT IgG might be suitable for use in routine practice for patients with RPL. Each test for aPL should be ascertained for obstetric significance, because similar assays may have different outcomes.
Subject(s)
Abortion, Habitual/immunology , Antibodies, Antiphospholipid/analysis , Antiphospholipid Syndrome/immunology , Obstetrics , Pregnancy Complications/immunology , Reagent Kits, Diagnostic , Adult , Antibodies, Anticardiolipin/blood , Female , Humans , Obstetrics/methods , Pregnancy , Pregnancy RateABSTRACT
Autoimmune diseases frequently manifest themselves in fulminating immune reactions involving T and B cells that lead to the appearance of circulating autoantibodies. Such antibodies are considered to be of diagnostic relevance and may be pathognomonic for their associated autoimmune diseases. The advent of recombinant protein expression technology has made it possible to economically produce high quality autoantigens for use in immunoassays to detect autoantibodies in patients' sera. This short review is intended to give the reader a brief description of the various autoantigen production methodologies with their advantages and disadvantages, and the limitations of these techniques in the diagnostics of autoimmune diseases.
