尿検査・腎機能検査の新しい流れ(5)

抗リン脂質抗体検査と関連疾患

野　島　順　三*
　　　　　　　　　　　　　　　　　　　　　　
Association between Anti-phospholipid Antibodies and
Thrombotic Complications in Systemic Lupus Erythematosus

Junzo NOJIMA, PhD*

A number of previous studies have shown that anti-phospholipid(aPL) antibodies(Abs) do not bind primarily to the negatively-charged phospholipid itself but rather to complexes of the phospholipid and plasma proteins, and that the most common antigenic targets are β₂-glycoprotein I recognized by anticardiolipin Abs and prothrombin recognized by most lupus anticoagulants. However, resent studies suggest that other phospholipid-binding proteins, particularly protein C, protein S, and annexin V, may be important targets as well. To clarify the association between the various types of aPL Abs and thrombotic complications in patients with systemic lupus erythematosus(SLE), we examined the prevalence of aPL Abs to various phospholipid-binding proteins(β₂-glycoprotein I, prothrombin, protein C, protein S, and annexin V). We found that anti-β₂-glycoprotein I Abs may be associated primarily with cerebral infarction and femoral artery thrombosis, and that anti-protein S Abs may be associated primarily with venous thromboembolism and renal thrombotic microangiopathy. Furthermore, anti-annexin V Abs might be closely related to fetal loss. These findings suggest that thrombotic complications in SLE depend on the antigenic specificities of aPL Abs, alone or in combination.
[Rinsho Byori 51 : 239〜247, 2003]

*Laboratory for Clinical Investigation, Osaka University Hospital, Suita 565-0871

【Key Words】antiphospholipid syndrome(抗リン脂質抗体症候群)，systemic lupus erythematosus(全身性エリテマトーデス)，β₂-glycoprotein I(β₂-グリコプロテイン I)，protein S(プロテインS)，annexin V(アネキシン�X)

*大阪大学大学院医学系研究科生体・病態情報学，同　医学部附属病院臨床検査部(〒565-0871 吹田市山田丘2-15)

E-mail :nojima@hp-lab.med.osaka-u.ac.jp