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Thromb Haemost 1999; 81(03): 436-441
DOI: 10.1055/s-0037-1614491
Review Article
Schattauer GmbH

Platelet Activation Induced by Combined Effects of Anticardiolipin and Lupus Anticoagulant IgG Antibodies in Patients with Systemic Lupus Erythematosus

Possible Association with Thrombotic and Thrombocytopenic Complications
Junzo Nojima
1   From the Central Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
,
Etsuji Suehisa
1   From the Central Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
,
Hirohiko Kuratsune
2   Department of Hematology and Oncology, Osaka University Medical School, Osaka, Japan
,
Takashi Machii
2   Department of Hematology and Oncology, Osaka University Medical School, Osaka, Japan
,
Takao Koike
3   Second Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan
,
Teruo Kitani
4   Sakai Municipal Hospital, Osaka, Japan
,
Yuzuru Kanakura
2   Department of Hematology and Oncology, Osaka University Medical School, Osaka, Japan
,
Nobuyuki Amino
5   Department of Laboratory Medicine, Osaka University Medical School, Osaka, Japan
› Author Affiliations
Further Information

Publication History

Received31 July 1998

Accepted after resubmission08 December 1998

Publication Date:
09 December 2017 (online)

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Summary

Antiphospholipid antibodies (aPL) are well known to be associated with arterial and venous thrombosis. In a series of 180 patients with systemic lupus erythematosus (SLE), the prevalence of arterial thrombosis was obviously higher in the patients who had both anticardiolipin antibodies (aCL) and lupus anticoagulant (LA) (17/35, 48.6%, p <0.05) (Table 1) than in the other patients bearing aCL or LA alone or neither of them (2/145, 1.4%). Since a substantial fraction of the former group of patients with arterial thrombosis also had thrombocytopenia (12/17, 70.6%), there was a possibility that aCL and LA might have enhanced platelet activation and aggregation. To test this possibility, we studied the in vitro effects of aCL and LA on the enhancement of platelet activation by flow cytometric analysis using anti-CD62P and anti-CD41 monoclonal antibodies directed against platelet activation-dependent granule-external membrane (PADGEM) protein and platelet glycoprotein IIb (GPIIb), respectively. Platelet activation defined by the surface expression of CD62P was not induced by aCL+·LA+ plasma only, but was significantly augmented by aCL+·LA+ plasma in combination with adenosine diphosphate (ADP) at a low concentration that had only a modest effect on platelet activation. In contrast, aCL+·LA–, aCL–·LA+ and aCL–·LA– plasma samples were incapable of enhancing platelet activation in the presence or absence of ADP stimulation. In addition to plasma samples, the purified IgG from aCL+·LA+ plasma (aCL+·LA+-IgG) also yielded apparent enhancement of platelet activation induced by ADP. Furthermore, platelet activation was generated by the mixture of aCL+·LA–-IgG and aCL–·LA+-IgG fractions prepared from individual patients, but not by each fraction alone. These results suggest that aCL and LA may cooperate to promote platelet activation, and may be involved, at least partially, in the pathogenesis of arterial thrombosis and thrombocytopenia in patients with SLE.

 

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