Strong correlation between the prevalence of cerebral infarction and the presence of anti-cardiolipin/beta2-glycoprotein I and anti-phosphatidylserine/prothrombin antibodies--Co-existence of these antibodies enhances ADP-induced platelet activation in vitro

Thromb Haemost. 2004 May;91(5):967-76. doi: 10.1160/TH03-10-0608.


Cerebral infarction is the most common arterial thromboembolic complication in the anti-phospholipid antibodies (aPL) syndrome. In an effort to clarify the roles of aPL in the pathogenesis of cerebral infarction in patients with SLE, we examined the levels of anti-cardiolipin/2-glycoprotein I antibodies (anti-CL/beta2-GPI) and anti-phosphatidylserine/prothrombin anti-bodies (anti-PS/PT) in addition to lupus anticoagulant (LA) activity in 126 patients with SLE (35 with cerebral infarction and 91 without thrombosis). Both anti-CL/beta2-GPI and anti-PS/PT strongly correlated with the presence of LA activity. The prevalence of cerebral infarction was obviously higher in the patients who had both anti-CL/beta2-GPI and anti-PS/PT (76.5% [26/34 cases], p<0.0001) than in the other patients having anti-CL/beta2-GPI or anti-PS/PT alone or neither of them (9.8% [9/92 cases]). Furthermore, we studied the in vitro effects of anti-CL/beta2-GPI and/or anti-PS/PT on the enhancement of platelet activation induced by stimulation with a low concentration of adenosine diphosphate (ADP). The purified IgG containing both anti-CL/beta2-GPI and anti-PS/PT caused significant enhancement of platelet activation caused by ADP. However, the purified IgG containing either anti-CL/beta2-GPI or anti-PS/PT had no enhancing effects on it. Furthermore, platelet activation was generated by the mixture of anti-CL/beta2-GPI-IgG and anti-PS/PT-IgG prepared from individual patients, but not by each fraction alone. These results indicate that anti-CL/beta2-GPI and anti-PS/PT may cooperate to promote platelet activation, which may contribute to the risk of cerebral infarction in patients with SLE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Anticardiolipin / blood
  • Antibodies, Antiphospholipid / blood*
  • Autoantibodies / blood
  • Case-Control Studies
  • Cerebral Infarction / blood
  • Cerebral Infarction / etiology*
  • Cerebral Infarction / immunology
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Glycoproteins / immunology
  • Glycoproteins / metabolism
  • Humans
  • Logistic Models
  • Lupus Coagulation Inhibitor / blood
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / complications*
  • Male
  • Middle Aged
  • Phosphatidylserines / immunology
  • Phosphatidylserines / metabolism
  • Platelet Activation / immunology
  • Prevalence
  • Prothrombin / immunology
  • Prothrombin / metabolism
  • beta 2-Glycoprotein I


  • Antibodies, Anticardiolipin
  • Antibodies, Antiphospholipid
  • Autoantibodies
  • Glycoproteins
  • Lupus Coagulation Inhibitor
  • Phosphatidylserines
  • beta 2-Glycoprotein I
  • Prothrombin