Scand. J. Imnnmol. 36, 647 652. 1992
EDITORIAL
Antiphospholipid Antibodies—New Insights into their Specificity and Clinical Importance
Anliphosphoiipid (aPL) antibodies* are auloantibodJcs which have been rcporlcd lo be associated with serious clinical manifcstalions such as vascular ihrombosis [1.2]. These events arc especially common in systemic lupus erythematosus (SLE). occurring in about one-quarter of cases overall [3]. aPL antibodies can be detected in solid phase immunoassays. or by the presence of false positive syphilis serology [4], or by the observation of a particular lypc of inhibition of in vitro clotting due to a factor termed the lupus anticoagulant (LA) [5], now known to be an aPL antibody. The simplicity of the solid phase anticardiolipin (aCL) immunoassay has resulted in a vast literature of epidemiological studies examining the prevalence of aCL antibodies* in a range of populations (reviewed in Refs 3 and 6). Despite this effort, there has been uncertainty regarding the clinical importance of aPL antibodies, particularly in individual patients. Although variability in the sensitivity and specificity of aPL assays has been an important contributing factor, a major problem has been lack of information about the specificity of aPL antibodies, and a lack of appreciation of the heterogeneity of this group of immunoglobulins. aPL antibodies have been most extensively studied in groups of patients with SLE where the published literature indicates LA and aCL antibodies are present in 3I-34'M, and40-44"
EDITORIAL
Antiphospholipid Antibodies—New Insights into their Specificity and Clinical Importance
Anliphosphoiipid (aPL) antibodies* are auloantibodJcs which have been rcporlcd lo be associated with serious clinical manifcstalions such as vascular ihrombosis [1.2]. These events arc especially common in systemic lupus erythematosus (SLE). occurring in about one-quarter of cases overall [3]. aPL antibodies can be detected in solid phase immunoassays. or by the presence of false positive syphilis serology [4], or by the observation of a particular lypc of inhibition of in vitro clotting due to a factor termed the lupus anticoagulant (LA) [5], now known to be an aPL antibody. The simplicity of the solid phase anticardiolipin (aCL) immunoassay has resulted in a vast literature of epidemiological studies examining the prevalence of aCL antibodies* in a range of populations (reviewed in Refs 3 and 6). Despite this effort, there has been uncertainty regarding the clinical importance of aPL antibodies, particularly in individual patients. Although variability in the sensitivity and specificity of aPL assays has been an important contributing factor, a major problem has been lack of information about the specificity of aPL antibodies, and a lack of appreciation of the heterogeneity of this group of immunoglobulins. aPL antibodies have been most extensively studied in groups of patients with SLE where the published literature indicates LA and aCL antibodies are present in 3I-34'M, and40-44"
