TY - CHAP
T1 - Chapter 3 Laboratory Heterogeneity of Antiphospholipid Antibodies
AU - Pierangeli, Silvia S.
AU - Rand, Jacob H.
N1 - Funding Information:
We are thankful to Dr Tri Te and to Alvaro Schleh for helping in the preparation of this manuscript and the assistance of medical student Ethan Rand and Dr. Lisa Senzel in the design of Figures 1 and 2. Dr Rand's studies were partially funded by a grant from the National Institutes of Health (HL-61331).
PY - 2009
Y1 - 2009
N2 - The anticardiolipin (aCL) test has been widely utilized by physicians since the mid-1980s for diagnosing patients with the antiphospholipid syndrome (APS). Establishment of this diagnosis has improved the management of patients with recurrent thrombosis and recurrent pregnancy losses. The test was first established in 1983 as a radioimmunoassay and soon thereafter converted into an enzyme-linked immunosorbent assay (ELISA). The other test commonly used in the diagnosis of APS is the lupus anticoagulant test (LAC). The aCL ELISA is sensitive for the diagnosis of APS but lacks specificity. On the other hand, the LAC assay, although more specific is not as sensitive as the aCL ELISA. More specific tests are now available such as the anti-β2 glycoprotein I (anti-β2GPI) assay, the antiprothrombin (anti-PT) assay and other ELISAs that utilize negatively charged phospholipids other than cardiolipin to coat the plates. In the past 25 years, there have been numerous efforts to standardize aCL, LAC, and anti-β2GPI tests. However, there are still reports of significant intra- and inter-laboratory variation in results for all three assays. This chapter discusses in detail the clinical utilities of these tests, technical problems associated with their use, the current laboratory classification criteria for diagnosis of APS, and possible new and better assays that may be available in the near future for diagnosis of APS.
AB - The anticardiolipin (aCL) test has been widely utilized by physicians since the mid-1980s for diagnosing patients with the antiphospholipid syndrome (APS). Establishment of this diagnosis has improved the management of patients with recurrent thrombosis and recurrent pregnancy losses. The test was first established in 1983 as a radioimmunoassay and soon thereafter converted into an enzyme-linked immunosorbent assay (ELISA). The other test commonly used in the diagnosis of APS is the lupus anticoagulant test (LAC). The aCL ELISA is sensitive for the diagnosis of APS but lacks specificity. On the other hand, the LAC assay, although more specific is not as sensitive as the aCL ELISA. More specific tests are now available such as the anti-β2 glycoprotein I (anti-β2GPI) assay, the antiprothrombin (anti-PT) assay and other ELISAs that utilize negatively charged phospholipids other than cardiolipin to coat the plates. In the past 25 years, there have been numerous efforts to standardize aCL, LAC, and anti-β2GPI tests. However, there are still reports of significant intra- and inter-laboratory variation in results for all three assays. This chapter discusses in detail the clinical utilities of these tests, technical problems associated with their use, the current laboratory classification criteria for diagnosis of APS, and possible new and better assays that may be available in the near future for diagnosis of APS.
KW - anticardiolipin antibodies
KW - antiphospholipid antibodies
KW - antiphospholipid syndrome
KW - lupus anticoagulant
UR - http://www.scopus.com/inward/record.url?scp=67649965216&partnerID=8YFLogxK
U2 - 10.1016/S1571-5078(08)00403-0
DO - 10.1016/S1571-5078(08)00403-0
M3 - Chapter
AN - SCOPUS:67649965216
SN - 9780444531698
T3 - Handbook of Systemic Autoimmune Diseases
SP - 35
EP - 53
BT - Antiphospholipid Syndrome in Systemic Autoimmune Diseases
A2 - Cervera, Ricard
A2 - Reverter, Joan Carles
A2 - Khamashta, Munther
ER -