Antiphospholipid antibodies are used to recognize certain proteins that are produced by the body against itself as a result of autoimmune reactions. They are associated with thrombocytopenia (a reduced platelet count in the blood), as well as with the threat of miscarriage, preeclampsia (the appearance of late toxicosis in pregnant women), and premature birth. Against the background of an increase in the content of these antibodies, the risks of blood clot formation increase, which can lead in the future to such dangerous pathologies as stroke and heart attack.
Description of the concept
Antiphospholipid antibodies have a multifaceted effect on the hemostatic system with damage to all its protective links: the endothelial barrier, the function of natural anticoagulants and endogenous fibrinolysis. They activate the platelet link of hemostasis along with the procoagulant factor.
The combination of the prothrombotic and non-thrombotic effect, including the activation of the inflammatory local response, along with the effect on the trophoblast and the characteristics of the embryo, lead to the development of the clinical picture and to a whole spectrum of various thrombotic complications. They occur in venous and arterial vessels, as well as in the microcirculation system by the nature of angiopathy. They can lead to reproductive losses in the form of gestosis and preeclampsia, as well as to placental insufficiency and fetal growth retardation.
Types of Antibody Data
They are divided into three classes, namely: antiphospholipid antibodies IgM, IgG and IgA. They are directed against the phospholipid structure of body cells and blood plasma proteins. Under their influence, the blood coagulation process is disrupted, which ultimately leads to thrombosis. Studies on the amount of antiphospholipid antibodies are performed in the presence of repeated miscarriages in the second and third trimester of pregnancy, as well as in the case of gestosis or premature birth. Only a few types of such antibodies are distinguished:
- Lupus anticoagulants.
- Anticardiolipin antibodies.
- β2-glycoproteins.
- Antibodies phosphatidylserine.
Lupus and anticardiolipin antibodies are often found. All except lupus anticoagulants are detected directly in blood samples.
The essence of the analysis
Analysis for antiphospholipid antibodies is required to identify a specific protein that the body forms against itself as a result of autoimmune reactions. In turn, phospholipids are an integral part of body cells. These elements enter directly into the cellular composition of membranes and platelets. They, in fact, are molecules of fat, which plays a key role in blood coagulation, however, the mechanism of their effect remains unclear to date. Antiphospholipids increase the risk of blood clotting disorders and blood clots in the veins and arteries, which can lead to strokes and heart attacks.
The presence of antiphospholipid antibodies is also associated with the occurrence of thrombocytopenia (a decrease in the blood platelet count), with the risks of repeated miscarriages (especially in the last third of pregnancy), as well as with toxicosis in the last stage of pregnancy and premature birth.
The presence of these antibodies is part of a symptomatic complex called antiphospholipid syndrome or Stovin’s disease. It also includes thrombosis along with obstetric pathologies (miscarriages, habitual miscarriage) and thrombocytopenia. This syndrome can be directly associated with other autoimmune diseases, especially with systemic lupus erythematosus, or develops without concomitant diseases (then they speak of primary antiphospholipid syndrome).
True, antibodies often appear in the human body and with an autoimmune disorder such as lupus erythematosus, in addition, they can be observed in the presence of HIV infection in humans, some forms of cancer, the use of certain medications, for example, phenothiazines and procainamide. In connection with all this, the definition of anticardiolipin antibodies is an additional analysis and their presence alone is not considered a diagnostic direct criterion for antiphospholipid syndrome. It is worth noting that the tests, exactly, as well as the diagnosis of this syndrome as a whole should be comprehensive, including several specific clinical indicators at once.
Submission of analysis: what is such a study used for and when is it prescribed
Analysis for antiphospholipid antibodies is carried out in order to determine the cause of thrombotic microangiopathy, as well as in a number of the following cases:
- To establish the causes of repeated fetal loss in late pregnancy.
- To find out the causes of thrombocytopenia.
- In order to determine the long formation time of thromboplastin.
When is such a study prescribed? The doctor may recommend it in the following cases:
- In case of suspicion of a person developing antiphospholipid syndrome (this study is conducted several times over six weeks).
- Against the background of repeated miscarriages as an addition to the test for the period of thromboplastin formation.
- Against the background of a repeated episode of thrombosis in a patient at a young age.
- When a person develops thrombocytopenia.
- Against the background of symptoms of thrombotic microangiopathy (with swelling of the extremities, shortness of breath and persistent headaches).
What is the norm of antiphospholipid antibodies?
Decryption: what the results mean
As part of the decoding, reference values are from 0 to 10 units per milliliter. A negative result is the lack of specific antibodies to IgM phospholipids. In the event that a low or moderate antibody content is detected during the study, this indicates the following:
- The presence of an infection in the body.
- Patient's use of certain medications.
When the concentration of antiphospholipid antibodies is noted above average values, which remains even within the framework of a repeated analysis after eight weeks, this indicates the following:
- The presence of a high risk of thrombosis in humans.
- During pregnancy, a similar situation reports a high risk of complications of gestation (in this case, monitoring of hemostatic system indicators is necessary).
- In the presence of certain clinical symptoms, we can talk about antiphospholipid syndrome.
In the case of examination for the presence of such antibodies and the diagnosis of a person there is an increased risk of thrombotic relapse angiopathy, repeated miscarriages and thrombocytopenia. True, the indicators of these analyzes cannot accurately predict the likelihood of complications and the type of severity of the disease in a particular patient.
It is worth noting that some patients may be subject to various forms of relapse, while others do not experience any complications. An example of this is asymptomatic patients who are diagnosed with the presence of antiphospholipid antibodies, after diagnosing a prolonged period of thromboplastin formation that occurs for another reason, for example, during a medical examination before surgery. As an example, asymptomatic elderly patients are also worth mentioning.
Lupus type - what does it mean?
This is a study of antibodies that are produced by the immune system against their phospholipids, which play a large role in the formation of blood clots.
How to prepare for blood donation for antiphospholipid antibodies of lupus type? First of all, you can’t eat food for three hours before the procedure, but you can drink non-carbonated clean water. Also stop taking "Heparin", as well as its analogues five days before the study. Exclude the same emotional and physical strain. In addition, you must not smoke thirty minutes before analysis. Why is a lupus-type antiphospholipid antibody test used? It is used in the following cases:
- To find out the causes of thrombosis.
- In order to establish the cause of abortion.
- To find out if an increase in these antibodies is caused by a lupus anticoagulant or other specific inhibitor.
- In order to diagnose antiphospholipid syndrome (in combination with a test for the establishment of anticardiolipin antibodies).
- In order to confirm the presence of lupus anticoagulant.
- In case of thrombosis.
- Against the background of the identification of a prolonged lupus anticoagulant (in cases of positive results, tests are usually repeated after several weeks in order to confirm the presence of lupus anticoagulant).
- When patients find anticardiolipin antibodies.
Antiphospholipid Antibody Syndrome
This disease is an autoimmune pathology that includes thrombosis, and in the presence of pregnancy causes fetal death. This syndrome can be caused by different antibodies, the effect of which is directed against several phospholipid binding proteins. They usually bind to the phospholipid component of the membrane, protecting it from excessive activation of coagulation.
Protective proteins are displaced by autoimmune antibodies, and thus, procoagulant surfaces of endothelial cells are produced, which in turn causes venous or arterial thrombosis. Coagulation tests can be prolonged due to the fact that phospholipid antibodies simply interfere with the accumulation of the coagulation factor and the activation process of these elements added to the plasma.
Lupus anticoagulant is an antiphospholipid antibody that binds to a protein complex. Initially, this syndrome was recognized in patients with lupus erythematosus. But such patients currently make up the smallest proportion of patients with autoimmune antibodies.
Diagnosis of this dangerous syndrome
Diagnosis consists of various laboratory tests, starting with the establishment of a partial thromboplastin time (i.e., analysis for PTT). This blood test for antiphospholipid antibodies is performed in patients who are expected to perform invasive procedures. It is also prescribed in the following cases:
- Patients with bleeding or the presence of increased coagulability of unknown etiology.
- Patients taking certain medications designed to thin the blood.
The presence of lupus anticoagulant is suspected if the FTV index is prolonged and is not corrected immediately after mixing with plasma in a ratio of one to one, but returns to normal if excess phospholipids are added (analysis is performed within the framework of clinical research laboratories). Next, the number of antibodies in the patient’s blood plasma is measured directly by detecting antibodies to IgM phospholipids, as well as IgG, which bind to glycoprotein on a microtiter plate.
What is the treatment for this syndrome?
For treatment, as a rule, anticoagulant therapy is performed. For prophylaxis and therapy, such drugs as Heparin along with Warfarin and Aspirin are used. It is not known whether the use of newer anticoagulants with which thrombin is inhibited is possible for the treatment of this disease.
The prognosis for this dangerous pathology is ambiguous. The success of treatment depends on many factors. First of all, it is important to donate blood for examination in order to determine the level of antibodies. Only on the basis of the results and clinical manifestations, proper treatment by a rheumatologist can be prescribed. But it should be borne in mind that many specialists will need to be consulted in connection with the fact that this disease affects many organs.
In no case should you self-medicate, as this is fraught with serious health consequences.
Antisperm antiphospholipid antibodies and their norm
Antisperm antibodies are elements for sperm membrane antigens. For the first time they were in the serum of men who were infertile, described by Wilson in 1954. Substances are usually found in blood, seminal plasma, cervical mucus, and, in addition, on the surface of sperm. Most often these are antiphospholipid antibodies IgG or IgM.
Normally, sperm antibodies in healthy men are detected in an amount of one to ten percent. In infertile men, they are kept in the amount of twenty percent.
Antibodies in men
Antisperm antibodies can appear at the stage of spermatocytes of the first order, while the level of their expression increases with development. These antibodies are distinguished by the property of autoantigenicity, that is, they are immunologically alien in their own body. Among healthy men, spermatozoa that are in the epididymis may undergo phagocytosis if ejaculation does not occur. True, this is not associated with the formation of antisperm antibodies, which is probably due to the following:
- The presence of immunological tolerance caused by sperm resorption processes.
- Blockade of the formation of antisperm antibodies by other antibodies.
- An individual feature of antibody formation.
The formation of antisperm antibodies in various departments of the reproductive male system is hindered by certain mechanisms. So, in the testicles, protection is carried out by a hematotesticular barrier that isolates spermatogenesis cells from immunocompetent elements of the body. The basis of this barrier is made up of special Sertoli cells with their processes.
After the release of sperm from the testicle, another defense mechanism works, consisting in their ability to adapt to the environment. This ability is much more pronounced in viable sperm. In addition, there are local regulatory factors in the sperm plasma that prevent the formation of antisperm antibodies and the formation of cellular antisperm sensitization (for example, immunosuppressive sperm plasma factor). Such factors are secreted in the adnexa of the reproductive male system.
As manifested in women
The genitals of a woman contain a large number of all kinds of immunocompetent cells. Natural sperm in the genital can cause an immune response. True, the immunological process that occurs in the female body immediately after sperm has not yet been studied. The formation of antibodies in the female body, as a rule, is hindered by various mechanisms that reduce the immune response.
With ovulation, the balance of T-lymphocytes changes. For example, the level of T-helpers decreases, and T-suppressors increase. In addition, the total concentration of immunoglobulins and C3 element of the complement system decreases. An important role in lowering the immune response to spermatozoa, as a rule, is played by the male defense mechanism in the form of sorption and desorption of surface antigens upon changing media, and, in addition, immunosuppressive factors of sperm plasma.
In addition, it is assumed that only a small number of genetically selected spermatozoa that immunologically differ from the majority fall into the fallopian tube, and the rest, in turn, die and block local immunity.
Thus, antiphospholipid antibodies have a multifaceted effect on the hemostatic system, any of its protective links in the form of the endothelial barrier, the functions of natural anticoagulants, endogenous fibrinolysis are damaged. In addition, the platelet link of hemostasis with procoagulant factors is activated.
Where is this study conducted?
A study on antiphospholipid antibodies in the "Hemotest" is quite possible to pass.
This medical laboratory is a modern high-tech complex that performs tens of thousands of medical tests every day for all Russian patients.
«» 3 000-3 500 .
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