Background A prominent place among rheumatic diseases takes systemic lupus erythematosus (SLE). The most common cause of mortality and the development of permanent disability in this pathology are Lupus-nephritis and Lupus-CNS. The cause of the processes development is tissue damage by circulating antibodies and immune complexes of various specificity. Thus, antibodies to cardiolipin cause a subtype of systemic lupus development with antiphospholipid syndrome (APS), which often can not suppress the disease activity by means of conventional basic therapy.
Objectives To create a stable and hemocompatible immobilized granular antigenic drugs (IGAD) to remove antibodies to cardiolipin in APS in SLE patients.
Methods 63 SLE patients of 16 to 64 years old that meet the criteria of the American Rheumatic Association were examined due to the criteria of phospholipid syndrome according to Hughes G.R.V. and Harris E.N. 1986. .To determine the level of anticardiolipin antibodies (ACA) an indirect enzyme-linked immunosorbent method was applied. Magnosorbent was gained by spatially oriented antigen fixation, its stabilization in a carrier taking into account hydrophobic and hydrophilic properties of cardiolipin molecule . Immunoadsorption was performed under in vitro. 20 ml of patient blood containing anticardiolipin, were perfused with a peristaltic micropump (manufactured by LKB, Sweden) at rate of 25ml/hr through a glass column containing 1ml of hemosorbent (IGAD). The ACA level was measured before and after sorption.
Results The values of anticardiolipin extinction in healthy individuals was 0.068±0.002. In ACA level analysis, its significant increase was identified (p<0.001) compared with controls (35 healthy individuals), in 49.2% SLE patients who amounted to patient group 1 (n=31), whereas 50.8% (n=32) belonging to patient group 2 was low and did not differ from the control group significantly. A significant difference between the 1st and 2nd groups was observed in patients with obstetric pathology, venous thrombosis, thrombocytopenia. Extremely high ACA level was observed in patient group 1, five of them had transient ischemic attack, two of them suffered from Sneddon's syndrome and one patient had an acute myocardial infarction. Generally, ACA level was high in 18 patients (28.6%), in 8 patients moderately increased (12.7%) and 5 patients (7.9%) it was slightly higher compared to the control group. In conducting ACA absorption procedure in vitro, their decrease was observed in all cases using the developed magnosorbent (the ACA level before and after sorption was 0.386±0.023 and 0.080±0.009, p<0.001).
Conclusions Thus, the proposed immunoadsorption method can be used in complex pathogenetic APS treatment in SLE patients.
Ames PRJ, Hughes GRV. Antiphospholipid Antibody Syndrome: Clinical and Therapeutic Aspects. Rheum in Europe 1995; 2: 289-90.
Hughes GRV, Harris EN, Gharavi AE. The Anticardiolipin Syndrome. J Rheumatology 1986; 13: 486-9.
Gontar IP, Emelyanova OI, Paramonova OV, Krasilnikov AN, Trubenko YuA. Production of Stable Immobilized Cardiolipin Compound: An Approach to Industrial Synthesis of Antigenic Nanostructures. Sovr Probl Nauki Obr 2014; 6. URL http://www.science-education.ru/120-16185: (in Russian)
Disclosure of Interest None declared
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