Anti-cardiolipin antibodies (ACA) are antibodies often directed against
cardiolipin
Cardiolipin (IUPAC name 1,3-bis(''sn''-3’-phosphatidyl)-''sn''-glycerol) is an important component of the inner mitochondrial membrane, where it constitutes about 20% of the total lipid composition. It can also be found in the membranes of most ...
and found in several diseases, including
syphilis
Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
,
antiphospholipid syndrome
Antiphospholipid syndrome, or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by antiphospholipid antibodies. APS provokes blood clots (thrombosis) in both arteries and veins as well as pregnancy- ...
,
livedoid vasculitis
Livedoid vasculopathy is a chronic cutaneous disease seen predominantly in young to middle-aged women. One acronym used to describe its features is "Painful purpuric ulcers with reticular pattern of the lower extremities" (PURPLE).
It can be div ...
,
vertebrobasilar insufficiency
Vertebrobasilar insufficiency (VBI) describes a temporary set of symptoms due to decreased blood flow (ischemia) in the posterior circulation of the brain. The posterior circulation supplies the medulla, pons, midbrain, cerebellum and (in 70-80 ...
,
Behçet's syndrome,
idiopathic spontaneous abortion,
and
systemic lupus erythematosus
Lupus, technically known as systemic lupus erythematosus (SLE), is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary among people and may be mild to severe. Comm ...
(SLE).
They are a form of
anti-mitochondrial antibody Anti-mitochondrial antibodies (AMA) are autoantibodies, consisting of immunoglobulins formed against mitochondria, primarily the mitochondria in cells of the liver.
The presence of AMA in the blood or serum of a person may be indicative of the pr ...
. In SLE, anti-DNA antibodies and anti-cardiolipin antibodies may be present individually or together; the two types of antibodies act independently.
This is in contrast to rheumatoid arthritis
with systemic sclerosis (
scleroderma
Scleroderma is a group of autoimmune diseases that may result in changes to the skin, blood vessels, muscles, and internal organs. The disease can be either localized to the skin or involve other organs, as well. Symptoms may include areas of ...
)
because anti-cardiolipin antibodies are present in both conditions, and therefore may tie the two conditions together.
Anti-cardiolipin antibodies can be classified in two ways:
* As IgM, IgG or IgA
* As β
2-glycoprotein dependent or independent
** In autoimmune disease, ACA are beta-2 glycoprotein dependent
** In
syphilis
Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
, ACA
are beta-2 glycoprotein independent and can be assayed using the
Venereal Disease Research Laboratory test
The Venereal Disease Research Laboratory test (VDRL) is a blood test for syphilis and related non-venereal treponematoses that was developed by the eponymous lab. The VDRL test is used to screen for syphilis (it has high sensitivity), whereas othe ...
Apolipoprotein H involvement
β
2-glycoprotein I has been identified as
Apolipoprotein H
β2-glycoprotein 1, also known as beta-2 glycoprotein 1 and Apolipoprotein H (Apo-H), is a 38 kDa multifunctional plasma protein that in humans is encoded by the ''APOH'' gene. One of its functions is to bind cardiolipin. When bound, the structur ...
and is required for the recognition of ACA in autoimmune disease.
Only a subset of autoimmune anti-cardiolipin antibodies bind Apo-H, these
anti-apolipoprotein antibodies
In autoimmune disease, anti-apolipoprotein H (AAHA) antibodies, also called anti-β2 glycoprotein I antibodies, comprise a subset of anti-cardiolipin antibodies and lupus anticoagulant. These antibodies are involved in sclerosis and are strongly ...
are associated with increased thrombosis.
References
{{Autoantibodies
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