Utilization of Dilute Russell’s Viper Venom Time to Detect Autoantibodies against β2-Glycoprotein I which Express Anticoagulant Activity in the Presence but not in the Absence of Exogenous Phospholipids

V Pengo; G Balestrieri; A Tincani; L Spatola; A Biasiolo; T Brocco

doi:10.1055/s-0038-1655918

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1997; 77(01): 123-126
DOI: 10.1055/s-0038-1655918

Coagulation

Schattauer GmbH Stuttgart

Utilization of Dilute Russell’s Viper Venom Time to Detect Autoantibodies against β₂-Glycoprotein I which Express Anticoagulant Activity in the Presence but not in the Absence of Exogenous Phospholipids

Authors

V Pengo

The Department of Clinical and Experimental Medicine, Thrombosis Center, University of Padova, Italy
G Balestrieri

¹The Unit of Clinical Immunology, Brescia Hospital, Italy
A Tincani

¹The Unit of Clinical Immunology, Brescia Hospital, Italy
L Spatola

¹The Unit of Clinical Immunology, Brescia Hospital, Italy
A Biasiolo

The Department of Clinical and Experimental Medicine, Thrombosis Center, University of Padova, Italy
T Brocco

The Department of Clinical and Experimental Medicine, Thrombosis Center, University of Padova, Italy

Abstract

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Summary

Lupus anticoagulant (LA) is a general term to define immunoglobulins interfering with phospholipid-dependent coagulation tests. It is now clear that the phospholipid-dependence of some LA is related to the presence of the phospholipid-binding plasma protein β2-glycoprotein I β2-GPI) and that autoantibodies to β2-GPI might represent a specific category of LA. To verify this hypothesis we have purified IgG autoantibodies to β2-GPI from plasma of 6 patients with antiphospholipid antibody syndrome, by means of agarose-immobilized human β2-GPI. All 6 preparations tested positive in anti-β2-GPI IgG antibody ELISA and showed a marked LA activity by prolonging dilute Russell Viper Venom Time (dRVVT) from a minimum of 5.3 s in patient # 1 to a maximum of 41.1 s in patient # 3. These IgG preparations behaved as typical LA, with this activity tending to disappear in the presence of increasing phospholipid (PL) concentrations. Moreover, the LA activity of the IgG preparations was not detectable in the absence of PL, in which case the ratio between dRVVT obtained in the presence and absence of IgG autoantibodies to β2-GPI was close to 1. This pattern was confirmed by using plasma from patients with antiphospholipid antibody syndrome testing positive for anti-β2-GPI IgG antibodies. These findings suggest that dRVVT performed both in the presence and absence of PL might constitute a sensitive screening test to detect specific antibodies with LA activity.

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References

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