- Volume 58 , Number 4
- Page: 723–4
Anti-cardiolipin antibodies in Mexican lepromatous leprosy patients
To The Editor:
Anti-phospholipid antibodies, especially anti-cardiolipin antibodies (ACA), have received careful attention mainly due to their presence in some infectious and autoimmune disorders where they have been associated with several clinical features (3,4). Such antibodies are also related to the biological false-positive reactions of syphilis, as can be demonstrated with non-treponemal tests such as the VDRL (Venereal Disease Research Laboratory) test (2). In leprosy patients, both ACA (6) and VDRLpositive reactions (1) are commonly present with no completely documented significance in the pathogenesis of the disease.
In a preliminary investigation looking for the relationship between ACA, VDRL antibodies and leprosy, sera from 56 lepromatous leprosy (LL) patients of Mexican Mestizo ethnic background, 18 of them undergoing erythema nodosum leprosum (ENL), were studied. The clinical and histopathological diagnosis and classification of the cases were made by experienced staff. All sera were assayed for VDRL antibodies by the standard slide flocculation method, and for IgM, IgG and IgA ACA, with the ELISA procedure proposed by Loizou, et al. (5) with slight modifications. The results were compared with those found in sera from 35 VDRL-and ACA-negative healthy individuals from a nonendemic area. In the ACA tests, positive values were defined as an optical absorbance (OA) > 5 standard deviations above the mean control value of the corresponding IgM, IgG or IgA determinations. This criterion was adopted because it assures the total exclusion of doubtful or false-positive results in the test.
The results obtained in the ACA determinations are presented in The Table. No differences were found in antibody levels in the presence or absence of ENL, and IgM antibodies were in a higher proportion than IgG or IgA. Regarding the VDRL antibodies, 44.4% of all LL cases had positive reactions without any correlation with either ENL reaction or the results in ACA evaluation.
The results are in agreement with other similar data for leprosy (6) in spite of differences in the method employed for the ACA determination. The analysis of the clinical records of our ACA-positiv'e patients does not show the presence of any pathological feature already associated with the anti-phospholipid syndrome. Prospective clinical and immunological studies of these patients looking for specific signs and symptoms of the syndrome are now in progress.
- Alejandro Escobar-Gutiérrez, Ph.D.
M. Eugenia Amezcua-Chavarria, M.Sc.
Sergio Pastén, Biol.
Departmento de Investigaciones Inmunológicas
Instituto Nacional de Diagnóstico y Referencia Epidemiológicos, SSA
Carpio 470
México, D.F. 11340, México
- Eduardo Castro, M.D.
Octavio Flores, M.D.
Obdulia Rodríguez, M.D.
Centro Dermatológico Dr. Pascua, SSA
Av. Central 100
México, D.F. 06780, México
REFERENCES
1. ALMEIDA, J. O. Serology in leprosy. Bull. WHO 42(1970)673-702.
2. COLACO, C. B. and MALE, D. K. Anti-phospholipid antibodies in syphilis and a thrombotic subset of SLE: distinct profiles of epitope specificity. Clin. Exp. Immunol. 59(1985)449-456.
3. HARRIS, E. N., ASHERSON, R. A. and HUGHES, G. R. Antiphospholipid antibodies-autoantibodies with a difference. Ann. Rev. Med. 39(1988)261-271.
4. HUGHES, G. R. V., HARRIS, E. N. and GHARAVI, A. E. The anticardiolipin syndrome. J. Rheumatol. 13(1986)486-489.
5. Loizou, S., MCCREA, J. D., RUDGE, A. C, REYNOLDS, R., BOYLE, C. C. and HARRIS, E. N. Measurement of anti-cardiolipin antibodies by an enzyme-linked immunosorbent assay (ELISA): standardization and quantitation of results. Clin. Exp. Immunol. 62(1985)738-745.
6. QUISMORIO, F. P. and REA, T. H. Serum antiphospholipid antibodies in leprosy. (Abstract) Int. J. Lepr. 56(1988)682.