Antiphospholipid antibody test is 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 number of platelets in the blood), as well as with the threat of miscarriage, preeclampsia (the appearance of late toxicosis in pregnant women) and with premature birth. Against the background of an increase in the content of these antibodies, the risks of the formation of blood clots increase, which can later lead to such dangerous pathologies as stroke and heart attack.
Description of the concept
Antiphospholipid antibodies have a multifaceted effect on the hemostasis 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 procoagulantfactor.
The combination of prothrombotic and non-thrombotic effects, including the activation of the local inflammatory 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 range of various thrombotic complications. They occur in venous and arterial vessels, as well as in the microcirculation system by the nature of angiopathy. Can lead to reproductive losses in the form of preeclampsia and preeclampsia, as well as fetoplacental insufficiency and fetal growth retardation.
Types of these antibodies
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 process of blood clotting is disrupted, which ultimately leads to thrombosis. Studies on the amount of antiphospholipid antibodies are performed in the presence of recurrent miscarriages in the second and third trimester of pregnancy, as well as in the event of preeclampsia or the occurrence of premature birth. There are only a few types of these antibodies:
- Lupus anticoagulants.
- Anticardiolipin antibodies.
- β2-glycoproteins.
- Phosphatidylserine antibodies.
Lupus and anticardiolipin antibodies are common. All but lupus anticoagulants are found directly in blood samples.
The essence of the analysis
Antiphospholipid antibody test is required to detect a specific protein thatthe body forms against itself as a result of autoimmune reactions. In turn, phospholipids are an integral part of the cells of the body. These elements enter directly into the cellular composition of membranes and platelets. They are, in fact, fat molecules that play a key role in blood clotting, although the mechanism of their action remains unclear to date. Antiphospholipids increase the risk of impaired blood clotting and the formation of blood clots in veins and arteries, which can lead to strokes and heart attacks.
The presence of antiphospholipid antibodies is also associated with the occurrence of thrombocytopenia (low platelets in the blood), with the risk of recurrent miscarriages (especially in the last third of pregnancy), as well as with toxicosis in the last stage of pregnancy and with 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, recurrent miscarriage) and thrombocytopenia. This syndrome can be directly related to other autoimmune diseases, especially systemic lupus, or develop without concomitant diseases (then called primary antiphospholipid syndrome).
True, antibodies often appear in the human body and with such an autoimmune disorder as lupus erythematosus, in addition, they can be observed in a person with HIV infection, certain forms of cancer, the use of certaindrugs, for example, phenothiazines and novocainamide. In connection with all this, the determination of anticardiolipin antibodies is an additional analysis and, in itself, their presence is not considered a diagnostic direct criterion for antiphospholipid syndrome. It is worth noting that the tests, just like the diagnosis of this syndrome as a whole, should be complex, including several specific clinical indicators at once.
Surveying an analysis: what is such a study used for and when is it assigned
Antiphospholipid antibody test is done to determine the cause of thrombotic microangiopathy and in some of the following cases:
- To determine the causes of recurrent fetal losses in late pregnancy.
- To find out the causes of thrombocytopenia.
- To determine the long time of thromboplastin formation.
When is such a study ordered? A doctor may recommend it in a number of the following cases:
- If a person is suspected of developing antiphospholipid syndrome (this test is performed several times over a six-week period).
- After multiple miscarriages as an adjunct to the thromboplastin period test.
- After 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 limbs, shortness of breath and constant headaches).
What is the norm for antiphospholipid antibodies?
Transcript: what the results mean
As part of the decoding, reference values range from 0 to 10 units per milliliter. A negative result is the absence of specific antibodies to IgM phospholipids. In the event that during the study a low or moderate content of antibodies is detected, then this indicates the following:
- The presence of an infection in the body.
- Patient use of certain medications.
When there is an above-average antiphospholipid antibody concentration that persists even as part of a re-test after eight weeks, this indicates the following:
- A person is at high risk for thrombosis.
- During pregnancy, this situation indicates a high risk of pregnancy complications (in this case, it is necessary to monitor the indicators of the hemostasis system).
- In the presence of certain clinical symptoms, we can talk about antiphospholipid syndrome.
When tested for these antibodies and diagnosed, there is an increased risk of thrombotic recurrent angiopathy, recurrent miscarriages and thrombocytopenia. True, the indicators of these tests 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 susceptible to various forms of recurrence of the disease, while others do not experienceany complications. An example of this is in asymptomatic patients who are diagnosed with antiphospholipid antibodies after an extended period of thromboplastin formation from another cause, such as during a medical examination prior to surgery. Asymptomatic elderly patients should also be mentioned as an example.
Lupus type - what does it mean?
This is a study of antibodies that are produced by the immune system against its phospholipids, which play a large role in the formation of blood clots.
How to properly prepare for blood donation for lupus antiphospholipid antibodies? First of all, you can not eat for three hours before the procedure, but you can drink non-carbonated pure water. Also stop taking "Heparin", as well as its analogues five days before the study. Eliminate the same emotional and physical overstrain. Among other things, you can not smoke thirty minutes before the analysis. What is a lupus antiphospholipid antibody test used for? It is used in the following cases:
- To find out the causes of thrombosis.
- To determine the reason for the abortion.
- To find out if the increase in these antibodies is due to lupus anticoagulant or another specific inhibitor.
- For the purpose of diagnosing antiphospholipid syndrome (in combination with an anticardiolipin antibody test).
- To confirm the presence of lupus anticoagulant.
- Bthrombosis.
- Due to the presence of long-term lupus anticoagulant (in cases of positive results, tests are usually repeated after a few weeks to confirm the presence of lupus anticoagulant).
- When anticardiolipin antibodies are detected in patients.
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 action of which is directed against several phospholipid binding proteins. They tend to bind to the phospholipid component of the membrane, protecting it from excessive activation of coagulation.
Autoimmune antibodies displace protective proteins, 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 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 represent the smallest proportion of patients with autoimmune antibodies.
Diagnosis of this dangerous syndrome
Diagnosis consists of various laboratory studies, starting with the establishment of a partial thromboplastin time (that is, an analysis for PTT). This blood test for antiphospholipid antibodies is performed in patients who are expected to undergo invasive procedures. It is also assigned in the following cases:
- Patients with unexplained bleeding or bleeding.
- Patients taking certain blood-thinning medications.
Lupus anticoagulant suspected if PTT is prolonged and not corrected immediately after mixing with plasma at a one-to-one ratio, but returns to normal if excess phospholipids are added (assay performed within 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 the glycoprotein on the microtiter plate.
What is the treatment of this syndrome
Treatment is usually with anticoagulant therapy. For prevention and therapy, drugs such as Heparin are used along with Warfarin and Aspirin. It is not known whether newer anticoagulants that inhibit thrombin can be used to treat this disease.
The prognosis for this dangerous pathology is ambiguous. The success of treatment depends on many factors. First of all, it's importanttimely donate blood for research in order to determine the level of antibodies. Only on the basis of the results and clinical manifestations can the correct treatment be prescribed by a rheumatologist. But at the same time, it should be borne in mind that consultation of many specialists will definitely be needed due to the fact that this disease affects many organs.
In no case should you self-medicate, as this is fraught with serious he alth consequences.
Anti-sperm antiphospholipid antibodies and their norm
Anti-sperm antibodies are elements to antigens of spermatozoa membranes. They were first described in the serum of men who were infertile, Wilson in 1954. Substances are usually found in blood, seminal plasma, cervical mucus, and, in addition, on the surface of spermatozoa. Most often, these are antiphospholipid antibodies IgG or IgM.
Normally, antisperm antibodies in he althy men are found in amounts from one to ten percent. In infertile representatives of the stronger sex, they are contained in the amount of twenty percent.
Antibodies in men
Anti-sperm antibodies can appear at the first-order spermatocyte stage, and their level of expression increases as development progresses. These antibodies are distinguished by the property of self-antigenicity, that is, they are immunologically foreign in their own body. Among he althy men, spermatozoa that are in the epididymis can undergo phagocytosis if ejaculation does not occur. True, this is not associated with the formation of anti-sperm antibodies, which is probably due to the following:
- The presence of immunological tolerance caused by the processes of resorption of spermatozoa.
- Blocking the formation of antisperm antibodies by other antibodies.
- An individual feature of antibody formation.
The formation of antisperm antibodies in various parts of the male reproductive system is hindered by certain mechanisms. Thus, in the testicles, protection is provided by the hematotesticular barrier, which isolates the cells of spermatogenesis from the immunocompetent elements of the body. This barrier is based on special Sertoli cells with their processes.
After the release of spermatozoa from the testicle, another defense mechanism works, which consists in their ability to adapt to the environment. This ability is much stronger in viable sperm. In addition, the sperm plasma contains local regulatory factors that prevent the formation of anti-sperm antibodies and the formation of cellular anti-sperm sensitizations (for example, the immunosuppressive factor of sperm plasma). Such factors are secreted in the adnexal gland of the male reproductive system.
As manifested in women
The genitals of a woman contain a large number of various immunocompetent cells. The natural entry of sperm into the genital tract can trigger an immune response. True, the immunological process that occurs in the female bodyimmediately after sperm ingestion is not yet well understood. The formation of antibodies in the female body, as a rule, is prevented by various mechanisms that reduce the immune response.
When ovulation changes the balance of T-lymphocytes. For example, the level of T-helpers decreases, and T-suppressors increases. Among other things, the total concentration of immunoglobulins and the 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 when changing environments, and, in addition, spermoplasma immunosuppressive factors.
In addition, it is assumed that only a small number of genetically selected spermatozoa enter the fallopian tube, which are immunologically different from the majority, and the rest, in turn, die and block local immunity.
Thus, antiphospholipid antibodies have a multifaceted effect on the hemostasis system, any of its protective links in the form of an endothelial barrier, the function of natural anticoagulants, and endogenous fibrinolysis are damaged. Among other things, the platelet link of hemostasis with procoagulant factors is activated.
Where this research is being done
The test for 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.
Antiphospholipid testantibodies in "Hemotest" costs 3,000-3,500 rubles.
You can go to any medical laboratory where this analysis is available. Also, screening for the presence of antiphospholipid antibodies is carried out in diagnostic centers and some private clinics.
