AIM AND METHODOLOGY: To provide a comprehensive review on new findings and current recommendations regarding antiphospholipid antibodies with particular emphasis on clinical impact on gestation. CONCLUSION: Antiphospholipid antibodies are an important risk factor for the development of a series of pregnancy-related complications. Early diagnosis and appropriate therapy can reduce the incidence of pregnancy loss and pregnancy-related complications.

• Klíčová slova
• anti-ß2-glycoprotein I antibodies, anticardiolipin antibodies, antiphospholipid antibodies, antiphospholipid syndrome, lupus anticoagulant,
• MeSH
• antifosfolipidové protilátky * krev   imunologie   MeSH
• antifosfolipidový syndrom * imunologie   diagnóza   komplikace   MeSH
• komplikace těhotenství * imunologie   MeSH
• lidé MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antifosfolipidové protilátky * MeSH

Apoptosis of tissues of fetal origin is thought to be one of the main sources of cell-free fetal DNA (cffDNA) in maternal circulation, impaired apoptosis is also involved in the mechanisms contributing to recurrent spontaneous miscarriages (RSM) associated with antiphospholipid syndrome (APS). The APS increases the risk for preeclampsia nine times. In preeclampsia, the elevated levels of cffDNA were described by different authors. To our knowledge, cffDNA in pregnant patients with APS was never studied. In our pilot study, we focused on the levels of cffDNA in four pregnant patients with treated primary APS and compared them with values obtained in twenty-one healthy subjects of comparable gestation age (the third trimester of pregnancy). We supposed that the increase of cffDNA concentration in our treated patients would signalize the elevated apoptosis of fetal tissues as in other pathological changes of placentation. The aim of our pilot study was to determine cffDNA concentrations in patients with treated APS and to compare them with values detected in healthy pregnant women of comparable gestation age in order to discover potential non-physiological elevations in patients. The elevated values of cffDNA were not observed in our patients (p value = 0.4363, Mann-Whitney test). All patients delivered healthy children. The measurement of concentrations of cffDNA seems to be a promising tool for monitoring of therapy effectiveness in pregnant women with APS but evaluation of randomized controlled trials would be necessary to determine the specificity and the sensitivity of this test.

• Klíčová slova
• Antiphospholipid antibodies (APA), antiphospholipid syndrome (APS), cell-free fetal DNA (cffDNA), pregnancy, recurrent spontaneous miscarriages (RSM),
• MeSH
• antifosfolipidové protilátky krev   imunologie   MeSH
• antifosfolipidový syndrom krev   diagnóza   genetika   MeSH
• DNA krev   MeSH
• dospělí MeSH
• komplikace těhotenství krev   diagnóza   genetika   MeSH
• lidé MeSH
• pilotní projekty MeSH
• plod imunologie   metabolismus   MeSH
• těhotenství MeSH
• třetí trimestr těhotenství krev   imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH
• DNA MeSH

PROBLEM: This study compares the frequencies of plasminogen activator inhibitor-1 (-675) 4G/5G polymorphism and its relationship with eight antiphospholipid antibodies (aPLs) in serum of 157 patients with repeated pregnancy loss (RPL). METHOD OF STUDY: PAI-1 (-675) 4G/5G polymorphism was determined using standard PCR-RFLP method. Enzyme-linked immunosorbent assay was used for the detection of aPLs against ph-serine, ph-ethanolamine, ph-inositol, ph-DL-glycerol, phosphatidic acid, annexin V, cardiolipin, and beta2-GPI. Allelic frequency and distribution of genotypes were calculated. The prevalence of the risk conferring 4G allele and 4G/4G homozygous genotype in patients and controls was compared, and the correlation between aPLs positivity and PAI-1 4G/4G genotype was tested by chi-square test. RESULTS: Statistically highly significant correlation between RPL and PAI-1 (-675) 4G/4G genotype was found. No correlation between PAI-1 (-675) 4G/5G polymorphism and the presence of antiphospholipid antibodies in RPL patients was observed. CONCLUSIONS: PAI-1 (-675) 4G/4G homozygous genotype increases the risk of RPL independently from the aPLs positivity.

• MeSH
• antifosfolipidové protilátky krev   MeSH
• běloši genetika   MeSH
• dospělí MeSH
• frekvence genu MeSH
• genotyp MeSH
• habituální potrat krev   genetika   imunologie   MeSH
• inhibitor aktivátoru plazminogenu 1 genetika   MeSH
• lidé MeSH
• polymorfismus genetický MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH
• inhibitor aktivátoru plazminogenu 1 MeSH

Autoimmune diseases can be accompanied by presence of various antiphospholipid antibodies (aPL). The laboratory criteria of antiphospholipid syndrome are based on detection of anticardiolipin, lupus anticoagulant or to antiβ2- glycoprotein I but currently a significance of other multiple aPL is being discussed. Because of their vascular and neuroinflammatory effect aPL, if being transplacentally transferred, might inflict damage in developing organism. The aim of our study was to determine the occurrence of eight selected aPL in offspring of mothers with proven autoimmune disease with aPL positivity. The possible influence of aPL presence on clinical, ultrasound and laboratory outcome of children was observed as well. The prospective study included 38 women: 17 women with primary antiphospholipid syndrome and 21 women with other diagnosed autoimmune disease with detected aPL. Also included were 39 children born to the above mentioned mothers between January 2009 and April 2010 in Perinatology Centre in Pilsen, Czech Republic. The control group consisted of 30 mothers without AD and their 30 healthy singletons. Preliminary results of the study showed the presence of aPL in 42.1% neonates of aPL positive mothers with autoimmune disease, six month later aPL were present in only 37.5 % of these children. Observed occurrence of aPL positivity at 6 months of age in originally negative offspring could be attributed to vaccination or food exposure. Psychomotor development of children has proceeded without major deviations. The follow-up study continues and will evaluate both groups of children at two years of age.

• MeSH
• antifosfolipidové protilátky krev   MeSH
• autoimunitní nemoci krev   imunologie   MeSH
• dospělí MeSH
• kojenec MeSH
• komplikace těhotenství krev   imunologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• novorozenec krev   imunologie   MeSH
• prospektivní studie MeSH
• studie případů a kontrol MeSH
• těhotenství MeSH
• vývoj dítěte MeSH
• zdravotní stav MeSH
• Check Tag
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• mladý dospělý MeSH
• novorozenec krev   imunologie   MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH

The objective of our study was to evaluate the significance of extended antiphospholipid profile in patients with venous thromboembolism without any systemic autoimmune disease. In 140 patients (age 18-69 years; 47.1% men) with venous thromboembolism and 136 control participants we tested anticardiolipin antibodies, anti-beta 2 glycoprotein I (anti-beta2-GPI) and also non-criteria antiphospholipid antibodies: antiphosphatidic acid, antiphosphatidylethanolamine, antiphosphatidylglycerol, antiphosphatidylinositol, antiphosphatidylserine. Commercial and in-house enzyme-linked immunosorbent assays were used. The antibodies with significantly higher prevalence in patients (compared to controls) were: immunoglobulin (Ig) M-anticardiolipin antibodies (12.9%; P = 0.035), IgG-anti-beta2-GPI (16.4%; P = 0.0032), IgM-antiphosphatidylethanolamine (14.3%; P = 0.014). In most cases, these three antibodies did not overlap. In conclusion, of non-criteria antiphospholipid antibodies, only antiphosphatidylethanolamine were significantly more prevalent in patients with venous thromboembolism, with only minor overlapping with the criteria antiphospholipid antibodies. Our results suggest the possible utility of searching for antiphosphatidylethanolamine in the clinical suspicion of antiphospholipid syndrome and the absence of criteria antiphospholipid antibodies.

• MeSH
• antifosfolipidové protilátky krev   MeSH
• antifosfolipidový syndrom krev   imunologie   MeSH
• antikardiolipinové protilátky krev   MeSH
• autoantigeny imunologie   MeSH
• beta-2-glykoprotein I imunologie   MeSH
• dospělí MeSH
• fosfatidylethanolaminy imunologie   MeSH
• fosfolipidy imunologie   MeSH
• imunoglobulin G krev   imunologie   MeSH
• imunoglobulin M krev   imunologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• senioři MeSH
• specificita protilátek MeSH
• trombofilie krev   genetika   imunologie   MeSH
• žilní tromboembolie krev   etiologie   imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH
• antikardiolipinové protilátky MeSH
• autoantigeny MeSH
• beta-2-glykoprotein I MeSH
• fosfatidylethanolaminy MeSH
• fosfolipidy MeSH
• imunoglobulin G MeSH
• imunoglobulin M MeSH

PROBLEM: The present work was undertaken to investigate the occurence of autoantibodies to eight various phospholipids in time of urgent termination of the pregnancy (sectio caesarea) in patients in reproductive age with severe preeclamptic symptoms. METHOD OF STUDY: Autoantibodies against annexin V, ph-serine, ph-ethanolamine, ph-inositol, ph-DL-glycerol, cardiolipin, beta2-glycoprotein I (beta2-GPI), and phosphatidic acid were studied by ELISA methods. RESULTS: Increased levels of IgA-beta2-glycoprotein I, IgG-beta2-glycoprotein I, IgG- anti-ph-serine, and IgG-anticardiolipin were found in sera of preeclamptic women in the time of urgent sectio caesarea when compared to the control group with physiological pregnancy. CONCLUSION: Supposed increase in various antiphospholipid antibodies (aPLs) levels due to the stress during the short time of admission and a need for a quick medical decision to terminate the pregnancy was not unambiguously proven, but our results are evidently influenced by the current urgent life-saving treatment.

• MeSH
• antifosfolipidové protilátky krev   MeSH
• beta-2-glykoprotein I imunologie   MeSH
• dospělí MeSH
• ELISA MeSH
• fosfoserin imunologie   MeSH
• lidé MeSH
• placentární oběh imunologie   MeSH
• potrat léčebný MeSH
• preeklampsie krev   imunologie   patofyziologie   terapie   MeSH
• těhotenství MeSH
• trombóza MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH
• beta-2-glykoprotein I MeSH
• fosfoserin MeSH

PROBLEM: The aim of this study was to investigate frequencies of eight antiphospholipid antibodies (aPLs) in serum, four genetic thrombophilic factors and their mutual relation in 206 patients with repeated pregnancy loss (RPL). METHOD OF STUDY: Enzyme-linked immunosorbent assay was used for detection of aPLs against ph-serine, ph-ethanolamine, ph-inositol, DL-glycerol, phosphatidic acid, anti-annexin V, cardiolipin, and beta2-GPI. FV 1691G>A (Leiden mutation), FII 20210G>A mutation, MTHFR 677C>T and MTHFR 1298A>C variant genotypes were determined using a melting curve analysis of the PCR amplification product detected by the fluorescence resonance energy transfer. Genotypic distribution and allelic frequencies were calculated. Correlation between aPLs and thrombophilic factors was tested by chi-square and Fisher exact test. RESULTS: Our results show significantly increased prevalence of aPLs against ph-inositol (17-19.6% dependent on number of spontaneous miscarriages) and against ph-serine (18-25%). aPLs in IgG prevail. In 96% of the studied group, at least one risk factor was found (either aPLs positivity or thrombophilic factor). Both aPLs and thrombophilic factors were present in 43%. In the group of women with three or more RPLs, strong positive correlation of aPLs positivity and thrombophilic risk factors was observed. CONCLUSION: Antiphospholipide antibodies and genetic thrombophilic factors are important risk factors in the pathogenesis of RPL. Both autoantibodies against various kinds of phospholipides and genetic thrombophilic factors must be studied together in diagnosis of RPL for appropriate treatment.

• MeSH
• antifosfolipidové protilátky biosyntéza   krev   genetika   imunologie   MeSH
• DNA sondy MeSH
• dospělí MeSH
• ELISA MeSH
• frekvence genu imunologie   MeSH
• genotyp MeSH
• habituální potrat epidemiologie   genetika   imunologie   MeSH
• kauzalita MeSH
• lidé středního věku MeSH
• lidé MeSH
• mutace MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• trombofilie genetika   imunologie   MeSH
• výsledek těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH
• DNA sondy MeSH

To characterize the impact of the potentially functional mutation--the G to A transition at the position 3400 of the leukemia inhibitory factor (LIF; a pluripotent cytokine that plays a central role in the control of the embryo implantation) gene that leads to the exchange of valine with methionine at codon 64 we evaluated the association of the LIF gene mutation and the levels of antiphospolipid antibodies (aPLs) in the peripheral blood of infertile women (the aPLs examination was part of our routine immunological test during the infertility check-up). Eight infertile mutation-positive women were diagnosed with idiopathic infertility (n=5) and endometriosis (n=3) and their levels of aPLs in serum were compared with 115 infertile women without any LIF gene mutation. Enzyme-linked immunosorbent assay was used for the detection of seven antiphospholipid antibodies; the results were statistically assessed by the Fisher's 2 by 2 exact test to evaluate the association of the LIF gene mutations and aPLs in serum of infertile patients. The presence of aPLs was significantly higher in our study group (100%) than in 30% of aPLs-positives in control infertile patients (p = 0.0035) which indicates that the aPLs are elevated in women with LIF gene mutations.

• MeSH
• antifosfolipidové protilátky krev   imunologie   MeSH
• bodová mutace * MeSH
• dospělí MeSH
• ELISA MeSH
• endometrióza krev   genetika   imunologie   MeSH
• heteroduplexní analýza metody   MeSH
• leukemický inhibiční faktor genetika   MeSH
• lidé MeSH
• sekvenční analýza DNA MeSH
• ženská infertilita krev   genetika   imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH
• leukemický inhibiční faktor MeSH
• LIF protein, human MeSH Prohlížeč

OBJECTIVE: The aim of this study is to evaluate outcomes of hematological examinations in patients under 60 years of age affected by central (CRVO) or branch (BRVO) retinal vein occlusion. Furthermore, it also proves possible existence of risk factors resulting in early atherosclerosis and hematological disease. PATIENTS AND METHODS: Eleven patients (5 women and 6 men) of 38 years of age in average (15-56 years) were examined. Eight patients suffered from CRVO, 3 patients from BRVO. All patients were tested for hematological diseases. We focused on the following hematological parameters: presence of paraprotein, homocysteine blood level, lipoprotein A, presence of antiphospholipid antibody, level of activated protein C resistance, protein S, protein C, antithrombin III. The average follow up period was 19 months. RESULTS: hematological screening was positive in 5 patients, 4 patients out of them suffered from CRVO. High homocysteine blood level was detected in 2 patients and more over, an increased level of antiphospholipid antibodies was diagnosed in 1 patient. An increased level of lipoprotein A was determined in 2 remaining patients. BRVO was diagnosed in one case. Outcome of the hematological examination proved the pathological level of activated protein C resistance and lower level of protein S. CONCLUSION: according to these results we assume, the co-existence of more risk factors for hematological disease increase the probability of CRVO.

• MeSH
• antifosfolipidové protilátky krev   MeSH
• antithrombin III analýza   MeSH
• dospělí MeSH
• hyperhomocysteinemie komplikace   MeSH
• koagulopatie komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipoprotein (a) krev   MeSH
• mladiství MeSH
• okluze retinální žíly komplikace   MeSH
• protein S analýza   MeSH
• rezistence k aktivovanému proteinu C komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH
• antithrombin III MeSH
• lipoprotein (a) MeSH
• protein S MeSH

The aim of this study was to evaluate the efficacy of prophylaxis using low-dose non-fractioned heparin and aspirin in the prevention of intrauterine growth restriction and low birth weights in patients suffering from antiphospholipid antibody syndrome. Intrauterine growth retardation and birth weights of 34 gestations involving 28 women with histories of multiple miscarriages and elevated antiphospholipid antibody levels were evaluated in a prospective study in the period from April 1988 to July 2004. A control group was formed of 39 women without previous history of miscarriages over a total of 40 gestations. Intrauterine growth retardation was considered when the weight of the newborn baby was below the tenth percentile for gestational age according to the fetal weight chart. Diagnosis of antiphospholipid antibodies was achieved using the ELIZA test to measure the IgG and IgM immunoglobulin levels. Evaluation of lupus anticoagulant was performed using the activated partial thromboplastin time (aPTT). Women suffering from antiphospholipid antibodies underwent prophylactic treatment during gestation with low doses of acetylsalicylic acid (100 mg daily) associated to low doses of subcutaneous heparin (5000 IU twice daily). The non-paired Student t-test, Fisher Exact and Mann-Whitney tests were used for statistical analysis with an a error of up to 5% considered acceptable. A statistically higher number of newborns suffered intrauterine growth retardation and low birth weights in the study group than in the control group. In conclusion, children of mothers suffering from antiphospholipid antibody syndrome, even those undergoing prophylactic treatment with low-dose non-fractioned heparin and aspirin, are associated to intrauterine growth retardation and low birth weights.

• MeSH
• antifosfolipidové protilátky krev   MeSH
• antifosfolipidový syndrom komplikace   farmakoterapie   MeSH
• komplikace těhotenství * farmakoterapie   MeSH
• lidé MeSH
• novorozenec MeSH
• růstová retardace plodu etiologie   psychologie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH