G. Balestrieri

Anti-beta 2 glycoprotein I antibodies in a general obstetric population: preliminary results on the prevalence and correlation with pregnancy outcome. Anti-β2 glycoprotein I antibodies are associated with some obstetrical complications, mainly preeclampsia-eclampsia

OBJECTIVE To evaluate the prevalence in normal pregnancies of anti-32 glycoprotein I (anti-beta2GPI) antibodies, and their association with obstetrical complications. STUDY DESIGN Prospective study of anti-beta2GPI and anticardiolipin (CL) antibodies in 510 healthy pregnant women at 15-18 weeks. According to the results, women were categorized into three groups: group I, negative for both antibodies; group II, positive for anti-beta2GPI antibodies; group III, positive for aCL only. The rates of fetal loss, abruptio placentae, preeclampsia-eclampsia, and fetal growth retardation were compared in the three groups. RESULTS Anti-beta2GPI antibodies were found in 20 women (3.9%) and aCL in 8 patients (1.6%). Obstetrical complications were more frequent, even if not significantly different, in group II, 15%, than in group I, 4.1% (difference 10.9%; 95% confidence interval (CI): 1.6-20.2%; p=0.0575), while no complications were seen in group III. Preeclampsia-eclampsia were significantly more frequent in group II (10%) than in group I (0.8%; difference 9.2%; 95% CI: 4.4-14%; p=0.021). The prevalence of fetal growth retardation was not significantly different in the two groups (5% vs. 2%, respectively). COMMENT Our findings indicate that anti-beta2GPI antibodies are associated with some obstetrical complications, mainly preeclampsia-eclampsia, even if more conventional antiphospholipid antibodies are not present. This observation suggests that these antibodies should be investigated in such cases, in order to improve the outcome of subsequent pregnancies, as well as in women with a history of early and/or recurrent severe preeclampsia in order to start a prophylactic treatment (i.e. low-dose aspirin or heparin).

Comparison of pathologic and normal sera by immune complex determination: five disease groups within 190 samples are discriminated by computer-selected combinations of 13 methods. Report of the Italian committee for the study of immune complexes (WIC).

Pathological (190) and normal (33) sera were tested for their content of circulating immune complexes (CIC) by a battery of 13 assays performed in 11 laboratories. Statistical processing was done both by pooling all pathological samples and by extracting those falling into well-defined disease groups, i.e., rheumatoid arthritis, diabetes, lupus, melanoma, and glomerulonephritis. Highly significant correlations between methods--taken two at a time--for each disease differed in proportion (ranging from 6 to 30%) and in the pattern displayed on a checkerboard. Disease-linked patterns were also found when a function maximizing discrimination between pathological and normal samples was derived by combining the information from all methods. Here the order and the weight attributed by the computer to the methods differed for each of the disease groups. Taken together these results are interpreted as an indication that all assays may not determine the same classes of CIC, and thus vary in sensitivity depending on the prevailing properties of the complexes present in the serum, which in turn may depend on the etiology, pathogenesis, and stage of the disease.

Circulating immune complexes in human acute leukaemia.

Summary. Circulating immune complexes (CIC) in the sera of 60 newly diagnosed leukaemic patients were investigated by two methods, 125I‐C1q binding test (C1q‐BA) and conglutinin binding assay (KgB‐SP). Positivity percentages were respectively 20.0% (C1q‐BA) and 28.3% (KgB‐SP). The small overlap between the results of the two methods suggests the occurrence of different types of CIC. The presence of CIC was found to be related only to clinical haemorrhage and thrombocytopenia; it did not prove to affect the prognosis and the survival of leukaemic patients.

Detection of Circulating Immune Complexes in Acute Non-Lymphatic Leukaemia: Is It Reliable?

The in vivo and in vitro phagocytic ability of leukaemic cells and the serum levels of circulating immune complexes (CIC) have been evaluated in 11 patients affected by acute non-lymphatic leukaemia (ANLL). High levels of serum CIC were detected in 17% of the cases showing phagocytic ability and in 80% of the cases lacking phagocytic ability (p less than 0.05). In 3 patients serum CIC determinations were negative while immunoglobulins with complement-fixing ability were detected in the cytoplasm of leukaemic cells indicating in vivo phagocytosis of CIC. These results suggest that leukaemic cells may sometimes interfere through their phagocytic ability on the detection of CIC in the serum. Therefore, the clinical and prognostic value of serum CIC in ANLL seems questionable.