Thromb Haemost 1994; 71(04): 424-427
DOI: 10.1055/s-0038-1642454
Review Article
Schattauer GmbH Stuttgart

Plasma Levels of Lipoprotein(a) Are Elevated in Patients with the Antiphospholipid Antibody Syndrome

Masahide Yamazaki
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
2   The department of Internal Medicine, Tsuruga City Hospital, Tsuruga, Japan
,
Hidesaku Asakura
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
,
Hiroshi Jokaji
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
,
Masanori Saito
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
,
Chika Uotani
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
,
Ichiro Kumabashiri
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
,
Eriko Morishita
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
,
Keiji Aoshima
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
,
Takayuki Ikeda
2   The department of Internal Medicine, Tsuruga City Hospital, Tsuruga, Japan
,
Tamotsu Matsuda
1   The Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
› Author Affiliations
Further Information

Publication History

Received: 10 August 1993

Accepted after resubmission: 30 November 1993

Publication Date:
06 July 2018 (online)

Summary

The mechanisms underlying clinical abnormalities associated with the antiphospholipid antibody syndrome (APAS) have not been elucidated. We measured plasma levels of lipoprotein(a) [Lp(a)], the active form of plasminogen activator inhibitor (active PAI), thrombin-antithrombin III complex (TAT) and soluble thrombomodulin (TM), to investigate the relationship of these factors to thrombotic events in APAS. Mean plasma levels of Lp(a), TAT, active PAI and TM were all significantly higher in patients with aPL than in a control group of subjects. Plasma levels of Lp(a) and active PAI were significantly higher in patients with aPL and arterial thromboses than in patients with aPL but only venous thromboses. There was a significant correlation between plasma levels of Lp(a) and active PAI in patients with aPL. These findings suggest that patients with aPL are in hypercoagulable state. High levels of Lp(a) in plasma may impair the fibrinolytic system resulting in thromboses, especially in the arterial system.

 
  • References

  • 1 Yamazaki M, Asakura H, Kawamura Y, Ohka T, Endo M, Matsuda T. Transient lupus anticoagulant induced by Epstein-Barr virus infection. Blood Coagulat Fibrinol 1991; 2: 771-4
  • 2 Feinstein DI. Lupus anticoagulant, thrombosis and fetal loss. N Engl J Med 1985; 313: 1348-50
  • 3 Harris NN, Asherson RA, Gharavi AE, Morgan SH, Derue GD, Hughes GRV. Thrombocytopenia in SLE and related autoimmune disorders: association with anticardiolipin antibody. Br J Haematol 1985; 59: 227-30
  • 4 Yamazaki M. Lupus anticoagulant. Rinshoui 1992; 18: 98-103 (in Japanese)
  • 5 Dahlen GH, Guyton JR, Attar M, Farmer JA, Kautz JA, Gotto AM. Association of levels of lipoprotein Lp(a), plasma lipids, and other lipoproteins with coronary artery disease documented by angiography. Circulation 1986; 74: 2540-4
  • 6 Edelberg JM, Pizzo SV. Lipoprotein(a) inhibits plasminogen activation in a template-dependent manner. Blood Coagulat Fibrinol 1991; 2: 759-64
  • 7 Hughes GRV, Harris NN, Gharavi AE. The anticardiolipin syndrome. J Rheumatol 1986; 13: 486-9
  • 8 Harris NN, Gharavi AE, Boey ML, Patel BM, Mackworth-Young CG, Loizou S, Hughes GRV. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983; ii: 1211-3
  • 9 Exner T, Rickard KA, Kronenberg H. A sensitive test demonstrating lupus anticoagulant and its behavioral patterns. Br J Haematol 1978; 40: 143-51
  • 10 Triplett DA, Brandt JT, Kaczor D, Schaeffer J. Laboratory diagnosis of lupus inhibitors: a comparison of the tissue thromboplastin inhibition procedure with a new platelet neutralization procedure. Am J Clin Pathol 1983; 79: 678-82
  • 11 Rosove MN, Ismail M, Koziol BJ, Runge A, Kasper CK. Lupus anticoagulants: with a kaolin clotting time using rabbit brain phospholipid in standard and high concentrations. Blood 1986; 68: 472-8
  • 12 Pelzer H, Schwarz A, Heimburger N. Determination of human thrombin- anti thrombin III complex in plasma with an enzyme-linked immunosorbent assay. Thromb Haemostas 1988; 59: 101-6
  • 13 Mimuro J, Koike Y, Sumi Y, Aoki N. Monoclonal antibodies to discrete regions in alpha-2-plasmin inhibitor. Blood 1987; 69: 446-53
  • 14 Sakata Y, Murakami T, Noro A, Mori K, Matsuda M. The specific activity of plasminogen activator inhibitor-1 in disseminated intravascular coagulation with acute promyelocytic leukemia. Blood 1991; 77: 1949-57
  • 15 Asakura H, Jokaji H, Saito M, Uotani C, Kumabashiri I, Morishita E, Yamazaki M, Matsuda T. Plasma levels of soluble thrombomodulin increase in cases of disseminated intravascular coagulation with organ failure. Am J Hematol 1991; 38: 281-7
  • 16 Berg K. A new serum type system in man: the Lp system. Acta Pathol Microbiol Scand Suppl 1963; 59: 166-7
  • 17 Scanu AM. Lipoprotein(a): a potential bridge between the fields of atherosclerosis and thrombosis. Arch Pathol Lab Medicine 1988; 112: 1045-7
  • 18 Eaton DL, Fless GM, Kohr WJ, McLean JW, Xu QT, Miller CG, Lawn RM, Scanu AM. Partial amino acid sequence of apolipoprotein(a) shows that it is homologous to plasminogen. Proc Natl Acad Sci USA 1987; 84: 3224-8
  • 19 Domenico F, Francesco V, Claudio Q, Antonella S, Renzo DA, Lucio Z, Francesco B. Fibrinolytic balance and lupus anticoagulant in patients with repeated spontaneous fetal loss. BMJ 1992; 305: 504-5
  • 20 Keeling DM, Campbell SJ, Mackie IJ, Machin SJ, Isenberg DA. The fibrinolytic response to venous occlusion and the natural anticoagulants in patients with antiphospholipid antibodies both with and without systemic lupus erythematosus. Br J Haematol 1991; 77: 354-9
  • 21 Asakura H, Shiratori Y, Jokaji H, Saito M, Uotani C, Kumabashiri I, Morishita E, Yamazaki M, Matsuda T. Changes in plasma levels of prothrombin fragment FI+2 in cases of disseminated intravascular coagulation. Acta Haematol 1993; 89: 22-5
  • 22 Walker ID, Davidson JF, Hutton I. Disorders “fibrinolytic potential” in coronary heart disease. Thromb Res 1977; 10: 509-10
  • 23 Perez RE, McClendon JR, Lie JT. Primary antiphospholipid syndrome with multiorgan arterial and venous thromboses. J Rheumatol 1992; 19: 1289-92
  • 24 Dano K, Andreasen PA, Grondahl-Hansen J, Kristensen P, Nielsen LS, Skriver L. Plasminogen activators, tissue degradation and cancer. Adv Cancer Res 1985; 44: 139-266
  • 25 Miles LA, Plow EF. Plasminogen receptors: ubiquitious sites for cellular regulation of fibrinolysis. Fibrinolysis 1988; 2: 61-71
  • 26 Castellino FJ. Recent advances in the chemistry of the fibrinolytic system. Chem Rev 1981; 81: 431-46
  • 27 Utermann G. The mysteries of Lipoprotein(a). Science 1989; 246: 904-10
  • 28 Morishita E, Matsuda T. Lipoprotein(a) on atherosclerosis and thrombosis. Geriatric Medicine 1992; 30: 1795-800 (In Japanese)
  • 29 Constans J, Pellegrin JL, Peuchant E, Dumon MF, Simonoff M, Clerc M, Leng B, Conri C. High plasma lipoprotein(a) in HIV-positive patients. Lancet 1993; 341: 1099-100
  • 30 Keeling DM, Birley H. Mach in SJ. Multiple transient ischemic attacks and a mild thrombotic stroke in a HIV-positive patient with anticardiolipin antibodies. Blood Coagulat Fibrinol 1990; 1: 333-5