Thromb Haemost 1974; 32(02/03): 554-563
DOI: 10.1055/s-0038-1647724
Original Article
Schattauer GmbH

Cofactor of the “Lupus Anticoagulant”

Georges E. Rivard
1   Departments of Medicine and Biochemistry, University of Southern California School of Medicine; the Los Angeles County-University of Southern California Medical Center; and the Division of Hematology-Oncology of the Children’s Hospital of Los Angeles, Los Angeles, California
,
Sandra Schiffman
1   Departments of Medicine and Biochemistry, University of Southern California School of Medicine; the Los Angeles County-University of Southern California Medical Center; and the Division of Hematology-Oncology of the Children’s Hospital of Los Angeles, Los Angeles, California
,
Samuel I. Rapaport
1   Departments of Medicine and Biochemistry, University of Southern California School of Medicine; the Los Angeles County-University of Southern California Medical Center; and the Division of Hematology-Oncology of the Children’s Hospital of Los Angeles, Los Angeles, California
› Author Affiliations
Further Information

Publication History

Received 06 August 1974

Accepted 21 August 1974

Publication Date:
30 June 2018 (online)

Summary

Normal plasma contains an activity known as cofactor which further lengthens the clotting time of the plasma of some patients with the “lupus anticoagulant.55 Cofactor has been characterized as either prothrombin or a gamma globulin. Our findings indicate that cofactor has the following properties: stable at room temperature but largely destroyed by heating for 30 min at 56° C; sparingly adsorbed by Al(OH)3 or BaS04; apparent molecular weight on gel filtration around 200,000 daltons ; precipit- able between 50-75% ammonium sulfate saturation. Cofactor was present in plasmas from patients with hereditary deficiencies of factor II, V, VII, VIII, IX, X, XI, XII, or Fletcher factor; however, less cofactor activity was demonstrable in plasmas deficient in factor II, V, or X than in normal plasma or the other deficiency plasmas. Plasma from patients receiving oral anticoagulant therapy had variable levels of cofactor activity which could not be correlated with levels of factor II, VII, IX, X, or staphylocoagulase-reacting factor. Cofactor activity was unaffected by treatment with an anti-human immunoglobulin antiserum. These data support the conclusion that the cofactor reacting with our patient’s “lupus anticoagulant55 is neither prothrombin nor an immunoglobulin, but rather a unique molecule with some properties in common with each.

 
  • References

  • 1 Abildgaard X. J. 1967; Purification of two progressive antithrombins of human plasma. Scandinavian Journal of Clinical and Laboratory Investigation 19: 190.
  • 2 Feinstein D. I, Rapaport S. I, Mc Gehee W.G, Patch M. J. 1970; Factor V anticoagulants: Clinical, biochemical and immunological observations. The Journal of Clinical Investigation 49: 1578.
  • 3 Feinstein D. I, Rapaport S. I. 1972. Acquired inhibitors of blood coagulation. In: Spaet T. H. (ed.), Progress in Hemostasis and Thrombosis. Grune and Stratton, Inc. 75.
  • 4 Josso F, Lavergne J. M, Gouault M, Prou-Wartelle O, Soulier J. P. 1968; Différents états moléculaires du facteur II (prothrombine). Leur étude à l’aide de la staphylocoagulase et d’anticorps anti-facteur II. I. Le facteur II chez les sujets traités par les antagonistes de la vitamine K. Thrombosis et Diathesis Haemorrhagica 20: 88.
  • 5 Loeliger A. 1959; Prothrombin as co-factor of the circulating anticoagulant in systemic lupus erythematosus. Thrombosis et Diathesis Haemorrhagica 03: 237.
  • 6 Murano G. 1971. Purification of prothrombin. In: Bang N. U, Beller F. K, Deutsch E, Mammen E. F. (eds.) Thrombosis and Bleeding Disorders. Academic Press; New York, London: 101.
  • 7 ØSterud B, Schiffman S. 1972; Gel filtration properties of factors II, VII, IX, IXa, and X. Thrombosis et Diathesis Haemorrhagica 28: 317.
  • 8 Owren P. A. 1949; A quantitative one-stage method for the assay of prothrombin. Scandinavian Journal of Clinical and Laboratory Investigation 01: 81.
  • 9 Proctor R. R, Rapaport S. I. 1961; The partial thromboplastin time with kaolin. A simple screening test for first stage plasma clotting factor deficiencies. American Journal of Clinical Pathology 36: 212.
  • 10 Rapaport S. I, Ames S. B. 1957; Clotting factor assays on plasma from patients receiving intramuscular or subcutaneous heparin. American Journal of The Medical Sciences 234: 678.
  • 11 Rapaport S. I, Schiffman S, Patch M. J, Ware A. G. 1961; A simple specific one-stage assay for plasma thromboplastin antecedent activity. Journal of Laboratory and Clinical Medicine 57: 771.
  • 12 Schiffman S, Rapaport S. I, Patch M. J. 1963; The identification and synthesis of activated plasma thromboplastin component (PTC’). Blood 22: 733.
  • 13 Schiffman S, Rapaport S. I, Patch M. J. 1965; Starch block electrophoresis of plasma and serum clotting factors. Separation of activated PTC (PTC’). Blood 25: 724.
  • 14 Yin E. T, Gaston L. W. 1965; Purification and kinetic studies on a circulating anticoagulant in a suspected case of lupus erythematosus. Thrombosis et Diathesis Haemorrhagica 14: 88.