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Anticardiolipin Antibody and Anti-beta 2 Glycoprotein I Antibody Assays

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Haemostasis

Part of the book series: Methods in Molecular Biology ((MIMB,volume 992))

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease and is a risk factor for a number of clinical manifestations; the classic presentations include fetal death or thrombosis (arterial or venous thromboembolism), in the presence of persistently increased titers of antiphospholipid (aPL) antibodies. The actual cause of APS is unknown but thought to be multifactorial. The disease is characterized by the presence of a heterogenous population of autoantibodies against phospholipid-binding proteins. APS presents either in isolation with no evidence of an underlying disease or in concert with an autoimmune disease such as systemic lupus erythematosus or rheumatoid arthritis. The wide diversity in clinical presentation often causes difficulty in identifying and treating patients and therefore a concise laboratory report containing interpretative comments is required to provide needed guidance to the clinician.

For a diagnosis of APS to be made both clinical and laboratory classification criteria must be met. Laboratory testing to identify aPL antibodies includes lupus anticoagulant (liquid-based clotting assays) and immunological solid-phase assays (usually enzyme-linked immunosorbent assay formats) for IgG and/or IgM anticardiolipin (aCL) antibodies and anti-beta 2 glycoprotein I (β2-GPI) antibodies. Other autoantibodies, such as those directed against anionic phospholipids, can also be assayed; however they are not of clinical significance.

Participation in a quality assurance program and an in-depth technical and clinical understanding of testing for aPL antibodies are required, as methods are limited by poor robustness, reproducibility, specificity, and standardization. Testing is further complicated by the lack of a “gold standard” laboratory test to diagnose or classify a patient as having APS.

This chapter discusses the clinical and laboratory theoretical and technical aspects of aCL and anti-β2GPI antibody assays.

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Author information

Authors and Affiliations

  1. External Quality Assessment, Quality Management Program – Laboratory Services, Toronto, ON, Canada

    Anne Raby

  2. Department of Medicine, McMaster University, Hamilton, ON, Canada

    Karen Moffat

  3. Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada

    Karen Moffat

  4. Division of Hematology and Thromboembolism, McMaster University and St Joseph’s Hospital, Hamilton, ON, Canada

    Mark Crowther

Authors
  1. Anne Raby
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  2. Karen Moffat
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  3. Mark Crowther
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Editor information

Editors and Affiliations

  1. Department of Paediatrics, University of Melbourne, n/a, Parkville, 3052, Victoria, Australia

    Paul Monagle

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© 2013 Humana Press

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Raby, A., Moffat, K., Crowther, M. (2013). Anticardiolipin Antibody and Anti-beta 2 Glycoprotein I Antibody Assays. In: Monagle, P. (eds) Haemostasis. Methods in Molecular Biology, vol 992. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-339-8_32

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  • DOI: https://doi.org/10.1007/978-1-62703-339-8_32

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-338-1

  • Online ISBN: 978-1-62703-339-8

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