Study about correlation of anti-neutrophil cytoplasmic antibodies and anticardiolipin antibodies with thromboangiitis obliterans

Abstract

Doctors often have difficulties in clinical diagnosis and clinical stage of thromboangiitis obliterans (TAO). Immunolesion was important in the initiation and progression of various kinds of vasculitis diseases, including TAO. Several kinds of immune complexes were developed by immunolesion, including anti-neutrophil cytoplasmic antibodies (ANCA) and anticardiolipin antibodies (ACA). Our aim was to determine if it is an effective way for clinical diagnosis and clinical stage of TAO by detection of the presence of ANCA and ACA in blood serum of patients with TAO and the relationship among the presence of ANCA, ACA and patients with different grades of TAO. Blood samples and clinical characteristics were collected from 38 patients with Rutherford grade I TAO, 30 patients with Rutherford grade II–III TAO, 75 patients with arteriosclerosis obliterans (ASO) and 65 healthy volunteers. Their serum samples were investigated for ANCA by indirect immunofluorescent (IIF), and for ACA and ANCA specificity antigens including reactivity to proteinase 3(PR3), myeloperoxidase (MPO), cathepsin G (CG), bactericidal/permesbility-increasing protein (BPI), elastase (HLE) and lactoferrin (LF) by enzyme linked immunosorbent assay (ELISA). (1) ANCA positive rate and titre were much higher in cases with Rutherford grade I TAO (52.6%, 20/38, 0.386 ± 0.458) and Rutherford grade II–III TAO (73.3%, 22/30, 0.847 ± 0.658) than those in cases with ASO (4%, 3/75, 0.011 ± 0.002) and healthy volunteers (0%,0/65, 0.010 ± 0.002) ( P < 0.01). ANCA positive rate and titre were higher in cases with Rutherford grade II–III TAO (73.3%, 22/30, 0.847 ± 0.658) than those in cases with Rutherford grade I TAO (52.6%, 20/38, 0.386 ± 0.458) ( P < 0.05). (2) ACA concentration was much higher in cases with Rutherford grade I TAO (270.13 ± 13.05 IU/mL) and Rutherford grade II–III TAO (279.33 ± 19.98 IU/mL) than that in cases with ASO (236.85 ± 17.32 IU/mL) and healthy volunteers (229.16 ± 15.55 IU/mL) ( P < 0.05) respectively. (3) In 42 cases of ANCA-positive samples, there were 20 cases reacted with MPO, 14 cases reacted with LF, five cases reacted with HLE, five cases reacted with BPI and no one reacted with PR3 and CG. All cases were Rutherford grade II–III TAO. Our results indicate that ANCA, ANCA specificity antigens and ACA were detected susceptibly and availably in patients with TAO. Thus, detection of ANCA, ANCA specificity antigens and ACA was helpful for clinical diagnosis of TAO and detection of ANCA and ANCA specificity antigens was helpful for clinical staging of TAO. They are important assistance for clinical diagnosis and stage of TAO.