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Anti-cardiolipin antibodies (ACA) are antibodies often directed against cardiolipin and found in several diseases, including syphilis, antiphospholipid syndrome, livedoid vasculitis, vertebrobasilar insufficiency, Behçet's syndrome, idiopathic spontaneous abortion, and systemic lupus erythematosus (SLE). They are a form of anti-mitochondrial antibody. In SLE, anti-DNA antibodies and anti-cardiolipin antibodies may be present individually or together; the two types of antibodies act independently. This is in contrast to rheumatoid arthritis with systemic sclerosis (scleroderma) because anti-cardiolipin antibodies are present in both conditions, and therefore may tie the two conditions together.

Anti-cardiolipin antibodies can be classified in two ways:

• As IgM, IgG or IgA
• As β₂-glycoprotein dependent or independent
  • In autoimmune disease, ACA are beta-2 glycoprotein dependent
  • In syphilis, ACA are beta-2 glycoprotein independent and can be assayed using the Venereal Disease Research Laboratory test

Apolipoprotein H involvement

β₂-glycoprotein I has been identified as apolipoprotein H and is required for the recognition of ACA in autoimmune disease. Only a subset of autoimmune anti-cardiolipin antibodies bind Apo-H, these anti-apolipoprotein antibodies are associated with increased thrombosis.

References

1. ^ Tringali GR, Julian AJ, Halbert WM (1969). "Effect of 2-mercaptoethanol treatment on anticardiolipin reactivity in sera from syphilitics and false positive reactors". The British Journal of Venereal Diseases. 45 (3): 202–4. doi:10.1136/sti.45.3.202. PMC 1048465. PMID 5346419.
2. Hull RG, Harris EN, Gharavi AE, et al. (1984). "Anticardiolipin antibodies: occurrence in Behçet's syndrome". Ann. Rheum. Dis. 43 (5): 746–748. doi:10.1136/ard.43.5.746. PMC 1001520. PMID 6497467.
3. Petri M, Golbus M, Anderson R, Whiting-O'Keefe Q, Corash L, Hellmann D (1987). "Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty-four women". Arthritis Rheum. 30 (6): 601–606. doi:10.1002/art.1780300601. PMID 3111489.
4. Harris EN, Gharavi AE, Boey ML, et al. (1983). "Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus". Lancet. 2 (8361): 1211–1214. doi:10.1016/S0140-6736(83)91267-9. PMID 6139567. S2CID 36643723.
5. Harris EN, Gharavi AE, Loizou S, et al. (1985). "Crossreactivity of antiphospholipid antibodies". Journal of Clinical & Laboratory Immunology. 16 (1): 1–6. PMID 3981615.
6. Keane A, Woods R, Dowding V, Roden D, Barry C (1987). "Anticardiolipin antibodies in rheumatoid arthritis". Br. J. Rheumatol. 26 (5): 346–350. doi:10.1093/rheumatology/26.5.346. PMID 3664159.
7. Malia RG, Greaves M, Rowlands LM, et al. (1988). "Anticardiolipin antibodies in systemic sclerosis: immunological and clinical associations". Clin. Exp. Immunol. 73 (3): 456–60. PMC 1541778. PMID 2974767.
8. McNeil HP, Simpson RJ, Chesterman CN, Krilis SA (1990). "Anti-phospholipid antibodies are directed against a complex antigen that includes a lipid-binding inhibitor of coagulation: beta 2-glycoprotein I (apolipoprotein H)". Proc. Natl. Acad. Sci. U.S.A. 87 (11): 4120–4124. Bibcode:1990PNAS...87.4120M. doi:10.1073/pnas.87.11.4120. PMC 54059. PMID 2349221.

• Autoantibodies