抗リン脂質抗体陽性妊婦における凝固線溶系動態に関する研究

概要

論文の詳細を見る
We investigated the coagulation and fibrinolysis systems in antiphospholipid antibody (APA) positive pregnant women, and the effects of their purified IgG on cultured human endothelial cells from umbilical cord vein (HUVEC) and human placental trophoblasts. Anticardiolipin antibody (ACA), antithrombin III (AT III), FDP D-dimer, thrombin-AT III complex (TAT), plasmin-α_2 plasmin inhibitor complex (PIC), tissue plasminogen activator inhibitor-1 (PAI-1), and thrombomodulin (TM) were measured in 46 normal and 12 APA positive pregnant women. Five APA positive pregnancies resulted in fetal loss in women who had no treatment and were ACA positive. Seven resulting in live birth showed lower titers of ACA after treatment with prednisolone and low-dose aspirin. The activities of these patients' coagulation systems were severely elevated while the fibrinolytic systems were not changed. Elevated serum TM, tPA and PAI-1 in the fetal loss group suggested endothelial cell and placental trophoblast damage. Release of PAI-1 by cultured HUVEC and placental trophoblasts increased with ACA IgG, whereas the amount of TM antigen in HUVEC was decreased by ACA IgG, and the activity of TM in placental trophoblasts was significantly decreased by ACA IgG. Therefore, it is suggested that the coagulation system enhancement in APA positive pregnant women can be explained by partially reduced TM.
東京女子医科大学の論文
1997-11-25