ANTICORPI ANTICARDIOLIPINA (ACA) NELLA SCLEROSI MULTIPLA: UN EPIFENOMENO?

A significantly higher prevalence of generally low titers of serum autoantibodies is commonly found in multiple sclerosis (MS) patients compared to normal controls, even if no autoimmune diseases are associated. These antibodies are directed against antigens of either nervous tissue or other tissues. Their increased frequency probably reflects an alteration of mechanisms controlling B-cells activity. Anticardiolipin antibodies (ACA) are autoantibodies directed against anionic phospholipids. They play a pathogenetic role in a syndrome characterized by an increased risk of thrombotic events and also of ischemic strokes (antiphospholipid antibody syndrome). ACA have been found in MS patients. The purpose of this study was to compare the frequency of ACA and other autoantibodies in MS patients. ACA serum titers and lupus anticoagulant activity (LA) were measured in 37 patients with MS and 67 healthy controls (age and sex matched). In the MS group the presence of antinuclear (ANA), parietal cell (APCA), smooth muscle (ASMA), and mitochondrial (AMA) autoantibodies was also checked. ACA titers higher than normal values were found in 18,9% of MS patients, Control subjects had all normal ACA values. Among other autoantibodies, only ASMA showed high frequency (24,3%). Difference between ACA and ASMA frequencies was not significant (chi-square test). LA was always normal also in patients who presented high ACA titers. As it has been hypothesized for other autoantibodies, ACA probably do not play a pathogenetic role in MS. Their presence could represent the consequence of nonspecific B-cells overactivity.