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(Circulation. 1996;94:2396-2401.)
© 1996 American Heart Association, Inc.

Articles

Anti–Endothelial Cell Antibodies in Takayasu Arteritis

Jens Eichhorn, MD; Dagmar Sima, MD; Bernhard Thiele, MD; Carsten Lindschau, PhD; Andreas Turowski, MD; Heiner Schmidt, MD; Wolfgang Schneider, MD; Hermann Haller, MD; Friedrich C. Luft, MD, FACP, FRCP (Edin)

Franz Volhard Clinic at the Max Delbruck Center for Molecular Medicine, Virchow Klinikum, Department of Pathology, Klinikum Buch and Charite University Hospital, Humboldt University of Berlin (Germany).

Correspondence to Friedrich C. Luft, Franz Volhard Clinic, Wiltberg Strasse 50, 13122 Berlin, FRG. E-mail fcluft@orion.rz.mdc-berlin.de.

Background Although a specific etiology for Takayasu arteritis has not been found, the bulk of evidence favors an autoimmune mechanism. We examined the sera of 19 patients with Takayasu arteritis for antineutrophil cytoplasmic antibodies (ANCA), antinuclear antibodies (ANA), anti-DNA antibodies, antibodies to extractable nuclear antigens (ENA), anti-Ro antibodies, anticardiolipin antibodies, circulating immune complexes, and anti–endothelial cell antibodies (AECA).

Methods and Results We used enzyme-linked immunoassays, immunofluorescence, counterimmunoelectrophoresis, fluorescent-activated cell sorter (FACS) analysis, and confocal microscopy. We found that although no patient had positive ANCA, ANA, anti-DNA antibodies, ENA antibodies, anti-Ro antibodies, or anticardiolipin antibodies, 18 of the 19 patients had AECA. The AECA titers of the patients were 2561±1458 compared with 126±15 arbitrary units in a normal group of control subjects (P<.001). To verify the specificity of AECA, we performed cytofluorimetry on human endothelial cells with the sera from patients and control subjects. Two entirely separate patterns of fluorescence intensity were identified. We next performed immunocytochemistry and confocal microscopy with human endothelial cells subjected to patients' sera and to sera from normal subjects. The cells subjected to sera from patients with Takayasu arteritis demonstrated specific immunofluorescent staining of their plasma membrane and cytosol.

Conclusions AECA are frequently present in patients with Takayasu arteritis. They may play a role in the pathogenesis. Furthermore, they may be useful as an additional diagnostic tool.

Key Words: arteries • vasculature • endothelium • cells • autoimmunity • collagen

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