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January 22, 1988, Vol 259, No. 4 >
ARTICLE | January 22, 1988

Epitopes in Medicine: Title and subTitle BreakThe Example of the Lupus Anticoagulant FREE

J. David Bessman, MD
JAMA. 1988;259(4):573-573. doi:10.1001/jama.1988.03720040065031
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References

In this issue of The Journal, Triplett et al1 discuss the relationship among an established laboratory test (lupus anticoagulant), an experimental laboratory test (anticardiolipin antibody), and a clinical phenomenon (thrombosis). To understand the conclusion of their work, a little background is needed. They observe that the target of the anticardiolipin assay may be an "epitope" of the lupus anticoagulant. An epitope (from the Greek word for "nearby place") is an antigenic determinant, a structure that can be identified by an antibody. However, the antigenic determinant may be unrelated except by proximity, not by cause, to some other structure of interest.

See also p 550.

Why the interest in epitopes? There is rapidly increasing interest in using specific antibodies for both therapy2,3 and diagnosis. With the development of monoclonal antibodies, much smaller targets can be used. An antibody to a given molecule may be directed only to part of

REFERENCES

1 +
Triplett DA, Brandt JT, Musgrave KA, et al:  The relationship between lupus anticoagulants and antibodies to phospholipid. JAMA 1988;;259:550-554.
2 +
Simpson PJ, Todd RF, Santone JC, et al:  The reduction of experimental canine myocardial reperfusion injury by a monoclonal antibody (anti Mol, anti CD11B) that inhibits leukocyte adhesion. J Clin Invest , in press.
3 +
Ramsay N, Le Bien T, Nesbit M, et al:  Autologous bone marrow transplantation for patients with acute lymphoblastic leukemia in second or subsequent remission: Results of bone marrow treated with monoclonal antibodies BA-1, BA-2 and BA-3, plus complement. Blood 1985;;66:508-513.
4 +
Polk BF, Fox R, Brookmayer R, et al:  Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men. N Engl J Med 1987;;316:61-66.
5 +
Elias M, Eldor A:  Thromboembolism in patients with the 'lupus' type circulating anticoagulant. Arch Intern Med 1984;;144:510-517.
6 +
Feinstein DI:  Lupus anticoagulant, thrombosis, and fetal loss. N Engl J Med 1985;;312:1348-1350.
7 +
Alving BM, Banerji B, Fogler WE, et al:  Lupus anticoagulant activities of murine monoclonal antibodies to liposomal phosphatidylinositol phosphate. Clin Exp Immunol 1987;;69:403-408.
8 +
Lockshin MD, Qamar T, Druzin ML, et al:  Antibody to cardiolipin, lupus anticoagulant and fetal death. J Rheumatol 1987;:74:259-262.
9 +
Harris EN, Gharavi AE, Brey ML, et al:  Anticardiolipin antibodies: Detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983;;2:1211-1214.
10 +
Alving BM, Baker CS:  Association of IgG cardiolipin antibody with thrombosis in patients with lupus anticoagulant, abstracted. Blood 1987;;70( (suppl 1) ):366A.

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1 +
Triplett DA, Brandt JT, Musgrave KA, et al:  The relationship between lupus anticoagulants and antibodies to phospholipid. JAMA 1988;;259:550-554.
2 +
Simpson PJ, Todd RF, Santone JC, et al:  The reduction of experimental canine myocardial reperfusion injury by a monoclonal antibody (anti Mol, anti CD11B) that inhibits leukocyte adhesion. J Clin Invest , in press.
3 +
Ramsay N, Le Bien T, Nesbit M, et al:  Autologous bone marrow transplantation for patients with acute lymphoblastic leukemia in second or subsequent remission: Results of bone marrow treated with monoclonal antibodies BA-1, BA-2 and BA-3, plus complement. Blood 1985;;66:508-513.
4 +
Polk BF, Fox R, Brookmayer R, et al:  Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men. N Engl J Med 1987;;316:61-66.
5 +
Elias M, Eldor A:  Thromboembolism in patients with the 'lupus' type circulating anticoagulant. Arch Intern Med 1984;;144:510-517.
6 +
Feinstein DI:  Lupus anticoagulant, thrombosis, and fetal loss. N Engl J Med 1985;;312:1348-1350.
7 +
Alving BM, Banerji B, Fogler WE, et al:  Lupus anticoagulant activities of murine monoclonal antibodies to liposomal phosphatidylinositol phosphate. Clin Exp Immunol 1987;;69:403-408.
8 +
Lockshin MD, Qamar T, Druzin ML, et al:  Antibody to cardiolipin, lupus anticoagulant and fetal death. J Rheumatol 1987;:74:259-262.
9 +
Harris EN, Gharavi AE, Brey ML, et al:  Anticardiolipin antibodies: Detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983;;2:1211-1214.
10 +
Alving BM, Baker CS:  Association of IgG cardiolipin antibody with thrombosis in patients with lupus anticoagulant, abstracted. Blood 1987;;70( (suppl 1) ):366A.

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