ANTIENDOTHELIAL CELL ANTIBODIES IN THROMBOANGIITIS-OBLITERANS

The occurrence of autoimmune phenomena in 28 patients with thromboangi itis obliterans (Buerger's disease) was determined. The following were sought: antineutrophil cytoplasmic antibodies against proteinase 3 (c ANCA) and myeloperoxidase (pANCA), antinuclear antibodies, anti-Ro ant ibodies, anticardiolipin antibodies, and antiendothelial cell antibodi es (AECA). For the last, an enzyme-linked immunosorbent assay was deve loped which verified the presence of the AECA phenomenon with immunofl uorescence and confocal microscopy. Seven patients with active disease had AECA titers of 1,857 +/- 450 arbitrary units (AU) compared with 1 26 +/- 15 AU in 30 normal control subjects (P < 0.001) and 461 +/- 41 AU in 21 patients in remission (P < 0.01). Antibodies from the sera of patients with active disease reacted not only with surface epitopes b ut also with sites within the cytoplasm of human endothelial cells. AE CA may be useful in following disease activity and may play a role in the pathogenesis of thromboangiitis obliterans.