الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Antiphospholipid antibodies are immunoglobulins, belonging to a group of heterogeneous autoantibodies directed against phospholipids and phospholipid protein complexes. The presence of these immunoglobulins has been associated with thromboembolic events such as deep vein thrombosis, pulmonary embolism, myocardial infarction and stroke.
Cerebral infarction associated with APL antibodies in young adults is the most common arterial manifestation. However, the importance of these various autoantibodies, whether they are a cause or a consequence or even only a coincidence is still a matter of debate.
The aim of the work was to study the role of the antiphospholipid antibodies (antiphosphatidyl-serine IgG, IgM and anti ß2 glycoprotiensІ IgG) in young ischemic stroke patients.
The present study was carried out on three groups of young subjects (15-44) years of age:
Group (І): Fifteen ischemic stroke patients with associated stroke risk factors.
Group (ІІ): Fifteen ischemic stroke patients without associated stroke risk factors.
Group (ІІІ): Ten control individuals who were young adults of the same age without history of stroke.
All studied groups were subjected to the following:
• Recording of historical data for patients including personal, present, past, family, drug and obstetrical history.
• Registration of anthropometric measures.
• Thorough clinical examination including neurological and musculoskeletal examination.
• Imaging studies including CT or MRI brain.
• Laboratory assessment including: CBC, ESR .FBS, serum cholesterol and triglycerides, CRP and (ELISA) technique which was used for the detection of antiphosphatidylserine IgG, IgM and anti β2 glycoprotiensІ IgG antibodies.
The results showed that serum a PS IgG antibodies levels were significantly the most prevalent studied antiphospholipids and showed the highest risk in ischemic stroke patients without stroke risk factors (8/15, 53.3%, O.R: 2.985) compared to ischemic stroke patients with stroke risk factors (1/15 , 6.7%) and control group (1/10 , 10%).
Similarly, serum a PS IgM antibodies levels were significantly prevalent in ischemic stroke patients without stroke risk factors (5/15, 33.3%, O.R: 2.78) compared to stroke patients with stroke risk factors (0/15, 0%) and control group (0/10, 0%). While serum anti β2 glycoprotiens І IgG levels were significantly prevalent in both ischemic stroke with and without stroke risk factors (7/15, 46.7%, O.R: 1.898 for each group) in comparison with control subjects (0/10, 0%).
There was no significant statistical difference between acute and chronic stroke patients as regards different laboratory tests including antiphospholipids.
Positive correlations were detected between aPS IgM and aPS IgG antibodies levels and between aPS IgM and aβ2glycoprotien І IgG levels. Also a positive correlation was detected between aPS IgG and aβ2glycoprotien І IgG levels. On the other hand, a negative correlation was found between antiphosphatidyl serine IgG (aPSIgG) antibodies levels and age, another negative correlation was detected between the antiphosphatidyl serine IgM (aPSIgM) value and age. There were no significant correlations detected between the studied antiphospholipid antibodies and stroke spasticity. There was a significant statistical relation between the frequency of stroke risk factors and the prevalence of aβ2glycoprotien І IgGs antibodies.
Finally, there was a significant relation between increasing the aβ2 glycoprotein І IgG antibodies and different stroke risk factors (smoking, sedentary life style, hypertension, previous stroke, history of hyperlipidemia, and stroke family history).
It was concluded from the current study that elevated antiphosphatidyl serine IgG IgM and β2glycoprotien І IgG antibodies titers are associated with increased risk of ischemic stroke without risk factors in young adults supporting a relevant role for antiphosphatidylserine IgG, IgM and anti-β2-glycoprotein I IgG in stroke aetiology. A PS IgG levels were significantly the most prevalent studied antiphospholipids and showed the highest risk in ischemic stroke without stroke risk factors, while anti β2glycoprotien І IgG antibodies titers were associated with increased risk of ischemic stroke in both stroke with and without risk factors. Moreover, Anti-β2-glycoprotein I IgG was associated with stroke risk factors suggesting that stroke risk factors may have a role in anti β2glycoprotien І IgG elevation, aPS IgG and IgM positively correlate with anti-β2-glycoprotein I IgG, as all are subtypes of antiphosholipid antibodies. APS IgM and IgG decrease with age as antiphospholipids are more common in young and middle aged adults. Finally antiphospholipids antibodies’ level has no role in stroke spasticity as well as duration of stroke.