Περίληψη:
Background Specific anti-phospholipids antibodies (aPLs) are used as
classification criteria of the antiphospholipid syndrome (APS). These
aPLs, although essential for diagnosis, do not predict disease
phenotypes, which may require specific therapies. Non-criteria aPLs are
rarely evaluated and their role is yet to be defined. In the current
study, we aimed to examine the association between criteria and
non-criteria aPLs and APS phenotypes. Methods Serum samples from 188
subjects, 130 APS patients and 58 controls were analyzed for the
presence of 20 aPLs (IgG and IgM isotypes to cardiolipin (CL),
beta2-glycoprotein1 (beta 2GP1), phosphatidic acid (P-acid),
phosphatidylcholine (PC), phosphatidylethanolamine (PE),
phosphatidylglycerol (PG), phosphatidylinositol (PI), phosphatidylserine
(PS), annexin-5 (AN) and prothrombin (PT) using a line immunoassay (GA
Generic Assays, Germany). Sero-positivity to the different aPLs/aPLs
profiles was correlated to APS phenotypes (i.e. arterial thrombosis, CNS
manifestations, venous thrombosis, relapsing disease, obstetric
morbidity). Results In this cohort, arterial thrombosis was associated
with accumulative number of >= 7/20 aPLs evaluated (OR 4.1; CI 95%
1.9-96, p = 0.001) as well as the sole presence of aPT (IgG) (OR 2.3;CI
95% 1.1-5.1, p = 0.03). CNS manifestations were linked with a profile
of 4 aPLs (IgG): aPT, aPG, aPI and aAN (OR 2.6;CI 95% 1.1-6.3, p =
0.03). Symptom-free period of >= 3 years was linked with lower number of
aPLs and the presence of aPI (IgG) (OR 3.0;CI 95% 1.08-8.1, p < 0.05)
or aAN (IgG) (OR 3.4;CI 95% 1.08-10.9, p < 0.05). APS related pregnancy
morbidity correlated with a profile of 2 aPLs (IgG): aCL and aPS (OR
2.9; CI 95% 1.3-6.5, p < 0.05) or the sole presence of aAN (IgG) (OR
2.8; CI 95% 1.02-8, p = 0.05). Conclusion In this study, we observed an
association between specific criteria/non-criteria aPLs or aPLs profiles
and clinical phenotypes of APS. Our data suggest that examination of a
wider variety of aPLs may allow better characterization of APS.
Συγγραφείς:
Volkov, Ilan
Seguro, Luciana
Leon, Elaine P.
Kovacs, Laszlo
and Roggenbuck, Dirk
Schierack, Peter
Gilburd, Boris
Doria,
Andrea
Tektonidou, Maria G.
Agmon-Levin, Nancy
