Clinical implications of the detection of antibodies directed against domain 1 of β2-glycoprotein 1 in thrombotic antiphospholipid syndrome.

Autor: Montalvão S; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil. Electronic address: silmara@unicamp.br., Elídio PS; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil. Electronic address: pri_kelidio@hotmail.com., da Silva Saraiva S; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil. Electronic address: sabrina_saraiva@yahoo.com.br., de Moraes Mazetto B; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil. Electronic address: brunamazetto_1@hotmail.com., Colella MP; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil. Electronic address: marinasp@unicamp.br., de Paula EV; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil; Discipline of Hematology and Hemotherapy, Department of Clinical Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP: 13083-887 Campinas, SP, Brazil. Electronic address: erich@unicamp.br., Appenzeller S; Rheumatology Unit, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP: 13083-887 Campinas, SP, Brazil. Electronic address: appenzellersimone@gmail.com., Annichino-Bizzacchi J; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil; Discipline of Hematology and Hemotherapy, Department of Clinical Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP: 13083-887 Campinas, SP, Brazil. Electronic address: joyce@unicamp.br., Orsi FA; Laboratory of Haemostasis, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480, Cidade Universitária 'Zeferino Vaz', CEP: 13083-970 Campinas, SP, Brazil; Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Brazil Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP: 13083-887 Campinas, SP, Brazil. Electronic address: ferorsi@unicamp.br.
Jazyk: angličtina
Zdroj: Thrombosis research [Thromb Res] 2016 Dec; Vol. 148, pp. 32-37. Date of Electronic Publication: 2016 Oct 04.
DOI: 10.1016/j.thromres.2016.10.001
Abstrakt: Introduction: Antibodies directed against domain 1 of β2 glycoprotein 1 (aβ2GP1-Dm1) have been involved in the immunopathogenesis of antiphospholipid syndrome (APS). However, the clinical relevance of aβ2GP1-Dm1 in thrombotic APS has not yet been fully explored.
Objectives: To determine the frequency of aβ2GP1-Dm1 in a cohort of patients with thrombotic APS, and to evaluate whether testing for aβ2GP1-Dm1 could have a clinical impact upon the risk assessment of the disease.
Methods: Patients were tested for aβ2GP1-Dm1 antibodies by chemiluminescence (BioFlash/AcuStar®, ES). The presence of aβ2GP1-Dm1 was evaluated in different clinical presentations of the disease.
Results: Eight-four patients with a history of venous or arterial thrombosis were included. Forty-five (54%) patients had aβ2GP1 antibodies and 40% of them were positive for aβ2GP1-Dm1. Levels of aβ2GP1-Dm1 were higher in patients with systemic autoimmune disease (AUC=0.665; 95% CI=0.544-0.786; P=0.01), positive antinuclear antibody (AUC=0.654; 95% CI=0.535-0.772; P=0.01), triple antiphospholipid antibody (aPL) positivity (AUC=0.680; 95% CI=0.534-0.825; P=0.02) and positive lupus anticoagulant (AUC=0.639; 95% CI=0.502-0.776; P=0.07). In this cohort, aβ2GP1-Dm1 antibodies were not associated with the site of the first thrombosis (OR=0,62, 95% CI=0.20-1.94, P=0.42), thrombosis recurrence (OR=1.0, 95% CI=0.37-2.71, P=1.0) or pregnancy morbidity (OR=1.5, 95% CI=0.33-7.34, P=0.58). In multivariate analysis, positivity for aβ2GP1-Dm1 antibodies was associated with the diagnosis of systemic autoimmune disease (OR=4.01, 95% CI=1.14-14.2; P=0.03) and triple aPL positivity (OR=3.59, 95% CI=0.87-14.85; P=0.07).
Conclusions: In the present cohort of thrombotic-APS patients, aβ2GP1-Dm1 antibodies were related to the diagnosis of systemic autoimmunity and complex serological profile of the disease, as triple aPL positivity and positive antinuclear antibody. Thus, our results suggest that testing for aβ2GP1-Dm1 antibodies may be useful for improving APS risk assessment.
(Copyright © 2016 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: