Fluctuation of Anti-Domain 1 and Anti-β 2 -Glycoprotein I Antibody Titers Over Time in Patients With Persistently Positive Antiphospholipid Antibodies.

Autor: Chighizola CB; Pediatric Rheumatology Unit, ASST G. Pini-CTO, University of Milan, Milan, Italy., Pregnolato F; Pediatric Rheumatology Unit, ASST G. Pini-CTO, University of Milan, Milan, Italy., Andrade D; Reumatologia, University of Sao Paulo, Sao Paulo, Brazil., Tektonidou M; First Department of Propaedeutic and Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece., Pengo V; Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy., Ruiz-Irastorza G; Unidad de Investigación de Enfermedades Autoinmunes, Servicio de Medicina Interna, Universidad del País Vasco/Euskal Herriko Unibertsitatea, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Spain., Belmont HM; Hospital for Joint Diseases, New York University, New York., Gerosa M; Clinical Rheumatology Unit, ASST G. Pini-CTO, University of Milan, Milan, Italy., Fortin P; PMedicine, Université Laval, Quebec, Canada., Branch DW; Department of Obstetrics, University of Utah and Intermountain Healthcare, Salt Lake City., Andreoli L; Rheumatology Unit, University of Brescia, Brescia, Italy., Petri MA; Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Cervera R; Department of Autoimmune Diseases, Hospital Clínic de Barcelona, Barcelona, Spain., Knight JS; Division of Rheumatology, University of Michigan, Ann Arbor., Willis R; Internal Medicine, University of Texas Medical Branch, Galveston., Efthymiou M; Department of Haematology, University College London, London, UK., Cohen H; Department of Haematology, University College London, London, UK., Erkan D; Rheumatology, Hospital for Special Surgery, New York, New York., Bertolaccini ML; Vascular Risk and Surgery Section, King's College London, London, UK.
Jazyk: angličtina
Zdroj: Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2023 Jun; Vol. 75 (6), pp. 984-995. Date of Electronic Publication: 2023 Apr 02.
DOI: 10.1002/art.42459
Abstrakt: Objective: The present study was undertaken to longitudinally evaluate titers of antibodies against β 2 -glycoprotein I (anti-β 2 GPI) and domain 1 (anti-D1), to identify predictors of variations in anti-β 2 GPI and anti-D1 titers, and to clarify whether antibody titer fluctuations predict thrombosis in a large international cohort of patients who were persistently positive for antiphospholipid antibodies (aPL) in the APS ACTION Registry.
Methods: Patients with available blood samples from at least 4 time points (at baseline [year 1] and at years 2-4 of follow-up) were included. Detection of anti-β 2 GPI and anti-D1 IgG antibodies was performed using chemiluminescence (BIO-FLASH; INOVA Diagnostics).
Results: Among 230 patients in the study cohort, anti-D1 and anti-β 2 GPI titers decreased significantly over time (P < 0.0001 and P = 0.010, respectively). After adjustment for age, sex, and number of positive aPL tests, we found that the fluctuations in anti-D1 and anti-β 2 GPI titer levels were associated with treatment with hydroxychloroquine (HCQ) at each time point. Treatment with HCQ, but not immunosuppressive agents, was associated with 1.3-fold and 1.4-fold decreases in anti-D1 and anti-β 2 GPI titers, respectively. Incident vascular events were associated with 1.9-fold and 2.1-fold increases in anti-D1 and anti-β 2 GPI titers, respectively. Anti-D1 and anti-β 2 GPI titers at the time of thrombosis were lower compared to titers at other time points. A 1.6-fold decrease in anti-D1 titers and a 2-fold decrease in anti-β 2 GPI titers conferred odds ratios for incident thrombosis of 6.0 (95% confidence interval [95% CI] 0.62-59.3) and 9.4 (95% CI 1.1-80.2), respectively.
Conclusion: Treatment with HCQ and incident vascular events in aPL-positive patients predicted significant anti-D1 and anti-β 2 GPI titer fluctuations over time. Both anti-D1 and anti-β 2 GPI titers decreased around the time of thrombosis, with potential clinical relevance.
(© 2023 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE
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