'Non-criteria antiphospholipid antibodies': bridging the gap between seropositive and seronegative Antiphospholipid Syndrome

Autor: Gloria Riitano, Agostina Longo, Roberta Misasi, Simona Truglia, Fulvia Ceccarelli, Cristiano Alessandri, Antonella Capozzi, S. Mancuso, Serena Recalchi, Fabrizio Conti, Sara De Carolis, Caterina De Carolis, Francesca Romana Spinelli, Maurizio Sorice
Jazyk: angličtina
Rok vydání: 2022
Předmět:
0301 basic medicine
Adult
Male
medicine.medical_specialty
SN-APS
Settore MED/47 - SCIENZE INFERMIERISTICHE OSTETRICO-GINECOLOGICHE
Cardiolipins
Antiphospholipid syndrome
TLC-immunostaining
aVim/CL
prognosis
Enzyme-Linked Immunosorbent Assay
Antiphospholipid
Phosphatidylserines
Antibodies
03 medical and health sciences
0302 clinical medicine
Rheumatology
Internal medicine
medicine
Humans
Vimentin
Pharmacology (medical)
Recurrent thrombosis
Good outcome
030203 arthritis & rheumatology
Lupus anticoagulant
Chromatography
biology
business.industry
Conventional treatment
Tlc immunostaining
Middle Aged
medicine.disease
Thin Layer
030104 developmental biology
beta 2-Glycoprotein I
Case-Control Studies
Cohort
biology.protein
Antibodies
Antiphospholipid
Female
Prothrombin
Chromatography
Thin Layer
Antibody
business
Popis: Objective We aimed to analyse the prevalence of non-criteria anti-phospholipid (aPL) antibodies and their role in the diagnosis, treatment and prognosis in a cohort of patients with clinical features consistent with a diagnosis of antiphospholipid syndrome (APS), but persistently negative for criteria aPL – anti-cardiolipin antibodies (aCL), anti-β2-glycoprotein I antibodies (aβ2-GPI) and lupus anticoagulant (LA) – named seronegative APS (SN-APS). Methods Sera from SN-APS patients were tested for aCL by TLC-immunostaining, anti-vimentin/cardiolipin (aVim/CL) and anti-phosphatidylserine/prothrombin (anti-PS/PT) by ELISA. Control groups of our study were APS patients and healthy controls. Results We enrolled 114 consecutive SN-APS patients, 69 (60.5%) resulted positive for at least one non-criteria test in two occasions 12 weeks apart. Among the persistently positive patients to these tests, 97% resulted positive for aCL by TLC-immunostaining, 52.3% for aVim/CL and 17.4% for aPS/PT. SN-APS patients with double positivity (aCL by TLC-immunostaining and aVim/CL) showed a likelihood positive ratio of 8 to present mixed thrombotic and obstetrical features. Among SN-APS patients tested positive, after the therapeutic changes, three cases of recurrent thrombosis were observed [median follow-up 41 months (IQR 39.5)]. Twenty pregnancies were recorded in 17 SN-APS patients after the detection of unconventional aPL and 12 of them (60%) experienced a good outcome under conventional treatment for APS. Conclusions This is the largest monocentric study demonstrating that aCL tested by TLC-immunostaining and aVim/CL can detect aPL positivity in SN-APS. It may encourage clinicians to monitor and provide adequate targeted therapy, which improve SN-APS prognosis.
Databáze: OpenAIRE
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