Kraiem Imen, Hadhri Samira, Ben Rejeb Mohamed, Ifa Lamia, Jmaa Ali, Ajmi Salem, Skouri Hadef
Laboratoire d'Hématologie et Banque du Sang, UR12ES05. CHU Sahloul, Sousse, Tunisie.
Laboratoire d'Hygiène Hospitalière CHU Sahloul, Sousse, Tunisie.
Clin Appl Thromb Hemost. 2016 Nov;22(8):734-742. doi: 10.1177/1076029615581364. Epub 2015 Apr 15.
The hypercoagulable state accompanying inflammatory bowel diseases (IBDs) is still poorly understood. The aim of this study was to assess antiphospholipid antibodies (APAs) and a large panel of inherited and acquired thrombotic markers simultaneously in a sample of Tunisian patients with IBD. In total, 89 consecutive patients with IBD (mean age 38 ± 15 years; 48 with Crohn disease and 41 with ulcerative colitis) and 129 controls were prospectively evaluated for immunoglobulin (Ig) G, IgM, and IgA antibodies against cardiolipin (aCL), β2glycoprotein I (aβ2GPI), and prothrombin (aPT); IgG and IgM antibodies against phosphatidic acid (aPA), phosphatidylinositol (aPI), and annexin V (aAnnV); lupus anticoagulant (LA); coagulation factors; natural inhibitors; and thrombotic genetic polymorphisms. Levels of fibrinogen, factors II, V, and VIII and von Willebrand factor, antithrombin, and protein C were significantly higher in patients with IBD than in controls (P < .05 for all comparisons). At least 1 APA subset was detected in 54 patients. The frequencies of antibodies against anionic phospholipids-aCL, aPI, and aPA-in patients with IBD were 15.9%, 21.3%, and 14.6%, respectively. The frequencies of antiphospholipid cofactor antibodies were 39.8% for aβ2GPI and 15.7% for both aAnnV and aPT. Isolated aβ2GPI IgA was detected in 22 patients, and 12 (13.5%) patients had LA. The IgA aβ2GPI antibodies were frequently detected in Tunisian patients with IBD. These results are of potential diagnostic, prognostic, and therapeutic interest.
炎症性肠病（IBD）所伴随的高凝状态仍未得到充分了解。本研究的目的是在一组突尼斯IBD患者样本中同时评估抗磷脂抗体（APA）以及一系列遗传性和获得性血栓形成标志物。总共对89例连续的IBD患者（平均年龄38±15岁；48例克罗恩病患者和41例溃疡性结肠炎患者）和129名对照者进行了前瞻性评估，检测针对心磷脂（aCL）、β2糖蛋白I（aβ2GPI）和凝血酶原（aPT）的免疫球蛋白（Ig）G、IgM和IgA抗体；针对磷脂酸（aPA）、磷脂酰肌醇（aPI）和膜联蛋白V（aAnnV）的IgG和IgM抗体；狼疮抗凝物（LA）；凝血因子；天然抑制剂；以及血栓形成基因多态性。IBD患者的纤维蛋白原、凝血因子II、V和VIII以及血管性血友病因子、抗凝血酶和蛋白C水平显著高于对照组（所有比较P < 0.05）。54例患者中检测到至少1个APA亚组。IBD患者中针对阴离子磷脂—aCL、aPI和aPA—的抗体频率分别为15.9%、21.3%和14.6%。抗磷脂辅助因子抗体的频率，aβ2GPI为39.8%，aAnnV和aPT均为15.7%。22例患者检测到孤立的aβ2GPI IgA，12例（13.5%）患者有LA。突尼斯IBD患者中经常检测到IgA aβ2GPI抗体。这些结果具有潜在的诊断、预后和治疗意义。
