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抗磷脂酰丝氨酸/凝血酶原抗体两点检测:与狼疮抗凝物及血栓风险的相关性。

Anti-Phosphatidylserine/Prothrombin Antibodies at Two Points: Correlation With Lupus Anticoagulant and Thrombotic Risk.

机构信息

Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

Department of Immunology, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain.

出版信息

Front Immunol. 2021 Oct 21;12:754469. doi: 10.3389/fimmu.2021.754469. eCollection 2021.

Abstract

Antibodies to phospholipids (aPL) and associated proteins are a hallmark in the diagnosis of anti-phospholipid syndrome (APS). Those included in the classification criteria are the lupus anticoagulant (LA) and the IgG and IgM isotypes of anticardiolipin (aCL) and anti-beta-2 glycoprotein I (β2GPI) antibodies. Non-classification criteria markers such as autoantibodies that recognize the phosphatidylserine/prothrombin (aPS/PT) complex have been proposed as biomarkers for APS. Studies of aPS/PT antibodies have shown a strong correlation to clinical manifestations and LA. We aimed to study the value and the persistence of aPS/PT IgG and IgM antibodies in a cohort of consecutive patients with clinical suspicion of APS and their utility as thrombotic risk markers. Our study, with 103 patients, demonstrates that persistently positive results for aPS/PT IgG antibodies were significantly associated with APS classification, thrombosis, triple aPL positivity, LA positive result, and the Global APS Score (GAPSS) > than 9 points (p < 0.01, for each condition). On the other hand, no association was seen with pregnancy morbidity (p = 0.56) and SLE (p = 0.07). Persistence of aPS/PT antibodies, defined according to the current laboratory classification criteria, likely improves the diagnosis and clinical assessment of patients with APS.

摘要

抗磷脂抗体 (aPL) 及其相关蛋白是抗磷脂综合征 (APS) 诊断的标志。分类标准中包括狼疮抗凝物 (LA) 以及 IgG 和 IgM 型抗心磷脂 (aCL) 和抗β-2 糖蛋白 I (β2GPI) 抗体。非分类标准标志物,如识别磷脂酰丝氨酸/凝血酶原 (aPS/PT) 复合物的自身抗体,已被提议作为 APS 的生物标志物。对 aPS/PT 抗体的研究表明,其与临床表现和 LA 具有很强的相关性。我们旨在研究在具有临床疑似 APS 的连续患者队列中 aPS/PT IgG 和 IgM 抗体的价值和持久性及其作为血栓形成风险标志物的用途。我们的研究纳入了 103 例患者,结果表明,aPS/PT IgG 抗体持续阳性与 APS 分类、血栓形成、三联 aPL 阳性、LA 阳性结果以及 GAPSS > 9 分显著相关 (p < 0.01,每种情况)。另一方面,与妊娠并发症 (p = 0.56) 和 SLE (p = 0.07) 无关。根据当前实验室分类标准,aPS/PT 抗体的持续存在可能会改善 APS 患者的诊断和临床评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be05/8592011/2ca794e373a0/fimmu-12-754469-g001.jpg

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