title: "New" antigenic targets and methodological approaches for refining laboratory diagnosis of antiphospholipid syndrome.
abstract: Antiphospholipid antibodies (aPLs) are a heterogeneous group of antibodies directed against phospholipids or protein/phospholipid complexes. Currently, aPLs are assessed using either "solid-phase" assays that identify anticardiolipin antibodies and anti-β2-glycoprotein I antibodies or "liquid-phase" assay that identifies lupus anticoagulant. However, in the last few years, "new" antigenic targets and methodological approaches have been employed for refining laboratory diagnosis of antiphospholipid syndrome (APS). In this review the potential diagnostic value of antibodies to domains of β2-GPI, prothrombin/phosphatidylserine, vimentin/cardiolipin, protein S, protein C, annexin A2, annexin A5, and phospholipid antigens is discussed. Moreover, new technical approaches, including chemiluminescence, multiline dot assay, and thin layer chromatography (TLC) immunostaining, which utilize different supports for detection of aPL, have been developed. A special focus has been dedicated on "seronegative" APS, that is, those patients with a clinical profile suggestive of APS (thromboses, recurrent miscarriages, or foetal loss), who are persistently negative for the routinely used aPL. Recent findings suggest that, in sera from patients with SN-APS, antibodies may be detected using "new" antigenic targets (mainly vimentin/cardiolipin) or methodological approaches different from traditional techniques (TLC immunostaining). Thus, APS represents a mosaic, in which antibodies against different antigenic targets may be detected thanks to the continuously evolving new technologies.
authors: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.
authors: Roberta
authors: R
authors: Misasi
authors: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.
authors: Antonella
authors: A
authors: Capozzi
authors: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.
authors: Agostina
authors: A
authors: Longo
authors: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.
authors: Serena
authors: S
authors: Recalchi
authors: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.
authors: Emanuela
authors: E
authors: Lococo
authors: Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia, Sapienza Università di Roma, Viale del Policlinico 155, 00161 Roma, Italy.
authors: Cristiano
authors: C
authors: Alessandri
authors: Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia, Sapienza Università di Roma, Viale del Policlinico 155, 00161 Roma, Italy.
authors: Fabrizio
authors: F
authors: Conti
authors: Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia, Sapienza Università di Roma, Viale del Policlinico 155, 00161 Roma, Italy.
authors: Guido
authors: G
authors: Valesini
authors: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.
authors: Maurizio
authors: 0000-0003-3534-1502
authors: M
authors: Sorice
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000032:analysis* / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000175:diagnosis*; D002308:Cardiolipins / Q000276:immunology; D002855:Chromatography, Thin Layer / Q000379:methods; D019411:Clinical Laboratory Techniques; D005455:Fluorescent Antibody Technique / Q000379:methods; D006801:Humans; D008163:Luminescent Measurements / Q000379:methods; D014746:Vimentin / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D002308:Cardiolipins; D014746:Vimentin