title: Lymphocyte Disturbances in Primary Antiphospholipid Syndrome and Application to Venous Thromboembolism Follow-Up.
abstract: Among patients with venous thromboembolism (VTE), the persistent detection of antiphospholipid (aPL) antibodies (Ab) represents an independent high risk factor for recurrence. However, oral anticoagulation vitamin K antagonist therapy, frequently used in these patients, is problematic in assessing and/or confirming a diagnosis of primary aPL syndrome (pAPS), suggesting use of alternative strategies. For this reason, and by analogy with other autoimmune diseases, a flow cytometer approach testing peripheral T cell subsets (CD3, CD4, and CD8), B cell subsets (B1, transitional, naive, and memory), and NK cells can be proposed. As an example and to validate the concept, pAPS patients selected from the monocentric VTE case-control EDITH's cohort were selected during their follow-up. As suspected and in contrast to non-APS VTE patients, other autoimmune diseases, and controls, pAPS VTE patients displayed specific lymphocyte disturbances. Quantitative and qualitative modifications were related to total CD4+T cell reduction, a lower CD4/CD8 ratio, and disturbance in B cell homeostasis with increased proportions of B1 cells, transitional B cells (CD24++CD38++), and naive B cells (IgD+CD27-), while memory B cells (IgD+CD27+and IgD-CD27+) were reduced. Interestingly, the absolute number of CD4+T cells positively correlated with IgG anti-cardiolipin Ab levels. Altogether, disturbances of T and B cell homeostasis characterized pAPS VTE patients during their follow-up. This suggests a means of profiling that could be used in addition to existing criteria to characterize them.
authors.affiliation: Laboratory of Immunology and Immunotherapy, Hôpital Morvan, University Hospital of Brest, Brest, France.|INSERM ESPRI, ERI29/EA2216, LabEx IGO "Immunotherapy Graft Oncology", Réseau épigénétique et réseau canaux ioniques du Cancéropole Grand Ouest, European University of Brittany, Brest, France.|Department of Internal Medicine and Chest Diseases, European University of Brittany, EA3878 (G.E.T.B.O, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Simonin
authors.affiliation: Department of Internal Medicine and Chest Diseases, European University of Brittany, EA3878 (G.E.T.B.O, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pasquier
authors.affiliation: Department of Internal Medicine and Chest Diseases, European University of Brittany, EA3878 (G.E.T.B.O, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Leroyer
authors.affiliation: INSERM ESPRI, ERI29/EA2216, LabEx IGO "Immunotherapy Graft Oncology", Réseau épigénétique et réseau canaux ioniques du Cancéropole Grand Ouest, European University of Brittany, Brest, France.|Unit of Rheumatology, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France.
authors.forename: Divi
authors.initials: D
authors.lastname: Cornec
authors.affiliation: Laboratory of Immunology and Immunotherapy, Hôpital Morvan, University Hospital of Brest, Brest, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Lemerle
authors.affiliation: Laboratory of Immunology and Immunotherapy, Hôpital Morvan, University Hospital of Brest, Brest, France.|INSERM ESPRI, ERI29/EA2216, LabEx IGO "Immunotherapy Graft Oncology", Réseau épigénétique et réseau canaux ioniques du Cancéropole Grand Ouest, European University of Brittany, Brest, France.
authors.forename: Boutahar
authors.initials: B
authors.lastname: Bendaoud
authors.affiliation: Laboratory of Immunology and Immunotherapy, Hôpital Morvan, University Hospital of Brest, Brest, France.|INSERM ESPRI, ERI29/EA2216, LabEx IGO "Immunotherapy Graft Oncology", Réseau épigénétique et réseau canaux ioniques du Cancéropole Grand Ouest, European University of Brittany, Brest, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Hillion
authors.affiliation: INSERM ESPRI, ERI29/EA2216, LabEx IGO "Immunotherapy Graft Oncology", Réseau épigénétique et réseau canaux ioniques du Cancéropole Grand Ouest, European University of Brittany, Brest, France.
authors.forename: Jacques-Olivier
authors.initials: JO
authors.lastname: Pers
authors.affiliation: Department of Internal Medicine and Chest Diseases, European University of Brittany, EA3878 (G.E.T.B.O, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Couturaud
authors.affiliation: Laboratory of Immunology and Immunotherapy, Hôpital Morvan, University Hospital of Brest, Brest, France. yves.renaudineau@univ-brest.fr.|INSERM ESPRI, ERI29/EA2216, LabEx IGO "Immunotherapy Graft Oncology", Réseau épigénétique et réseau canaux ioniques du Cancéropole Grand Ouest, European University of Brittany, Brest, France. yves.renaudineau@univ-brest.fr.
authors.forename: Yves
authors.initials: Y
authors.lastname: Renaudineau
mesh_terms: D000818:Animals; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000175:diagnosis / Q000276:immunology*; D015551:Autoimmunity; D016175:B-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D015415:Biomarkers; D006801:Humans; D016130:Immunophenotyping; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology* / Q000378:metabolism; D012698:Serologic Tests; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D054556:Venous Thromboembolism / Q000097:blood* / Q000175:diagnosis / Q000276:immunology*
chemical_list: D015415:Biomarkers
keywords: Antiphospholipid syndrome; Autoimmunity; B cells; Lymphocytes; Venous thromboembolism