Antiphosphatidylserine/prothrombin antibodies as biomarkers to identify severe primary antiphospholipid syndrome.
BACKGROUND
Anti-phosphatidylserine/prothrombin (aPS/PT) antibodies have begun to be considered potentional biomarkers for antiphospholipid syndrome (APS). This cohort study investigate the role of aPS/PT antibodies as a risk factor for severe APS by evaluating the association between those antibodies and clinical/laboratory profiles of APS.


METHODS
Plasma/serum samples from 197 APS patients, 100 healthy subjects and 106 patients with autoimmune diseases were collected. IgG/IgM aPS/PT antibodies were assayed using commercial ELISA kit.


RESULTS
Prevalences of IgG and IgM aPS/PT (p<0.0001 and p=0.0009, respectively) and their titres (p<0.0001 and p=0.0002, respectively) were significantly higher in thrombosis/pregnancy group with respect to pregnancy morbidity alone. Prevalences of IgG and IgM aPS/PT (p<0.0001 and p=0.0004, respectively) and their mean levels (p=0.0001 for both) were significantly higher in the prematurity linked to life-threatening obstetric complications group with respect to miscarriage group. There was a significant relationship between IgG and IgM aPS/PT (p=0.001 and p=0.0002) and their mean levels were higher (p=0.0004 and p=0.0002, respectively) in the thrombotic microangiopathy group, considered a milestone manifestation of catastrophic APS. The relationship between IgG and IgM aPS/PT was significant and mean levels were higher in triple positive antiphospholipid antibody patients than in double and single positivity ones (p<0.0001 for all).


CONCLUSIONS
APS/PT antibodies were associated to severe thrombosis, severe pregnancy complications inducing prematurity, and vascular microangiopathy, all generally associated to high risk APS forms requiring strong therapy.
U.O.C di Reumatologia, Dipartimento di Medicina-DIMED, Policlinico Universitario, Via Giustiniani, 2-35128 Padova.
Ariela
A
Hoxha
Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova.
Elena
E
Mattia
Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova.
Marta
M
Tonello
Department of Medicine, S. Martino Hospital, Belluno.
Chiara
C
Grava
Clinical Cardiology, Thrombosis Centre, University of Padova, Padova.
Vittorio
V
Pengo
Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova.
Amelia
A
Ruffatti
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood* / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010718:Phosphatidylserines / Q000276:immunology*; D011247:Pregnancy; D011516:Prothrombin / Q000276:immunology*; D012189:Retrospective Studies
D017152:Antibodies, Antiphospholipid; D015415:Biomarkers; D010718:Phosphatidylserines; D011516:Prothrombin
anti-phosphatidylserine/prothrombin antibodies; antiphospholipid syndrome; lupus anticoagulant; pregnancy complications; thrombosis; thrombotic microangiopathy