Arsène Mekinian1, Marie-Charlotte Bourrienne2, Lionel Carbillon3, Amélie Benbara3, Abisror Noémie4, Sylvie Chollet-Martin2, Ahmed Tigaizin3, Francois Montestruc5, Olivier Fain4, Pascale Nicaise-Roland2. 1. AP-HP, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Hôpital Saint-Antoine, Sorbonne Universités, UPMC University Paris 06, F-75012, Paris, France. Electronic address: arsene.mekinian@aphp.fr. 2. AP-HP, Unité Fonctionnelles d'Immunologie, Auto-Immunité et Hypersensibilités, Hôpital Bichat-Claude Bernard, Paris, France. 3. AP-HP, Service de Gynécologie-Obstétrique, Hôpital Jean Verdier, Université Paris 13, Bondy, France. 4. AP-HP, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Hôpital Saint-Antoine, Sorbonne Universités, UPMC University Paris 06, F-75012, Paris, France. 5. eXYSTAT, Malakoff, France.
Abstract
OBJECTIVES: To describe the prevalence of non-conventional APL in patients with obstetrical APS without conventional APL and the impact of treatment on pregnancy outcome. METHODS: Patients with clinical obstetrical criteria were tested for anti-phosphatidylethanolamine (aPE) IgG/M, anti-prothrombin/phosphatidylserine (anti-PS/PT) IgG/M, and anti-annexin V IgG. Pregnancy losses rates were compared between APS, non-conventional APS, and non-APL and in untreated pregnancies to treated ones for each group. RESULTS: Using the cutoffs (ROC), 65/96 (68%) patients have been considered as non-conventional APS and compared to 83 APS and 31 patients without APL. The obstetrical history in non-conventional APS did not differ in comparison to confirmed APS. The frequencies of anti-annexin V IgG antibodies tended to be more frequent in non-conventional APS (88% versus 73%; p = 0.06), and those of anti-PE IgG and M were similar. The anti-PS/PT IgG and M antibodies were more frequent in confirmed APS than in non-conventional APS (63% and 37% versus 4% and 5%, respectively, p < 0.0001). Overall, 261 pregnancies in patients with non-conventional APS were compared with 81 pregnancies of confirmed APS and 132 pregnancies from non-APL group. Out of 474, 136 (29%) patients have been treated during pregnancies, and treatment significantly increased the rate of live birth (26% in untreated versus 72% in treated pregnancies, p < 0.0001). In univariate analyses, treatment effect on pregnancy losses was similar in patients with APS and non-conventional APS, with odds ratio at 3.3 (95% CI: 1.8-6.1) and 6.9 (95% CI: 3.9-12.3) (p = 0.49) and significantly more important for the 2 APS groups pooled versus non-APL group [OR at 1.9 (95% CI: 1.1-3.5) for non-APL group versus 5.3 (95% CI: 3.5-8.1) for APS groups, p = 0.0025]. CONCLUSION: In this study, 68% of patients with clinical criteria for obstetrical APS seronegative for conventional APL have non-conventional APL. These patients have a significant decrement of pregnancy losses if they receive treatment for APS during their pregnancy.
OBJECTIVES: To describe the prevalence of non-conventional APL in patients with obstetrical APS without conventional APL and the impact of treatment on pregnancy outcome. METHODS:Patients with clinical obstetrical criteria were tested for anti-phosphatidylethanolamine (aPE) IgG/M, anti-prothrombin/phosphatidylserine (anti-PS/PT) IgG/M, and anti-annexin V IgG. Pregnancy losses rates were compared between APS, non-conventional APS, and non-APL and in untreated pregnancies to treated ones for each group. RESULTS: Using the cutoffs (ROC), 65/96 (68%) patients have been considered as non-conventional APS and compared to 83 APS and 31 patients without APL. The obstetrical history in non-conventional APS did not differ in comparison to confirmed APS. The frequencies of anti-annexin V IgG antibodies tended to be more frequent in non-conventional APS (88% versus 73%; p = 0.06), and those of anti-PE IgG and M were similar. The anti-PS/PT IgG and M antibodies were more frequent in confirmed APS than in non-conventional APS (63% and 37% versus 4% and 5%, respectively, p < 0.0001). Overall, 261 pregnancies in patients with non-conventional APS were compared with 81 pregnancies of confirmed APS and 132 pregnancies from non-APL group. Out of 474, 136 (29%) patients have been treated during pregnancies, and treatment significantly increased the rate of live birth (26% in untreated versus 72% in treated pregnancies, p < 0.0001). In univariate analyses, treatment effect on pregnancy losses was similar in patients with APS and non-conventional APS, with odds ratio at 3.3 (95% CI: 1.8-6.1) and 6.9 (95% CI: 3.9-12.3) (p = 0.49) and significantly more important for the 2 APS groups pooled versus non-APL group [OR at 1.9 (95% CI: 1.1-3.5) for non-APL group versus 5.3 (95% CI: 3.5-8.1) for APS groups, p = 0.0025]. CONCLUSION: In this study, 68% of patients with clinical criteria for obstetrical APS seronegative for conventional APL have non-conventional APL. These patients have a significant decrement of pregnancy losses if they receive treatment for APS during their pregnancy.
Authors: Oscar Cabrera-Marante; Edgard Rodríguez de Frías; Manuel Serrano; Fernando Lozano Morillo; Laura Naranjo; Francisco J Gil-Etayo; Estela Paz-Artal; Daniel E Pleguezuelo; Antonio Serrano Journal: Int J Mol Sci Date: 2020-11-26 Impact factor: 5.923
Authors: Daniel E Pleguezuelo; Oscar Cabrera-Marante; Magdalena Abad; Edgard Alfonso Rodriguez-Frias; Laura Naranjo; Alicia Vazquez; Olga Villar; Francisco Javier Gil-Etayo; Manuel Serrano; Alfredo Perez-Rivilla; Laura de la Fuente-Bitaine; Antonio Serrano Journal: J Clin Med Date: 2021-05-13 Impact factor: 4.241
Authors: Ilan Volkov; Luciana Seguro; Elaine P Leon; László Kovács; Dirk Roggenbuck; Peter Schierack; Boris Gilburd; Andrea Doria; Maria G Tektonidou; Nancy Agmon-Levin Journal: Auto Immun Highlights Date: 2020-05-15