Tess Marchetti1, Camillo Ribi2, Thomas Perneger3, Marten Trendelenburg4, Uyen Huynh-Do5, Philippe de Moerloose1, Carlo Chizzolini6. 1. Hemostasis Unit, Department of Internal Medicine Specialties, University Hospital and School of Medicine, Geneva, Switzerland. 2. Division of Clinical Immunology and Allergy, University Hospital Lausanne, Lausanne, Switzerland. 3. Clinical Epidemiology, Department of Community Health and Medicine, University Hospital and School of Medicine, Geneva, Switzerland. 4. Division of Internal Medicine and Clinical Immunology Laboratory, Department of Biomedicine, University Hospital Basel, Basel, Switzerland. 5. Department of Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 6. Clinical Immunology Unit, Department of Internal Medicine Specialties, University Hospital and School of Medicine, Geneva, Switzerland, Switzerland.
Abstract
Objectives: aPL are frequently present in SLE. In a well characterized SLE cohort we aimed at investigating the prevalence of aPL and assessing their analytical performance and clinical association by testing criteria specificities including LA, aCL IgG and IgM, anti-β2-glycoprotein 1 (antiβ2GP1) IgG and IgM, as well as the non-criteria aPS-PT IgG and IgM and anti-β2GP1 domain 1 (aD1) IgG. Methods: We included 178 patients satisfying the ACR SLE classification criteria, from whom 283 samples and thrombotic events were collected longitudinally. Each sample was tested for criteria and non-criteria aPL using validated techniques in a single centre. Results: All assays provided highly reproducible results. Of the samples, 42.5% were positive for at least one criteria assay, 20.5% showed double positivity and 12.6% triple positivity. All criteria and non-criteria specificities persisted over time. Most antibody titres were only moderately correlated; however, strong correlation was observed on one hand between aD1 IgG, antiβ2GP1 IgG and aCL IgG, and on the other between aPS-PT IgG and LA. aD1 IgG titres were extremely elevated in triple-positive samples. aPS-PT IgG by itself, and jointly with LA, was associated with thrombosis, an association mostly driven by venous thrombotic events. Conclusions: In this SLE cohort, the non-criteria aPL aD1 IgG and aPS-PT IgG performed differently. aD1 IgG was highly enriched in triple-positive samples, and aPS-PT IgG, jointly with LA, was associated with thrombotic events.
Objectives: aPL are frequently present in SLE. In a well characterized SLE cohort we aimed at investigating the prevalence of aPL and assessing their analytical performance and clinical association by testing criteria specificities including LA, aCL IgG and IgM, anti-β2-glycoprotein 1 (antiβ2GP1) IgG and IgM, as well as the non-criteria aPS-PT IgG and IgM and anti-β2GP1 domain 1 (aD1) IgG. Methods: We included 178 patients satisfying the ACR SLE classification criteria, from whom 283 samples and thrombotic events were collected longitudinally. Each sample was tested for criteria and non-criteria aPL using validated techniques in a single centre. Results: All assays provided highly reproducible results. Of the samples, 42.5% were positive for at least one criteria assay, 20.5% showed double positivity and 12.6% triple positivity. All criteria and non-criteria specificities persisted over time. Most antibody titres were only moderately correlated; however, strong correlation was observed on one hand between aD1 IgG, antiβ2GP1 IgG and aCL IgG, and on the other between aPS-PT IgG and LA. aD1 IgG titres were extremely elevated in triple-positive samples. aPS-PT IgG by itself, and jointly with LA, was associated with thrombosis, an association mostly driven by venous thrombotic events. Conclusions: In this SLE cohort, the non-criteria aPL aD1 IgG and aPS-PT IgG performed differently. aD1 IgG was highly enriched in triple-positive samples, and aPS-PT IgG, jointly with LA, was associated with thrombotic events.
Authors: M Frodlund; A Vikerfors; G Grosso; T Skogh; J Wetterö; K Elvin; I Gunnarsson; A Kastbom; Ö Dahlström; J Rönnelid; E Svenungsson; C Sjöwall Journal: Clin Exp Immunol Date: 2018-09-12 Impact factor: 4.330