Antiphosphatidylserine/prothrombin antibodies (aPS/PT) as potential diagnostic markers and risk predictors of venous thrombosis and obstetric complications in antiphospholipid syndrome

Shi, Hui; Zheng, Hui; Yin, Yufeng; Hu, Qiongyi; Teng, Jialin; Sun, Yue; Liu, Honglei; Cheng, Xiaobing; Ye, Junna; Su, Yutong; Wu, Xin; Zhou, Jinfeng; Norman, Gary L.; Gong, Huiyun; Shi, Xun; Peng, Yibing; Wang, Xuefeng; Yang, Chengde

doi:10.1515/cclm-2017-0502

Cited by 84 publications

(73 citation statements)

References 36 publications

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“…The left part of the figure concerns pregnancy morbidities, in which "early pregnancy morbidity" refers to at least one fetal loss before 10 weeks of pregnancy, and "late pregnancy morbidity" refers to at least one stillbirth after 10 weeks of pregnancy or premature delivery before 34 weeks of pregnancy. All the outcomes have been adjusted with sex and age anticoagulant detection [14] since the latter assay and its ancillary confirmatory assays is technically demanding and is not performed in many laboratories. Lupus anticoagulant remains a mysterious set of heterogeneous antibodies yet to be confirmed, while aPS/PT antibodies stand for an independent biomarker for APS and add value to SNAPS patients' management.…”

Section: Discussionmentioning

confidence: 99%

“…Anti-phosphatidylserine/prothrombin antibodies (aPS/ PT) are now acknowledged as a highly effective potential marker for APS [10,11]. As a result of its remarkable diagnostic performance and high prevalence in the LA-positive patient group, as validated by multiple studies [12][13][14], aPS/PT has gained much attention and was included in both the APS-S (Otomo) and the Global APS Score (GAPSS), widely used systems for patient thrombotic risk assessment [15]. Additional biomarkers continue to be evaluated for their value to APS diagnosis and management.…”

Section: Introductionmentioning

confidence: 99%

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“Non-criteria” antiphospholipid antibodies add value to antiphospholipid syndrome diagnoses in a large Chinese cohort

Liu

Wan

et al. 2020

Arthritis Res Ther

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Background: Despite expansion in the 2006 Sydney antiphospholipid syndrome (APS) classification criteria to include IgG/IgM anti-β2-glycoprotein (aβ2GPI) antibodies in addition to IgG/IgM anti-cardiolipin antibodies (aCL) and lupus anticoagulant (LAC), some individuals with clinical features of APS remain seronegative (seronegative APS or SNAPS) and are at risk of recurrent thrombosis and pregnancy morbidities. Our aim was to assess the value of "non-criteria" aPL antibodies to detect these SNAPS patients.Methods: One hundred ninety-two APS patients, 90 SNAPS patients, 193 autoimmune disease controls, and 120 healthy controls were evaluated. Ten antiphospholipid antibodies (aPLs) were tested using commercial kits, including 5 non-criteria aPLs: anti-phosphatidylserine/prothrombin antibodies (aPS/PT) IgG/IgM, aCL IgA, aβ2GPI IgA, and anti-β2GPI Domain 1 (aβ2GPI-D1) IgG. Results: Up to 60.9% of the SNAPS and 93.5% of APS patients were detected by at least one non-criteria aPL. aPS/ PT IgG had the highest Youden index in classifying APS and SNAPS from controls. aPS/PT IgG and aβ2GPI Domain 1 IgG seem to be the most significant risk factors for thrombotic events and pregnancy morbidity, respectively. aPS/ PT IgG/IgM and aβ2GPI-D1 IgG were detected in some SNAPS patients, while IgA isotypes of aCL/aβ2GPI tended to appear together with other biomarkers. The combined analysis showed enhanced diagnostic performance with the inclusion of non-criteria aPLs. Conclusions: Recognition of SNAPS patients is critical for clinical management and prevention of potential thrombotic and obstetric adverse events. The non-criteria antiphospholipid antibodies help to identify a considerable portion (60.9%) of these patients who otherwise may remain untreated and at clinical risk.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“Non-criteria” antiphospholipid antibodies add value to antiphospholipid syndrome diagnoses in a large Chinese cohort

Liu

Wan

et al. 2020

Arthritis Res Ther

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“…The study included specimens from 192 consecutive patients with APS (including 88 primary APS and 104 secondary APS) collected from the APS‐Shanghai (APS‐SH) database, which has been maintained by expert rheumatologists at the Rheumatology Department of Shanghai Jiao Tong University School of Medicine (Shanghai, China) since 2000 . The control group consisted of 104 patients with systemic lupus erythematosus (APS‐negative SLE), 29 with Sjorgen's syndrome (SS), 31 with rheumatoid arthritis (RA), and 30 with ankylosing spondylitis (AS), as well as 120 healthy controls (108 females, 12 males) with no confirmed autoimmune disease and infectious diseases.…”

Section: Methodsmentioning

confidence: 99%

Clinical performance of automated chemiluminescent methods for anticardiolipin and anti‐β2‐glycoprotein I antibodies detection in a large cohort of Chinese patients with antiphospholipid syndrome

Wan

Liu

et al. 2020

Int J Lab Hematology

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Introduction To assess the clinical performance and correlations of automated chemiluminescence assay (CIA) and enzyme‐linked immunosorbent assay (ELISA) for detecting antiphospholipid (aPL) antibodies in the diagnosis of antiphospholipid syndrome (APS). Methods The study recruited 505 subjects, including 192 with APS, 193 with connective tissue diseases other than APS, and 120 healthy donors. We measured anticardiolipin (aCL) and anti‐β2‐glycoprotein I (anti‐β2GPI) antibodies IgG, IgM, and IgA in all the samples using both CIA and ELISA. Results Total agreement between the two methods ranged from 83.50% for anti‐β2GPI IgG antibodies to 92.76% for anti‐β2GPI IgM antibodies in all the groups. Anti‐β2GPI and aCL IgG assays showed the highest Spearman's rho coefficients (anti‐β2GPI IgG = 0.742, aCL IgG = 0.715). Anti‐β2GPI IgG CIA showed the highest sensitivity for diagnosis of APS at 80.21%, which was significantly higher than the sensitivity of anti‐β2GPI IgG ELISA (52.08%). For diagnosis of APS, anti‐β2GPI IgG CIA had the best discrimination power with the area under the curves (AUC) of 0.922, followed by aCL IgG CIA (AUC of 0.905). While the CIA AUC was slightly higher in all cases, the difference was not statistically significant. Conclusion CIA measurements had a good agreement and correlation with comparative ELISA assays. The CIA anti‐β2GPI IgG however was significantly more sensitive for APS diagnosis. The two assay methodologies showed comparable predictive powers and support the value of the CIA method for improved diagnosis and management of patients with APS.

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“…The TEG parameters were correlated with other clinical and laboratory data, such as LAC status, PLT level, and UTP and SLEDAI values. Patients with positive LAC status, higher PLT levels, UTP >500 mg/24 h, and higher SLEDAI values are known to have a greater risk of thrombosis. Figure shows the change in the parameters with disease severity in the active disease patient group.…”

Section: Discussionmentioning

confidence: 99%

Evaluating hypercoagulability in new‐onset systemic lupus erythematosus patients using thromboelastography

Gong

Shi

Zhou

et al. 2019

Clinical Laboratory Analysis

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Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease that involves T cell, B cell, and dendritic cell dysfunction, as well as antinuclear autoantibody production. 1 Several clinical and scientific studies of SLE indicate an increased risk of thrombosis in these cases. [2][3][4][5] Moreover, patients with SLE may exhibit accelerated atherosclerosis, and higher cardiovascular morbidity and mortality. 6The traditional parameters for screening coagulopathy include prothrombin time (PT) and activated partial thromboplastin time (aPTT). However, in Owaidah's study, among patients with positive lupus anticoagulant (LAC) status, 61% exhibited abnormal aPTT results that could not be corrected by mixing with normal plasma; moreover, the PT test yielded normal results in 90% cases. 7 However, there is a limitation of the aPTT and PT test in these cases, as the results may reflect a certain product in the coagulation process, rather than the actual marker they are intended to reflect. Moreover, SLE Abstract Background: Thromboelastography (TEG) can reflect the coagulation status in vivo, from clot formation to clot lysis. In the present study, we aimed to evaluate the function of TEG in detecting coagulation in patients with SLE and sought to explore the correlation between clinical and laboratory data. Methods:A total of 41 patients with new-onset SLE who had not undergone treatment and 56 healthy controls were included. TEG and other laboratory tests were performed, and clinical data were collected.Results: A significant difference in the TEG reaction time and TEG achievement of clot firmness was observed between the groups. Moreover, these parameters were correlated with the lupus anticoagulant levels, platelet count, 24-hour urinary total protein quantity, and systemic lupus erythematosus disease activity index. Conclusion:Our study demonstrated the prospective value of TEG in evaluating hypercoagulability in patients with SLE.

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Antiphosphatidylserine/prothrombin antibodies (aPS/PT) as potential diagnostic markers and risk predictors of venous thrombosis and obstetric complications in antiphospholipid syndrome

Abstract: Anti-PS/PT antibody assays demonstrated high diagnostic performance for Chinese patients with APS, detected some APS patients negative for criteria markers and may serve as potential risk predictors for venous thrombosis and obstetric complications.

Cited by 84 publications

References 36 publications

“Non-criteria” antiphospholipid antibodies add value to antiphospholipid syndrome diagnoses in a large Chinese cohort

“Non-criteria” antiphospholipid antibodies add value to antiphospholipid syndrome diagnoses in a large Chinese cohort

Clinical performance of automated chemiluminescent methods for anticardiolipin and anti‐β2‐glycoprotein I antibodies detection in a large cohort of Chinese patients with antiphospholipid syndrome

Evaluating hypercoagulability in new‐onset systemic lupus erythematosus patients using thromboelastography

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