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

Liu, Tingting; Gu, Jieyu; Wan, Lei; Hu, Qiongyi; Teng, Jialin; Liu, Honglei; Cheng, Xiaobing; Ye, Junna; Su, Yutong; Sun, Yue; Zhou, Jinfeng; Norman, Gary L.; Wang, Xuefeng; Yang, Chengde; Shi, Hui

doi:10.1186/s13075-020-2131-4

Cited by 53 publications

(58 citation statements)

References 44 publications

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“…While the need for routine testing for aPS/PT is still under debate, there is overwhelming clinical evidence that these antibodies are associated with thrombosis and pregnancy loss in patients with APS and that their presence increases the risk of developing such an event [ 21 , 26 , 27 ]. Data coming from two available systematic reviews [ 23 , 28 ] involving about 10,000 subjects have shown a strong association between aPS/PT and the clinical manifestations of APS. With the available level of evidence, aPS/PT testing can be considered a robust test applicable in the management of patients suspected of APS, which is also beyond the scope of this research.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Particle-Based Multi-Analyte Technology for Detection of Anti-PhosphatidylSerine/Prothrombin Antibodies

et al. 2020

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Among “extra-criteria” antiphospholipid (aPL) antibodies, anti-phosphatidylserine/prothrombin (aPS/PT) antibodies, are considered a part of risk assessment strategies when investigating patients suspected of having antiphospholipid syndrome (APS). aPL detection is currently performed by solid-phase assays to identify anti-cardiolipin (aCL), anti-β2glycoprotein I (aβ2GPI) and aPS/PT antibodies, but new techniques are emerging. Among these, particle-based multi-analyte technology (PMAT), which allows the full automation and simultaneous digital detection of autoantibodies and proteins, including IgG, IgA and IgM isotypes of aCL, aβ2GPI and aPS/PT. The aim of this study was to investigate the agreement of aPS/PT testing between enzyme-linked immunosorbent assay (ELISA) and the PMAT platform. A total of 94 patients were enrolled in the study, including 71 patients with confirmed APS and 23 “aPL carriers”. aPS/PT IgG showed a moderate binomial agreement between ELISA and PMAT (k = 0.57, 95% CI 0.45–0.75), and aPS/PT IgM showed a moderate agreement (k = 0.60, 95% CI 0.45–0.75). Moreover, when considering the continuous agreement, both aPS/PT IgG and IgM showed a statistically significant correlation between ELISA and PMAT (Spearman’s correlation = 0.69, p < 0.001 and 0.72, p < 0.001, respectively). This study demonstrates that PMAT technology is a reliable method for aPS/PT IgG and IgM testing when compared to the available commercial ELISA kit.

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Section: Discussionmentioning

confidence: 99%

Validation of the Particle-Based Multi-Analyte Technology for Detection of Anti-PhosphatidylSerine/Prothrombin Antibodies

et al. 2020

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“…The determined cut-off (99th percentile) in ELISA for positivity of aCL is >40 GPL/MPL [16]. The cut-off recommended by the manufacturer in CLIA for positivity of aCL is >20 CU (99th percentile) [24].…”

Section: Anti-cardiolipinmentioning

confidence: 96%

“…Positivity of LA is a much more risky factor for the development of thromboembolism, cerebral ischemia, and recurrent reproduction losses in comparison with aCL and anti-β2GPI and even other non-criteria antibodies [23]. LA was demonstrated in 69% in a group of 192 patients with APS [24]. Choi et al [25] carried out a retrospective study of 833 patients with a persistent presence of aPLs and they found that 46.9% of 96 patients with clinical manifestations of APS had positive LA vs. a group of 737 asymptomatic carriers, where the incidence of LA was only 25.6%.…”

Section: Lupus Anticoagulantmentioning

confidence: 98%

“…The determined cut-off (99th percentile) in the enzyme-linked imunosorbent assay (ELISA) for positivity of anti-β2GPI is >40 IgG antiphospholipid units/mL (GPL), or IgM antiphospholipid units/mL (MPL) [16]. According to Liu et al, anti-β2GPI IgG is the best predictor of arterial thrombosis, with an odds ratio (OR) = 6.5 [24]. Demonstration of anti-β2GPI IgG has higher specificity for APS than aCL IgG, but lower sensitivity for APS than demonstration of aCL IgG at the same time [27].…”

Section: Anti-β2-glycoprotein-imentioning

confidence: 99%

“…IgG is the best predictor of arterial thrombosis, with an odds ratio (OR) = 6.5 [24]. Demonstration of anti-β2GPI IgG has higher specificity for APS than aCL IgG, but lower sensitivity for APS than demonstration of aCL IgG at the same time [27].…”

Section: Anti-β2-glycoprotein-imentioning

confidence: 99%

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Current Promising Biomarkers and Methods in the Diagnostics of Antiphospholipid Syndrome: A Review

et al. 2021

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Antiphospholipid syndrome (APS) is a hypercoagulation condition associated with the incidence of heterogenic antiphospholipid antibodies (aPLs), which non-specifically affect hemostasis processes. APS is clinically manifested by recurrent arterial and venous thromboses and reproduction losses. The aPL antibodies, which may induce clinical manifestations of APS, include criteria antibodies anti-cardiolipin, anti-β2-glycoprotein-I, and lupus anticoagulant, but also non-criteria antibodies, for example anti-β2-glycoprotein-I domain I, anti-phosphatidylserine/prothrombin, anti-annexin V, and many others. APS occurs mostly in patients of younger and middle age, most frequently in females. Laboratory diagnostics of APS are quite difficult, as they include a wide spectrum of examining methods, which are based on various principles of detection and are performed using various laboratory techniques. The objective of the review is to describe the current state of potentially examined biomarkers and methods in APS diagnostics. The aforementioned biomarkers are lupus anticoagulant, anti-β2-glycoprotein-I, anti-cardiolipin, anti-β2-glycoprotein-I domain I, anti-phosphatidylserine/prothrombin, anti-β2-glycoprotein-I IgA, anti-cardiolipin IgA, anti-annexin V and II, anti-prothrombin, anti-cardiolipin/vimentin, anti-protein S/protein C, and antibodies against phospholipid antigens for whose diagnostics we may use some of the methods established for a long time and some of the modern methods—the coagulation method for the determination of lupus anticoagulant (LA), enzyme-linked imunosorbent assay (ELISA), chemiluminescence analysis (CLIA), multiplex fluorescence flow immunoassay (MFFIA), fluorescence enzyme immunoassay (EliA), line immunoassay (LIA), multiline dot assay (MLDA), and thin-layer chromatography (TLC). Conclusion: Antibodies against phosphatidylethanolamine, phosphatidic acid, phosphatidylserine, phosphatidylinositol, cardiolipin/vimentin complex, and annexin V are currently the most studied new markers. However, these assays have not been standardized until now, both from the laboratory and clinical point of view. In this review we summarize the evidence of the most studied aPL markers and their potential clinical significance in seronegative APS (SN-APS).

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Prevalence and clinical significance of antiphospholipid antibodies in patients with coronavirus disease 2019 admitted to intensive care units: a prospective observational study

et al. 2021

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Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19-induced coagulopathy, its clinical significance remains uncertain. Therefore, this study aimed to evaluate the prevalence and clinical significance of aPLs among critically ill patients with COVID-19. This prospective observational study included 60 patients with COVID-19 admitted to intensive care units (ICU). The study outcomes included prevalence of aPLs, and a primary composite outcome of all-cause mortality and arterial or venous thrombosis between antiphospholipid-positive and antiphospholipid-negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. A total of 60 critically ill patients were enrolled. Among them, 57 (95%) were men, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found be antiphospholipid-positive; 21 of them were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during their ICU stay did not differ between antiphospholipid-positive and antiphospholipid-negative patients (4 [18%] vs. 6 [16%], adjusted odds ratio 0.98, 95% confidence interval 0.1–6.7; p value = 0.986). The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

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

Cited by 53 publications

References 44 publications

Validation of the Particle-Based Multi-Analyte Technology for Detection of Anti-PhosphatidylSerine/Prothrombin Antibodies

Validation of the Particle-Based Multi-Analyte Technology for Detection of Anti-PhosphatidylSerine/Prothrombin Antibodies

Current Promising Biomarkers and Methods in the Diagnostics of Antiphospholipid Syndrome: A Review

Prevalence and clinical significance of antiphospholipid antibodies in patients with coronavirus disease 2019 admitted to intensive care units: a prospective observational study

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