Antiphospholipid antibody isotypes and target autoantigen subgroups as predictors for different clinical manifestations of antiphospholipid syndrome
Abstract
To investigate the isotypes of antiphosfolipid antibodies (APLA) in patients with different clinical manifestations of antiphospholipid syndrome (APS). 568 patients who had tested positive for APLA were evaluated retrospectively. Anticardiolipin (ACL), anti-beta-2-glycoprotein-1 (AB2GP1), anti-phosphatidylserin (APSe), anti-phosphatidylinositol (API) and anti-phosphatidic acid (APA) IgG and IgM antibodies were determined by ELISA.
Over the years, only 61 individuals (11 %) have shown repeated APLA positivity and have fulfilled APS classification criteria. In 46 female and 15 male patients with a mean age of 43±12. 13/61 individuals have suffered from recurrent miscarriages, 35/61 patients have shown symptoms of peripheral vein thrombosis and 13/61 patients have shown symptoms of arterial thrombosis in different location.
In women with recurrent miscarriages, APLA IgM were more common than APLA IgG and than APLA IgM/IgG double-positive findings. In other APS cohorts, distribution of APLA isotypes was equal.
In APS patients with miscarriages, concentrations of all APLA examined were significantly lower than in other groups. In logistic regression analysis, combination of AB2GP1+ACL and AB2GP1+APSe showed the highest association with miscarriages.
Combinations of AB2GP1+ACL+APSe and AB2GP1+ACL+APA showed significant associations with venous thrombosis. The combination of distinct antiphospholipid antibody isotypes target autoantigen subgroups seems to predict different clinical manifestations of APS.