ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1

Anti-â2GP1- Domain-1 Antibodies Are a Marker Of APS Severity

Nancy Agmon-Levin1, Luciana Seguro2, Cristina Rosário3, Michael Mahler4, Mariele Gatto5, Nir Tomer6, Elaine P. Leon7, Andrea Doria8, László Kovács9, Nathalie Costedoat-Chalumeau10, Boris Gilburd11 and Yehuda Shoenfeld12, 1The Zabludowicz Center for Autoimmune Diseases, Tel-Hashomer, Israel, 2Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 3Internal Medicine Department, Hospital de Pedro Hispano, Rua Dr. Eduardo Torres Matosinhos, Porto, Portugal, 4Research, INOVA Diagnostics, San Diego, CA, 5Department of Medicine-DIMED, University of Padova, Padova, Italy, 6The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel, 7Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 8Division of Rheumatology, University of Padova, Padova, Italy, 9Department of Rheumatology, University of Szeged, Szeged, Hungary, 10Internal Medicine, Hopital Cochin, Paris, France, 11The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel, 12The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan, Israel

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Antiphospholipid Syndrome: Clinical Manifestations and New Biomarkers in Antiphospholipid Syndrome

Session Type: Abstract Submissions (ACR)

Background/Purpose: Autoantibodies targeting Domain-1(D1) of beta-2-glycoprotein-1(β2GP1) are common among patients with the antiphospholipid syndrome (APS)1. However, few studies assessed their clinical relevance and correlation with other anti-phospholipid antibodies (aPLA). Thus, in the current study we evaluated the correlations between anti-β2GP1-D1 levels and APS clinical and serological parameters.

Methods: Serum samples of 178 APS patients, 50 healthy subjects and 47 patients diagnosed with sepsis were utilized to determine levels of IgG-antibodies to cardiolipin(aCL), β2GP1 and β2GP1-D1 (BIO-FLASH®, INOVA). Demographic, clinical and serological (i.e. Lupus anticoagulant (LAC)) data were analyzed.

Results: Among APS patients aCL, anti-β2GP1 and anti-β2GP1-D1 were present in 60%, 70% and 49%, respectively. The presence of anti-β2GP1-D1 antibodies correlated with the presence of LAC (91 vs. 67%; p<0.001), aCL (98 vs. 23%; p<0.001). Triple aPLA positivity was present in 89% of anti-β2GP1-D1 positive sample compared with 16% among anti-β2GP1-D1 negative samples (p<0.001). Anti-β2GP1-D1 antibodies correlated with higher titers of aCL antibodies (p<0.001) and anti -β2GP1 (p=0.03).

Anti β2GP1 antibodies correlated with the occurrence of venous thrombosis (p< 0.009). Anti-β2GP1-D1 positivity (>20CU) related to the occurrence of any thrombotic event (91% vs. 79% OR 2.54; 95% CI 1.05-6.15; p=0.039). Medium levels of anti-β2GP1-D1 (>30CU) correlated with arterial thrombosis (55% vs. 33% OR=2.5; 95%CI 1.37-4.67; p = 0.006). High levels of anti-β2GP1-D1 (>64CU) were associated with multiple thrombotic events (62% vs. 31% OR 3.58; 95%CI 1.49-8.61; p=0.005) arterial thrombosis (60% vs. 33% OR 3.04; 95%CI 1.61-5.73; p=0.001) and CNS manifestations (45% vs. 27% OR 1.99; 95%CI 1.03-3.81; p=0.038).

Conclusion: In our cohort of APS patients, anti-β2GP1-D1 antibodies were a marker of high risk aPLA profile. Moreover their presence, particularly in med-high levels correlated with repeated thromboses, arterial occlusion and CNS-related manifestations. Thus, anti-β2GP1-D1 may potentially serve as a biomarker of thrombosis in APS.

1 Mahler M, et al  Autoimmun Rev. 2012;12(2):313-7.

Disclosure:

N. Agmon-Levin,
None;

L. Seguro,
None;

C. Rosário,
None;

M. Mahler,

Inova Diagnostics, Inc.,

3;

M. Gatto,
None;

N. Tomer,
None;

E. P. Leon,
None;

A. Doria,
None;

L. Kovács,
None;

N. Costedoat-Chalumeau,
None;

B. Gilburd,
None;

Y. Shoenfeld,
None.

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