Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: , Methods: , Results: and Conclusion:
The antiphospholipid syndrome (APS) is a thrombophilic disorder characterized by clinical manifestations of vascular thrombosis and obstetric complications associated with the presence of specific antiphospholipid antibodies (aPLs). Most patients with APS can be identified using the conventional laboratory assays for LAC, IgG/IgM anti-cardiolipin (aCL), and IgG/IgM anti-ß2glycoprotein I (ß2GPI) antibodies. Some patients with clinical manifestations highly suggestive of APS however are negative for these classic biomarkers and new biomarkers are needed to identify these “seronegative APS or SNAPS) patients. Anti-Phosphatidylserine/Prothrombin (aPS/PT) antibodies are positive in many SNAPS patients. In the present study we assessed the prevalence and significance of aPS/PT, as well conventional APS biomarkers, in a large cohort of well-characterized patients with APS from the Shanghai region of China.
186 Chinese patients meeting the criteria for the classification of APS using the Sydney criteria (67 primary and119 secondary APS), 48 with SNAPS, 176 disease controls ((79 systemic lupus erythematosus (SLE), 29 Sjogren’s syndrome (SS), 30 ankylosing spondylitis (AS), 38 rheumatoid arthritis (RA)), and 90 healthy donors were examined. IgG and IgM aPS/PT, IgG, IgM, IgA anticardiolipin (aCL), and IgG, IgM, IgA anti-ß2-glycoprotein I (anti-ß2GPI) antibodies were tested by QUANTA Lite® ELISA kits (Inova Diagnostics, San Diego, CA). Statistical analyses were performed using SPSS 23.0 (IBM, Chicago, IL, USA) or Analyze-it ver 4.6 (Analyze-it Software, LTD). T-test, Mann-Whitney U test, Kappa test, Fisher’s exact or Chi-square tests were applied.
160(86.0%) of APS patients were positive for at least one aPS/PT isotype. 135(72.6%) were positive for IgG aPS/PT, 124/186(66.7%) positive for IgM aPS/PT, and 99(53.2%) positive for both. Approximately half of the SNAPS patients were positive for IgG and/or IgM aPS/PT. Highly significant associations between IgG aPS/PT and venous thrombotic events (OR 6.72) and IgG/IgM aPS/PT and pregnancy loss (OR 9.44) were found. Levels of IgM aPS/PT were significantly different in APS patients with thrombotic manifestations and those with fetal loss (p=0.014). The association between IgG/IgM aPS/PT and LAC was highly significant (p<0.001), when both were positive the OR for APS was 101.6. Notably, 91.95%(80/87) of LAC positive specimens were positive for IgG and/or IgM aPS/PT suggesting aPS/PT is an effective option when LAC testing is not available.
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.
To cite this abstract in AMA style:Shi H, Hu Q, Zheng H, Teng J, Norman G, Zhou J, Yang C. Anti-Phosphatidylserine/Prothrombin Antibodies (aPS/PT) As Potential Diagnostic Markers and Risk Predictors of Venous Thrombosis and Obstetric Complications in Antiphospholipid Syndrome [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/anti-phosphatidylserineprothrombin-antibodies-apspt-as-potential-diagnostic-markers-and-risk-predictors-of-venous-thrombosis-and-obstetric-complications-in-antiphospholipid-syndrome/. Accessed August 21, 2018.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-phosphatidylserineprothrombin-antibodies-apspt-as-potential-diagnostic-markers-and-risk-predictors-of-venous-thrombosis-and-obstetric-complications-in-antiphospholipid-syndrome/