Acquired activated protein C resistance is associated with IgG antibodies to protein S in patients with systemic lupus erythematosus
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- 作者：Junzo Nojima ; Yoshinori Iwatani ; Kiyoshi Ichihara ; Hidehiro Tsuneoka ; Toshizo Ishikawa ; Masashi Yanagihara ; Toru Takano ; Yoh Hidaka
- 关键词：Anti-phospholipid antibodies ; Systemic lupus erythematosus ; Acquired activated protein C resistance ; Anti-protein S antibodies ; Lupus anticoagulant
- 刊名：Thrombosis Research
- 出版年：2009
- 出版时间：May 2009
- 年：2009
- 卷：124
- 期：1
- 页码：127-131
- 全文大小：396 K
文摘
The objective of this study was to clarify the roles of anti-phospholipid antibodies (aPLs) in the pathogenesis of acquired activated protein C resistance (APC-R) in patients with systemic lupus erythematosus (SLE). We examined several aPLs levels (lupus anticoagulant, anti-cardiolipin antibodies, anti-β2-glycoprotein I antibodies, anti-protein C antibodies, and anti-protein S antibodies), the APC-R test, and the factor V Leiden test in 85 SLE patients. Acquired APC-R, which was not found in any patient with the factor V Leiden mutation, was present in 26 (30.6 % ) of 85 patients, and confirmed that acquired APC-R was a significant risk factor for thromboembolic complications [odd ratio (OR), 3.36; 95 % confidence interval (CI), 1.24-9.11]. Multivariate logistic analysis revealed that both LA and anti-PS strongly associated with the presence of APC-R, and that the correlation between anti-PS and APC-R was much stronger (OR, 46.7; 95 % CI, 6.99-311) than that between LA and APC-R (OR, 11.3; 95 % CI, 2.26-57.0). Furthermore, the mean value of APC sensitivity ratios was significantly lower in SLE patients with anti-PS (mean ± SD, 1.68 ± 0.37, p < 0.0001) than in those without anti-PS (2.23 ± 0.40). These results suggest that acquired APC-R is most strongly attributable to functional interference of the APC pathway by anti-PS, which contribute to risk of thromboembolic complications.