Prevalence and significance of anti-prothrombin (aPT) antibodies in patients with Lupus Anticoagulant (LA)

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• 作者：V. Pengo ; G. Denas ; E. Bison ; A. Banzato ; S. Padayattil Jose ; P. Gresele ; F. Marongiu ; N. Erba ; F. Veschi ; A. Ghirarduzzi ; E. De C ; ia ; B. Montaruli ; M. Marietta ; S. Testa ; D. Barcellona ; A. Tripodi
• 关键词：β ; ₂Glycoprotein I ; antibodies ; Lupus Anticoagulant ; prothrombin ; thrombosis
• 刊名：Thrombosis Research
• 出版年：2010
• 出版时间：August 2010
• 年：2010
• 卷：126
• 期：2
• 页码：150-153
• 全文大小：204 K

文摘

ass=""h4"">Objective

Anti-prothrombin (aPT) antibodies have been found in Lupus Anticoagulant (LA) positive patients. Their prevalence and relative contribution to thromboembolic risk in LA-positive patients is not well defined. The aim of this study was to determine their presence and association with thromboembolic events in a large series of patients with confirmed LA.

ass=""h4"">Methods

Plasma from LA-positive patients was collected at Thrombosis Centers and sent to a reference central laboratory for confirmation. Positive plasma was tested using home-made ELISA for the presence of aPT and anti-β₂GPI antibodies.

ass=""h4"">Results

LA was confirmed in 231 patients. Sixty-one of 231 (26 % , 95 % CI 22-33) LA positive subjects were positive for IgG aPT and 62 (27 % , 95 % CI 21-33) were positive for IgM aPT antibodies. Clinical features of Antiphospholipid Syndrome (APS) were not associated with the presence of IgG aPT [43 APS in 61 (70 % ) positive and 109 APS in 170 (64 % ) negative IgG aPT subjects, p = ns] or IgM aPT. Rate of positivity of IgG and IgM aβ₂GPI was significantly higher than that of IgG and IgM aPT. Clinical events accounting for APS occurred in 97 of 130 (75 % ) IgG aβ₂GPI positive and in 55 of 101 (54 % ) IgG aβ₂GPI negative patients (OR 2.4, 95 % CI 1.4 to 4.3, p = 0.002). No significant association with clinical events in patients positive for both IgG aPT and IgG aβ₂GPI as compared to those positive for one or another test was found. When patients negative for both IgG aPT and IgG aβ₂GPI (LA positive only) were compared with remaining patients, a significantly lower association with clinical events was found (OR = 0.4, 95 % CI: 0.2 to 0.7, p = 0.004).

ass=""h4"">Conclusions

As compared to IgG aβ₂GPI, the prevalence of IgG aPT in patients with LA is significantly lower and not associated with the clinical features of APS.