血液学および血栓塞栓性疾患ジャーナル
オープンアクセス

概要

Detection of Anti-Domain I β-2 Glycoprotein I Antibodies as New Potential Target in Antiphospholipid Syndrome Diagnosis

Slavik L, Janek D, Ulehlova J, Krcova V, Hlusi A and Prochazkova J

Anti-cardiolipin antibodies (ACL) and anti-β-2-glycoprotein I antibodies (anti-2GPI) represent two out of three laboratory criteria for detection of antiphospholipid syndrome (APS). The domain I (DI) in anti-β-2-glycoprotein I is a new target for better identification of antibodies and may be associated with thrombotic risk in antiphospholipid syndrome.
Anti-β2GPI antibodies specifically reacting with DI have a particular clinical importance being more commonly detected among patients with APS and other autoimmune diseases. This observation implies that compared with antibodies targeting the whole molecule, anti-DI antibodies have higher specificity for APS. Routine testing for anti- DI antibodies in clinical practice can be used for an easy differentiation of subjects carrying clinically meaningful anti- β2GPI antibodies from those individuals with a benign autoantibody profile.
The aim of our study was to determine the significance of the domain I in the anti-β-2-glycoprotein I as a new biomarker for determining thrombotic risk in antiphospholipid syndrome.
We investigate the DI anti-β2GPI on a group of 74 patients with antiphospholipid syndrome diagnosis. All patients have positive antibodies in at least one class ACL and anti-β2GPI antibodies.
We detect DI anti-β2GPI positivity in 21 samples in our group. The thrombotic complications had been observed in 21 from 74 patients. The incidence of thrombotic complications in the total group was established as 28.4%, in comparison to the group DI anti-β2GPI positive with the incidence of thrombotic complications 57%. Performing of assay improved a positive predictive value from 25% pre-test to 68% for patients with positive test. The new chemiluminescent method for detection of DI anti-β2GPI shows a better compliance with clinical outcome than the actual diagnostic scheme.