One hundred ninety-two APS patients, 90 SNAPS patients, 193 autoimmune disease controls, and 120 healthy controls were evaluated. Ten antiphospholipid antibodies (aPLs) were tested using commercial kits, including 5 non-criteria aPLs: anti-phosphatidylserine/prothrombin antibodies (aPS/PT) IgG/IgM, aCL IgA, aβ2GPI IgA, and anti-β2GPI Domain 1 (aβ2GPI-D1) IgG.
Up to 60.9% of the SNAPS and 93.5% of APS patients were detected by at least one non-criteria aPL. aPS/PT IgG had the highest Youden index in classifying APS and SNAPS from controls. aPS/PT IgG and aβ2GPI Domain 1 IgG seem to be the most significant risk factors for thrombotic events and pregnancy morbidity, respectively. aPS/PT IgG/IgM and aβ2GPI-D1 IgG were detected in some SNAPS patients, while IgA isotypes of aCL/aβ2GPI tended to appear together with other biomarkers. The combined analysis showed enhanced diagnostic performance with the inclusion of non-criteria aPLs.
Recognition of SNAPS patients is critical for clinical management and prevention of potential thrombotic and obstetric adverse events. The non-criteria antiphospholipid antibodies help to identify a considerable portion (60.9%) of these patients who otherwise may remain untreated and at clinical risk.
一百九十二位APS患者,90名SNAPS患者,193个自身免疫性疾病对照,对120名健康对照进行了评估。使用商业试剂盒测试了十种抗磷脂抗体(aPL),包括5个非标准aPLs:抗磷脂酰丝氨酸/凝血酶原抗体(aPS/PT)IgG/IgM,aCLIgA,αβ2GPIIgA,和抗β2GPI结构域1(aβ2GPI-D1)IgG。
通过至少一种非标准aPL检测到高达60.9%的SNAPS和93.5%的APS患者。aPS/PTIgG在将APS和SNAPS与对照分类方面具有最高的Youden指数。aPS/PTIgG和aβ2GPI结构域1IgG似乎是血栓形成事件和妊娠发病率的最重要风险因素,分别。在一些SNAPS患者中检测到aPS/PTIgG/IgM和aβ2GPI-D1IgG,而aCL/aβ2GPI的IgA同种型倾向于与其他生物标志物一起出现。组合分析显示,纳入非标准aPL的诊断性能增强。
识别SNAPS患者对于临床管理和预防潜在的血栓形成和产科不良事件至关重要。非标准抗磷脂抗体有助于鉴定这些患者中相当一部分(60.9%),否则这些患者可能仍未治疗并处于临床风险中。