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Abstract：
Non-criteria antiphospholipid antibodies (aPLs) increase the diagnostic value for antiphospholipid syndrome (APS) and contribute to better recognition of seronegative APS (SNAPS). However, the clinical utility and the diagnostic value of non-criteria aPLs are inconsistent. This study aimed to investigate the prevalence and clinical significance of 7 non-criteria aPLs in a large APS cohort.
Seven non-criteria aPLs, including anti-phosphatidylserine/prothrombin (aPS/PT) antibodies IgG/IgA/IgM, anti-phosphatidylethanolamine antibodies (aPE) IgG/IgA/IgM, anti-Annexin V antibodies (aAnnexinV) IgG/IgA/IgM, anti-phosphatidylserine antibodies (aPS) IgM, aPS IgG, antibodies directed against a mixture of phospholipids (APhL) IgG, and APhL IgM were tested among 175 patients with APS, 122 patients with other autoimmune diseases (as disease controls), and 50 healthy controls.
In the present study, the highest prevalence of non-criteria aPLs was seen in aAnnexinV (58.86%). APhL IgG and aPS IgM showed the highest specificity (95.35%) and aPS/PT showed the highest Youden index (0.3991) for the diagnostic value of APS. The aAnnexinV also showed the highest prevalence in SNAPS (43.3%), followed by APhL IgM (21.7%), aPE (16.7%) and aPS/PT (16.7%). APhL IgG, aPS/PT, and aPS IgG showed positive association with thrombotic events in APS patients [APhL IgG: odds ratio (OR) = 2.26, 95% confidence interval (CI) 1.18-4.34, p = 0.013; aPS/PT: OR = 2.48, 95% CI: 1.32-4.69, p = 0.004; aPS IgG: OR = 1.90, 95% CI 1.01-3.60, p = 0.046; respectively). The inclusion of the non-criteria aPLs increased the accuracy of APS diagnosis from 65.7% to 87.4%.
Our data provide evidence that adding the non-criteria aPLs can improve the diagnostic accuracy in APS. APhL IgG, aPS/PT, and aPS IgG may be potential biomarkers to predict the risk of thrombosis in APS.
Seven non-criteria aPLs, including anti-phosphatidylserine/prothrombin (aPS/PT) antibodies IgG/IgA/IgM, anti-phosphatidylethanolamine antibodies (aPE) IgG/IgA/IgM, anti-Annexin V antibodies (aAnnexinV) IgG/IgA/IgM, anti-phosphatidylserine antibodies (aPS) IgM, aPS IgG, antibodies directed against a mixture of phospholipids (APhL) IgG, and APhL IgM were tested among 175 patients with APS, 122 patients with other autoimmune diseases (as disease controls), and 50 healthy controls.
In the present study, the highest prevalence of non-criteria aPLs was seen in aAnnexinV (58.86%). APhL IgG and aPS IgM showed the highest specificity (95.35%) and aPS/PT showed the highest Youden index (0.3991) for the diagnostic value of APS. The aAnnexinV also showed the highest prevalence in SNAPS (43.3%), followed by APhL IgM (21.7%), aPE (16.7%) and aPS/PT (16.7%). APhL IgG, aPS/PT, and aPS IgG showed positive association with thrombotic events in APS patients [APhL IgG: odds ratio (OR) = 2.26, 95% confidence interval (CI) 1.18-4.34, p = 0.013; aPS/PT: OR = 2.48, 95% CI: 1.32-4.69, p = 0.004; aPS IgG: OR = 1.90, 95% CI 1.01-3.60, p = 0.046; respectively). The inclusion of the non-criteria aPLs increased the accuracy of APS diagnosis from 65.7% to 87.4%.
Our data provide evidence that adding the non-criteria aPLs can improve the diagnostic accuracy in APS. APhL IgG, aPS/PT, and aPS IgG may be potential biomarkers to predict the risk of thrombosis in APS.
摘要：
非标准抗磷脂抗体（aPL）可提高抗磷脂综合征（APS）的诊断价值，并有助于更好地识别血清阴性APS（SNAPS）。然而,非标准aPL的临床效用和诊断价值不一致.本研究旨在调查大型APS队列中7种非标准aPL的患病率和临床意义。
七种非标准aPL，包括抗磷脂酰丝氨酸/凝血酶原（aPS/PT）抗体IgG/IgA/IgM，抗磷脂酰乙醇胺抗体（aPE）IgG/IgA/IgM，抗膜联蛋白V抗体（aAnnexinV）IgG/IgA/IgM，抗磷脂酰丝氨酸抗体（aPS）IgM，aPSIgG，针对磷脂（APhL）IgG混合物的抗体，在175例APS患者中检测了AphLIgM，122名患有其他自身免疫性疾病的患者（作为疾病对照），和50个健康对照。
在本研究中，非标准aPL的患病率最高的是aAnnexinV(58.86%).AphLIgG和aPSIgM对APS的诊断价值表现出最高的特异性(95.35%),aPS/PT表现出最高的Youden指数(0.3991)。aAnnexinV在SNAPS中也显示出最高的患病率（43.3％），其次是AphLIgM（21.7％），aPE（16.7%）和aPS/PT（16.7%）。AphLIgG,aPS/PT,在APS患者中,和aPSIgG与血栓形成事件呈正相关[APhLIgG:比值比(OR)=2.26,95%置信区间(CI)1.18~4.34,p=0.013;aPS/PT:OR=2.48,95%CI:1.32~4.69,p=0.004;aPSIgG:OR=1.90,95%CI1.01~3.60,p=0.046).纳入非标准aPL将APS诊断的准确性从65.7%提高到87.4%。
我们的数据提供了证据，表明添加非标准aPL可以提高APS的诊断准确性。AphLIgG,aPS/PT,和aPSIgG可能是预测APS血栓形成风险的潜在生物标志物。
七种非标准aPL，包括抗磷脂酰丝氨酸/凝血酶原（aPS/PT）抗体IgG/IgA/IgM，抗磷脂酰乙醇胺抗体（aPE）IgG/IgA/IgM，抗膜联蛋白V抗体（aAnnexinV）IgG/IgA/IgM，抗磷脂酰丝氨酸抗体（aPS）IgM，aPSIgG，针对磷脂（APhL）IgG混合物的抗体，在175例APS患者中检测了AphLIgM，122名患有其他自身免疫性疾病的患者（作为疾病对照），和50个健康对照。
在本研究中，非标准aPL的患病率最高的是aAnnexinV(58.86%).AphLIgG和aPSIgM对APS的诊断价值表现出最高的特异性(95.35%),aPS/PT表现出最高的Youden指数(0.3991)。aAnnexinV在SNAPS中也显示出最高的患病率（43.3％），其次是AphLIgM（21.7％），aPE（16.7%）和aPS/PT（16.7%）。AphLIgG,aPS/PT,在APS患者中,和aPSIgG与血栓形成事件呈正相关[APhLIgG:比值比(OR)=2.26,95%置信区间(CI)1.18~4.34,p=0.013;aPS/PT:OR=2.48,95%CI:1.32~4.69,p=0.004;aPSIgG:OR=1.90,95%CI1.01~3.60,p=0.046).纳入非标准aPL将APS诊断的准确性从65.7%提高到87.4%。
我们的数据提供了证据，表明添加非标准aPL可以提高APS的诊断准确性。AphLIgG,aPS/PT,和aPSIgG可能是预测APS血栓形成风险的潜在生物标志物。
