Anti-beta 2 glycoprotein I IgA in the SLICC classification criteria dataset

Objective Anti-beta 2 glycoprotein I IgA is a common isotype of anti-beta 2 glycoprotein I in SLE. Anti-beta 2 glycoprotein I was not included in the American College of Rheumatology (ACR) SLE classification criteria, but was included in the Systemic Lupus International Collaborating Clinics (SLICC) criteria. We aimed to evaluate the prevalence of anti-beta 2-glycoprotein I IgA in SLE versus other rheumatic diseases. In addition, we examined the association between anti-beta 2 glycoprotein I IgA and disease manifestations in SLE. Methods The dataset consisted of 1384 patients, 657 with a consensus physician diagnosis of SLE and 727 controls with other rheumatic diseases. Anti-beta 2 glycoprotein I isotypes were measured by ELISA. Patients with a consensus diagnosis of SLE were compared to controls with respect to presence of anti-beta 2 glycoprotein I. Among patients with SLE, we assessed the association between anti-beta 2 glycoprotein I IgA and clinical manifestations. Results The prevalence of anti-beta 2 glycoprotein I IgA was 14% in SLE patients and 7% in rheumatic disease controls (odds ratio, OR 2.3, 95% CI: 1.6, 3.3). It was more common in SLE patients who were younger patients and of African descent (p = 0.019). Eleven percent of SLE patients had anti-beta 2 glycoprotein I IgA alone (no anti-beta 2 glycoprotein I IgG or IgM). There was a significant association between anti-beta 2 glycoprotein I IgA and anti-dsDNA (p = 0.001) and the other antiphospholipid antibodies (p = 0.0004). There was no significant correlation of anti-beta 2 glycoprotein I IgA with any of the other ACR or SLICC clinical criteria for SLE. Those with anti-beta 2 glycoprotein I IgA tended to have a history of thrombosis (12% vs 6%, p = 0.071), but the difference was not statistically significant. Conclusion We found the anti-beta 2 glycoprotein I IgA isotype to be more common in patients with SLE and in particular, with African descent. It could occur alone without other isotypes.

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High disease activity is associated with higher blood pressure in recent onset rheumatoid arthritis patients, post-hoc analyses of IMPROVED study

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.388 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

M Gegenava ◽

SA Bergstra ◽

H Maassen ◽

CF Allaart

Keyword(s):

Rheumatoid Arthritis ◽

Blood Pressure ◽

Disease Activity ◽

Classification Criteria ◽

Recent Onset ◽

American College Of Rheumatology ◽

Cardiovascular Morbidity And Mortality ◽

The Difference ◽

Post Hoc ◽

Acpa Status

Abstract Funding Acknowledgements Type of funding sources: None. Background Rheumatoid arthritis (RA) is a chronic autoimmune disease with a high prevalence of cardiovascular morbidity and mortality. Purpose: purpose of our project was to investigate the association between disease activity and systolic and diastolic blood pressure (SBP, DBP) in patients with recent-onset rheumatoid arthritis (RA 2010 criteria) or undifferentiated arthritis (UA) who were treated to target disease activity score (DAS)<1.6 in the IMPROVED study. Methods: The associations between disease activity and SBP/DBP were tested for 610 patients (364 RA, 246 UA), cross-sectionally and over time. GEE analyses were performed with both SBP and DBP as outcome measures and disease activity categories (DAS<1.6;>1.6 but ≤2.4; >2.4), CRP level, treatment arms or the number of visits on a certain drug as potential predictors in separate analyses. Separate analyses tested potential contributions of gender, anti-cyclic citrullinated peptide antibodies (ACPA) status, and fulfilling the 2010 ACR/EULAR (American college of rheumatology/ European league against rheumatism) classification criteria. In addition association of BP with various levels of disease activity was tested with T-test. Results: At the baseline mean (SD) SBP was 133 (20) and DBP mean (SD) was 80 (10). SBP > 140mm Hg was observed in 40% of patients and DBP > 90 mm Hg in 21% of patients. SBP and DBP statistically significantly decreased during 5 years follow up (mainly during year 1), but the difference in mm Hg was small. Estimates from GEE analysis showed that patients with high DAS >2.4 (HDAS) had a statistically significantly higher SBP (average 3 mm Hg higher, 95% CI 1.7; 4.2, p < 0.01), than the patients in with DAS ≤2.4. ANOVA analyses showed a statistically significant association between SBP and DAS. In addition, post hoc analyses showed that patients with HDAS had a statistically significantly higher SBP (mean (SD) 132 (19) than the patients with DAS < 1.6 (remission) (mean (SD) 129 (20), p < 0.01), and patients in LDAS but DAS≥1.6 had a statistically significantly higher SBP (mean (SD) 131 (19) than the patients in remission (mean (SD) 129 (20), p = 0.02) (Figure 1), whereas no association was found between DAS category and DBP. Gender, ACPA status or fulfilling the 2010 classification criteria did not influence the relation between DAS and blood pressure. Conclusions: In patients with RA or UA, a higher DAS is associated with higher blood pressure, but the clinical impact is unclear. Abstract Figure 1

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Isolated IgA Anti-β2 Glycoprotein I Antibodies in Patients with Clinical Criteria for Antiphospholipid Syndrome

Journal of Immunology Research ◽

10.1155/2014/704395 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 34

Author(s):

Raquel Ruiz-García ◽

Manuel Serrano ◽

José Ángel Martínez-Flores ◽

Sergio Mora ◽

Luis Morillas ◽

...

Keyword(s):

Autoimmune Disease ◽

Antiphospholipid Syndrome ◽

Antiphospholipid Antibodies ◽

Arterial Thrombosis ◽

Clinical Manifestations ◽

Diagnostic Systems ◽

Clinical Criteria ◽

Glycoprotein I ◽

Standardized Diagnostic ◽

Disease Present

Seronegative antiphospholipid syndrome (SNAPS) is an autoimmune disease present in patients with clinical manifestations highly suggestive of Antiphospholipid Syndrome (APS) but with persistently negative consensus antiphospholipid antibodies (a-PL). IgA anti-β2 Glycoprotein I (aB2-GPI) antibodies are associated with APS. However, they are not currently considered to be laboratory criteria due to the heterogeneity of published works and the use of poor standardized diagnostic systems. We have aimed to assess aPL antibodies in a group of patients with clinical manifestations of APS (C-APS) to evaluate the importance of the presence of IgA aB2GPI antibodies in APS and its relation with other aPL antibodies. Only 14% of patients with C-APS were positive for any consensus antibody, whereas the presence of isolated IgA aB2GPI antibodies was found in 22% of C-APS patients. In patients with arterial thrombosis IgA aB2GPI, antibodies were the only aPL antibodies present. Serologic profile in primary APS (PAPS) is different from systemic autoimmune disorders associated APS (SAD-APS). IgA aB2GPI antibodies are more prevalent in PAPS and IgG aB2GPI antibodies are predominant in SAD-APS. The analysis of IgA aB2GPI antibodies in patients with clinical manifestations of PAPS might avoid underdiagnosed patients and provide a better diagnosis in patients with SAD-APS. Laboratory consensus criteria might consider including analysis of IgA aB2GPI for APS diagnosis.

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Assessment of the New 2012 EULAR/ACR Clinical Classification Criteria for Polymyalgia Rheumatica: A Prospective Multicenter Study

The Journal of Rheumatology ◽

10.3899/jrheum.151103 ◽

2016 ◽

Vol 43 (5) ◽

pp. 893-900 ◽

Cited By ~ 18

Author(s):

Gulsen Ozen ◽

Nevsun Inanc ◽

Ali Ugur Unal ◽

Seda Bas ◽

Gezmis Kimyon ◽

...

Keyword(s):

Diagnostic Criteria ◽

Polymyalgia Rheumatica ◽

Area Under The Curve ◽

Classification Criteria ◽

Lower Sensitivity ◽

Clinical Classification ◽

Acute Phase Reactants ◽

Clinical Criteria ◽

American College Of Rheumatology ◽

Multicenter Prospective Study

Objective.To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) polymyalgia rheumatica (PMR) clinical classification criteria in discriminating PMR from other mimicking conditions compared with the previous 5 diagnostic criteria in a multicenter prospective study.Methods.Patients older than 50 years, presenting with new-onset bilateral shoulder pain with elevated acute-phase reactants (APR), were assessed for the fulfillment of the new and old classification/diagnostic criteria sets for PMR. At the end of the 1-year followup, 133 patients were diagnosed with PMR (expert opinion) and 142 with non-PMR conditions [69 rheumatoid arthritis (RA)]. Discriminating capacity, sensitivity, and specificity of the criteria sets were estimated.Results.Discriminating capacity of the new clinical criteria for PMR from non-PMR conditions and RA as estimated by area under the curve (AUC) were good with AUC of 0.736 and 0.781, respectively. The new criteria had a sensitivity of 89.5% and a specificity of 57.7% when tested against all non-PMR cases. When tested against all RA, seropositive RA, seronegative RA, and non-RA control patients, specificity changed to 66.7%, 100%, 20.7%, and 49.3%, respectively. Except for the Bird criteria, the 4 previous criteria had lower sensitivity and higher specificity (ranging from 83%–93%) compared with the new clinical criteria in discriminating PMR from all other controls.Conclusion.The new 2012 EULAR/ACR clinical classification criteria for PMR is highly sensitive; however, its ability to discriminate PMR from other inflammatory/noninflammatory shoulder conditions, especially from seronegative RA, is not adequate. Imaging and other modifications such as cutoff values for APR might increase the specificity of the criteria.

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IgM Anti-ß2Glycoprotein I Is Protective Against Lupus Nephritis and Renal Damage in Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.100650 ◽

2010 ◽

Vol 38 (3) ◽

pp. 450-453 ◽

Cited By ~ 32

Author(s):

TARANEH MEHRANI ◽

MICHELLE PETRI

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Nephritis ◽

Protective Effect ◽

Lupus Erythematosus ◽

Renal Damage ◽

Damage Index ◽

Clinical Manifestations ◽

Systemic Lupus ◽

American College Of Rheumatology ◽

Glycoprotein I

Objective.Antibodies to ß2glycoprotein I (IgG and IgM isotypes) have recently been added to the laboratory criteria of the revised antiphospholipid syndrome classification criteria. We investigated whether IgM anti-ß2-glycoprotein I (anti-ß2-GPI) is associated with clinical manifestations of systemic lupus erythematosus (SLE).Methods.Anti-ß2-GPI was measured in 796 patients with SLE (93% women, 53% white, 38% African American, mean age 45 yrs). IgM anti-ß2-GPI (> 20 phospholipid units) was found in 16%. Associations were determined with clinical manifestations of SLE and with components of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index.Results.As expected, IgM anti-ß2-GPI was highly associated with both the lupus anticoagulant and with anticardiolipin. It was associated with transient ischemic attack (OR 2.64, p = 0.04), but not significantly with venous or arterial thrombosis. IgM anti-ß2-GPI was protective against lupus nephritis (OR 0.54, p = 0.049), renal damage (p = 0.019), and hypertension (OR 0.58, p = 0.008). This protective effect remained after adjustment for ethnicity.Conclusion.In SLE, IgM anti-ß2-GPI is not associated with thrombosis but is protective against lupus nephritis and renal damage. “Natural” autoantibodies of the IgM isotype may have a protective effect.

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Approach to the Diagnostics of Atopic Dermatitis in Dogs in Conditions of Clinical Practice

Acta Veterinaria Brno ◽

10.2754/avb200776030461 ◽

2007 ◽

Vol 76 (3) ◽

pp. 461-468 ◽

Cited By ~ 3

Author(s):

S. Počta ◽

M. Svoboda

Keyword(s):

Atopic Dermatitis ◽

Clinical Signs ◽

The Other ◽

Age Group ◽

German Shepherd ◽

Clinical Criteria ◽

Allergy Test ◽

Skin Allergy ◽

The Difference ◽

French Bulldog

The aim of this work was to elucidate the incidence of atopic dermatitis in dogs regarding their age, sex and individual breeds, verify the diagnostic criteria of the disease by Willemse and Prélaund and evaluate their sensitivity in the conditions of this country. In the group of 94 dogs, atopic dermatitis was diagnosed in the period from 1994 to 2005. The highest frequency among breeds was documented in Boxer (100%) and French Bulldog (84.6%), being significantly (p < 0.05) higher than in Shar-pei (41.7%) and Dalmatian (41.7%). The difference was even highly significant (p < 0.01) compared to Dachshund (2.7%), German Shepherd (6%), Cocker Spaniel (11.1%), and Poodle (3.3%). On the other hand, no significant differences were found between sexes. The commonly affected age group was 67 patients (71.2% cases) at the age between three and six years. The diagnosis was made using the clinical criteria by Willemse and Prélaund to verify the sensitivity of these criteria. It was found to be 72% by Willemse, 68% by Prélaund, and the difference was not statistically significant. In all 94 patients various stages of pruritus were detected. The most frequent clinical signs were facial or digital affecting 94.7% patients (89/91) and secondary pyoderma was found in 72.3% patients (68/94). Skin allergy test for specification of the diagnosis was performed in 73.4% cases (69/94).

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Up to Date in Internal Medicine: From Older to the New 2019 Systemic Lupus Erythematosus Classification Criteria

Internal Medicine ◽

10.2478/inmed-2019-0091 ◽

2019 ◽

Vol 16 (6) ◽

pp. 29-35

Author(s):

Alina Dima ◽

Bianca Dumitrescu ◽

Daniela Nicoleta Popescu ◽

Magda Pârvu

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Classification Criteria ◽

Systemic Lupus ◽

American College Of Rheumatology ◽

European League Against Rheumatism ◽

Autoimmune Pathology ◽

Wide Range

AbstractSystemic lupus erythematosus (SLE) is considered the prototype of autoimmune diseases, the most complex autoimmune pathology and it is characterized by a wide range of immune processes, important antibodies production as well as an impressive spectrum of clinical manifestations. The great variety of lupus signs and symptoms caused difficulties in establishing well-defined classification criteria, as well as sustaining the clinical diagnosis.In 2019, a joint initiative of European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) released a new set of classification criteria for SLE, worldwide SLE experts were involved, this being the largest SLE classification effort up to date.

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The Significance of Antibodies against Domain I of Beta-2 Glycoprotein I in Antiphospholipid Syndrome

Seminars in Thrombosis and Hemostasis ◽

10.1055/s-0037-1601329 ◽

2017 ◽

Vol 44 (05) ◽

pp. 458-465 ◽

Cited By ~ 4

Author(s):

Walid Chayouâ ◽

Hilde Kelchtermans ◽

Bas Laat

Keyword(s):

Risk Stratification ◽

Antiphospholipid Syndrome ◽

Clinical Manifestations ◽

Detection Methods ◽

Clinical Value ◽

Pregnancy Morbidity ◽

Glycoprotein I ◽

Patients At Risk ◽

Beta 2 ◽

Domain I

AbstractThe antiphospholipid syndrome (APS) is characterized by vascular thrombosis and/or pregnancy morbidity with the persistent presence of antiphospholipid antibodies (aPLs). Progress is being made in understanding the pathogenesis of the syndrome, but difficulties persist in the identification of patients at risk for thrombosis and/or pregnancy morbidity. Beta-2 glycoprotein I (β2GPI), a plasma protein consisting of five sushi domains, is thought to be the main antigenic target of aPLs. Antibodies recognizing domain I of β2GPI are predominantly present in patients with an elevated risk of thrombosis, whereas antidomain IV/V antibodies are found in nonthrombotic autoimmune diseases. Indeed, domain I antibodies proved to be pathogenic in multiple studies. Retrospective studies have provided evidence for an added clinical value of antidomain I antibodies in the risk stratification of patients with APS. Still, wide ranges of odds ratio exist between studies, probably due to differences in the study and control population, and detection methods used. Despite the proven pathogenicity of antidomain I antibodies and their correlations with clinical manifestations of APS, heterogeneity of the current studies has prohibited their acceptance in the official diagnostic criteria. Well-designed large longitudinal prospective studies with available and new, preferentially functional, assays for the risk stratification of patients with APS are required.

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Kaolin clotting time and dilute Russell's viper venom time distinguish between prothrombin-dependent and beta 2-glycoprotein I-dependent antiphospholipid antibodies

Blood ◽

10.1182/blood.v86.2.617.bloodjournal862617 ◽

1995 ◽

Vol 86 (2) ◽

pp. 617-623 ◽

Cited By ~ 104

Author(s):

M Galli ◽

G Finazzi ◽

EM Bevers ◽

T Barbui

Keyword(s):

Factor Xa ◽

Type A ◽

The Other ◽

Type B ◽

Clotting Time ◽

Positive Group ◽

Glycoprotein I ◽

Factor Ixa ◽

Beta 2 ◽

Kaolin Clotting Time

Antiphospholipid (aPL) antibodies include anticardiolipin (aCL) and lupus anticoagulant (LA) antibodies. LA antibodies recognize the complex of lipid-bound (human) prothrombin, in this way inhibiting the phospholipid-dependent coagulation reactions, whereas aCL antibodies are directed towards beta 2-glycoprotein I (beta 2-GPI) bound to an anionic lipid surface. According to their behavior in coagulation reactions, we have divided aCL antibodies into two groups: aCL-type A, which inhibit the phospholipid-dependent coagulation reactions because they enhance the binding of beta 2-GPI to the procoagulant phospholipid surface; and aCL-type B antibodies, which are devoid of anticoagulant properties. We report the distinctive laboratory and clinical profiles of 25 patients with well-characterized, phospholipid-dependent inhibitor of coagulation. Fourteen patients had LA antibodies (aCL-type B were concomitantly present in 10 cases, while in the other four, aCL titer was normal), and the other 11 had aCL-type A antibodies. The laboratory evaluation of the two groups showed the dilute Russell viper venom time (dRVVT) to be the most abnormal coagulation test in the aCL- type A-positive group, whereas the kaolin clotting time (KCT) was the most abnormal assay in the LA-positive group. In fact, the ratios of the coagulation times of patient plasma over normal pooled plasma (mean +/- standard deviation) for LA versus aCL-type A antibodies were 1.48 +/- 0.27 versus 2.20 +/- 0.42, P = .0001, and 2.22 +/- 0.42 versus 1.50 +/- 0.42, P = .0003, for the dRVVT and KCT, respectively. No differences were observed either in the ratios of the activated partial thromboplastin times and the prothrombin times or the plasma levels of beta 2-GPI and prothrombin. Conversely, aCL titers were significantly higher in aCL-type A-positive patients (147 +/- 44 U) than in the LA- positive group (61 +/- 55 U; P = .0003). We ruled out the possibility that platelet contamination of plasma could account for the observed coagulation profiles, as the two patterns were reproduced in platelet- free plasma. In addition, we performed clotting tests in plasma in the presence of phospholipids and calcium after addition of factor IXa or factor Xa. The assay performed with factor Xa was more sensitive to the presence of aCL-type A antibodies, while the assay performed with factor IXa was preferentially sensitive to LA-containing plasmas, supporting the earlier findings with the dRVVT and KCT assays.(ABSTRACT TRUNCATED AT 400 WORDS)

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ANTIPHOSPHOLIPID SYNDROME

Health and Ecology Issues ◽

10.51523/2708-6011.2017-14-4-1 ◽

2017 ◽

pp. 4-11

Author(s):

E. V. Makarenko

Keyword(s):

Blood Plasma ◽

Antiphospholipid Syndrome ◽

Antiphospholipid Antibodies ◽

Arterial Thrombosis ◽

Lupus Anticoagulant ◽

Pregnancy Complication ◽

Classification Criteria ◽

Clinical Criteria ◽

Glycoprotein I ◽

Acquired Thrombophilia

Antiphospholipid syndrome is autoimmune acquired thrombophilia associated with the formation of antibodies to phospholipids, which is manifested by recurrent venous or arterial thrombosis and/or pathology of pregnancy. Antiphospholipid antibodies are a heterogeneous group of autoantibodies interacting with phospholipids, which are components of cell membranes and phospholipid-binding proteins of blood plasma. Antiphospholipid syndrome can affect vessels of any caliber and localization, with thrombosis accompanied by no morphological signs of inflammation in the wall of the vessel. Obstetrical pathology is manifested by loss of the fetus, which can occur at any time of pregnancy, as well as other complications of pregnancy, such as preeclampsia and placental insufficiency. Based on the classification criteria, antiphospholipid syndrome is diagnosed if one of the clinical criteria (thrombosis or pregnancy complication) and one of the laboratory criteria including the lupus anticoagulant, antibodies to cardiolipin or β2-glycoprotein I, are revealed. The main tactic of the treatment of patients with antiphospholipid syndrome is to prevent thrombosis. For this purpose, the traditional therapy with anticoagulants and antiaggregants is applied. In addition, new medicines are being developed and evaluated

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Rheumatic Disease Among Oklahoma Tribal Populations: A Cross-sectional Study

The Journal of Rheumatology ◽

10.3899/jrheum.110984 ◽

2012 ◽

Vol 39 (10) ◽

pp. 1934-1941 ◽

Cited By ~ 8

Author(s):

JASMINE R. GADDY ◽

EVAN S. VISTA ◽

JULIE M. ROBERTSON ◽

AMY B. DEDEKE ◽

VIRGINIA C. ROBERTS ◽

...

Keyword(s):

Rheumatic Disease ◽

American Indian ◽

Rheumatic Diseases ◽

Lupus Erythematosus ◽

Cross Sectional Study ◽

Anticardiolipin Antibodies ◽

Cross Sectional ◽

American College Of Rheumatology ◽

Tribal Populations ◽

The Difference

Objective.Rheumatic diseases cause significant morbidity within American Indian populations. Clinical disease presentations, as well as historically associated autoantibodies, are not always useful in making a rapid diagnosis or assessing prognosis. The purpose of our study was to identify autoantibody associations among Oklahoma tribal populations with rheumatic disease.Methods.Oklahoma tribal members (110 patients with rheumatic disease and 110 controls) were enrolled at tribal-based clinics. Patients with rheumatic disease (suspected or confirmed diagnosis) were assessed by a rheumatologist for clinical features, disease criteria, and activity measures. Blood samples were collected and tested for common rheumatic disease autoantibodies [antinuclear antibody (ANA), anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factor (RF), anti-Ro, anti-La, anti-Sm, anti-nRNP, anti-ribosomal P, anti-dsDNA, and anticardiolipins].Results.In patients with suspected systemic rheumatic diseases, 72% satisfied American College of Rheumatology classification criteria: 40 (36%) had rheumatoid arthritis (RA), 16 (15%) systemic lupus erythematosus, 8 (7%) scleroderma, 8 (7%) osteoarthritis, 4 (4%) fibromyalgia, 2 (2%) seronegative spondyloarthropathy, 1 Sjögren’s syndrome, and 1 sarcoidosis. Compared to controls, RA patient sera were more likely to contain anti-CCP (55% vs 2%; p < 0.001) or RF IgM antibodies (57% vs 10%; p < 0.001); however, the difference was greater for anti-CCP. Anti-CCP positivity conferred higher disease activity scores (DAS28 5.6 vs 4.45; p = 0.021) while RF positivity did not (DAS28 5.36 vs 4.64; p = 0.15). Anticardiolipin antibodies (25% of rheumatic disease patients vs 10% of controls; p = 0.0022) and ANA (63% vs 21%; p < 0.0001) were more common in rheumatic disease patients.Conclusion.Anti-CCP may serve as a more specific RA biomarker in American Indian patients, while the clinical significance of increased frequency of anticardiolipin antibodies needs further evaluation.

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