scholarly journals Antiphospholipid antibodies and anticoagulant therapy: capillaroscopic findings

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Giorgia Ferrari ◽  
Emanuele Gotelli ◽  
Sabrina Paolino ◽  
Giampaola Pesce ◽  
Luca Nanni ◽  
...  
Keyword(s):  
Antiphospholipid Antibodies ◽  
Oral Anticoagulants ◽  
Anticardiolipin Antibodies ◽  
Systemic Autoimmune Disease ◽  
Nailfold Videocapillaroscopy ◽  
Microvascular Endothelium ◽  
Microvascular Damage ◽  
Glycoprotein I ◽  
Quantitative Score ◽  
Endothelium Damage

Abstract Background Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by specific vascular and obstetric manifestations and by antiphospholipid antibodies (aPL) positivity. Microvascular damage in the course of APS and “aPL carrier” patients without symptoms is poorly investigated. Objectives This study aims to compare nailfold videocapillaroscopy (NVC) microvascular parameters in APS patients and non-symptomatic "aPL carriers" and to investigate their possible correlations with different aPL subtypes. Methods NVC was performed during standard evaluations in 18 APS patients (mean age 50 ± 13.8 years), 24 "aPL carriers" without symptoms (mean age 46.4 ± 16.4 years), and 18 control patients (CTR) (mean age 74 ± 12.5 years) taking oral anticoagulants for non-immunological indications (i.e., cardiovascular accidents). All patients were investigated for the presence of dilated capillaries, giant capillaries, microhemorrhages, capillary loss, and further non-specific/specific abnormalities (i.e., branched “bushy” capillaries, sign of neoangiogenesis) by NVC. Every alteration was also classified according to a semi-quantitative score. Lupus anticoagulant, anticardiolipin antibodies, and antibeta2 glycoprotein I antibodies were tested in each patient. Results APS patients showed at NVC increased frequency of microhemorrhages (p = 0.039)—particularly a “comb-like” pattern (parallel hemorrhages) (p = 0.002)—than "aPL carriers". Of note, there were no significant differences concerning the isolated number of microhemorrhages between APS and the CTR group (p = 0.314), but “comb-like” hemorrhages were significantly more frequent in the APS group (p = 0.034). Not any significant correlation was found between the aPL subtypes and NVC parameters. Conclusions APS patients showed significantly a greater number of non-specific NVC abnormalities than "aPL carriers", particularly the “comb-like” NVC pattern. Oral anticoagulants may represent a confounding factor for isolated microhemorrhages. Not any correlation was found between aPL subtypes and NVC parameters. Further investigations are needed to better characterize the microvascular endothelium damage induced by aPL.

scholarly journals Recent advances in understanding antiphospholipid syndrome

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2908 ◽  
Author(s):  
Maria Laura Bertolaccini ◽  
Giovanni Sanna
Keyword(s):  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Anticardiolipin Antibodies ◽  
Coagulation Cascade ◽  
Systemic Autoimmune Disease ◽  
Vascular Thrombosis ◽  
Clinical Criteria ◽  
Pregnancy Morbidity ◽  
Glycoprotein I ◽  
Hughes Syndrome

Antiphospholipid syndrome (APS), also known as Hughes Syndrome, is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity in the presence of persistently positive antiphospholipid antibodies. A patient with APS must meet at least one of two clinical criteria (vascular thrombosis or complications of pregnancy) and at least one of two laboratory criteria including the persistent presence of lupus anticoagulant (LA), anticardiolipin antibodies (aCL), and/or anti-b2 glycoprotein I (anti-b2GPI) antibodies of IgG or IgM isotype at medium to high titres in patient’s plasma. However, several other autoantibodies targeting other coagulation cascade proteins (i.e. prothrombin) or their complex with phospholipids (i.e. phosphatidylserine/prothrombin complex), or to some domains of β2GPI, have been proposed to be also relevant to APS. In fact, the value of testing for new aPL specificities in the identification of APS in thrombosis and/or pregnancy morbidity patients is currently being investigated.

scholarly journals Hemostasis system and immunomorphologic state of placenta under presence of antiphospholipid antibodies in plasma with consideration of their class and pregnancy outcome

2004 ◽  
Vol 53 (1) ◽  
pp. 22-26
Author(s):  
N. G. Kosheleva ◽  
L. В. Zubzhitskaia ◽  
О. N. Arzhanova ◽  
О. V. Tyshkevich ◽  
Y. Gromyko ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Antiphospholipid Antibodies ◽  
Lupus Anticoagulant ◽  
Recurrent Miscarriage ◽  
Anticardiolipin Antibodies ◽  
Research Groups ◽  
Hemostasis System ◽  
Autoimmune Antibodies ◽  
Glycoprotein I ◽  
Tissue Damages

The present study was undertaken to investigate hemostasis system of 197 women with recurrent miscarriage: Analysis placentas by immunomorphology are studied of 41 women and of 52 women with autoimmune antibodies to 2-glycoprotein-I (2-GPI) in placenta. There was exposed hyperactivation platelets blood of all women with antiphospholipid antibodies irrespective of groups with significantly was increased at the beginning of pregnancy and progressed with growing gestation. As result of investigation it is determined certain connection between outcome of pregnancy and activation degree platelets blood in vasculars. Was found absence influence anticardiolipin antibodies (aCL) on plasmocoagulative link hemostasis. The circulation of lupus anticoagulant (LA) was accompanied indication of hypercoagulation. In all research groups was determined significant oppression of fibrinolisis. Analysis placentas by immunomorphology was determined significantly tissue damages with LA and 2-GPI-dependent aCL.

Anticardiolipin Antibodies Block the Inhibition by β2-Glycoprotein I of the Factor Xa Generating Activity of Platelets

1993 ◽  
Vol 70 (02) ◽  
pp. 342-345 ◽  
Author(s):  
Wei Shi ◽  
Beng H Chong ◽  
Philip J Hogg ◽  
Colin N Chesterman
Keyword(s):  
Antiphospholipid Antibodies ◽  
Lupus Anticoagulant ◽  
Fetal Loss ◽  
Factor Xa ◽  
Anticardiolipin Antibodies ◽  
Recurrent Fetal Loss ◽  
Glycoprotein I ◽  
Activated Platelets ◽  
Inhibit Factor

SummaryAntiphospholipid antibodies, defined either by lupus anticoagulant (LA) activity or positive anticardiolipin immunoabsorbent assay (ACA) are associated with a predisposition to thromboses, recurrent fetal loss or thrombocytopenia. The mechanisms for these predispositions remain undefined. We have enriched immunoglobulin fractions from two patient plasmas to obtain antibodies with LA activity but no ACA, or conversely, with ACA positivity but no LA, in order to investigate in vitro characteristics which might explain a thrombotic propensity. β2-glycoprotein I (β2-GPI), the plasma cofactor required for ACA binding to negatively charged phospholipid, has previously been shown to inhibit prothrombinase generation in the presence of activated platelets (8). We now report that β2-GPI, at physiological concentrations, inhibits the generation of factor Xa in the presence of activated gel-filtered platelets. Further, ACA interferes with this inhibition, resulting in protracted, unopposed factor Xa generation. This interference with β2-GPI, a natural anticoagulant component of plasma, is potentially prothrombotic. LA immunoglobulins behave differently and inhibit factor Xa generation in a manner similar to β2-GPI. These findings provide the basis for a previously unsuspected mechanism for thrombosis in patients with aPL.

scholarly journals Antiphospholipid Antibodies and Recurrent Thrombotic Events: Persistence and Portfolio

2015 ◽  
Vol 40 (5-6) ◽  
pp. 293-300 ◽  
Author(s):  
Colum F. Amory ◽  
Steven R. Levine ◽  
Robin L. Brey ◽  
Mulugeta Gebregziabher ◽  
Stanley Tuhrim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Antiphospholipid Antibodies ◽  
Arterial Occlusion ◽  
Anticardiolipin Antibodies ◽  
Primary Analysis ◽  
Vein Thrombosis ◽  
Glycoprotein I ◽  
Single Positive ◽  
Ischemic Attack

Background: There are very limited prospective data on the significance of persistent antiphospholipid antibodies (aPL) and recurrent thrombo-occlusive events (TOEs). We investigated the prognostic value of (1) 2 newer aPL assays, (2) an aPL portfolio and (3) persistent aPL positivity following stroke. Methods: A total of 1,770 subjects from the APASS-WARSS study underwent further aPL testing for antibodies to phosphatidylserine (aPS) and anti-β2-glycoprotein-I (anti-β2GPI) from stored sera. Follow-up aPL status was also tested in a subset of subjects. Primary analysis was based on time to any TOE (ischemic stroke, myocardial infarction, transient ischemic attack, deep vein thrombosis, pulmonary embolism or systemic arterial occlusion)/death at 2 years. Cox proportional hazard analyses assessed whether aPL independently related to outcome. Results: Persistent anti-β2GPI decreased the time to TOE/death after adjustment for potential confounders (hazards ratio (HR) 2.86, 95% CI 1.21-6.76, p = 0.017). When persistent anti-β2GPI was combined with another persistently positive aPL, time to TOE/death was also reduced (HR 3.79, 95% CI 1.18-12.14, p = 0.025). Neither persistent anticardiolipin antibodies nor persistent aPS alone nor a single positive anti-β2GPI nor aPS was associated with decreased time to TOE/death. No single positive aPL, portfolio of baseline aPL or any persistent aPL increased the rate of TOE/death. Conclusions: Rates of TOE/death were not influenced by aPL results at baseline or follow-up. Persistent anti-β2GPI alone, and with persistent second aPL, was independently associated with decreased time to TOE/death. Persistent aPL, an aPL portfolio and newer aPL in ischemic stroke patients are not helpful in predicting an increased rate of recurrent TOEs.

Phospholipid inhibitors

2011 ◽  
Vol 31 (04) ◽  
pp. 243-250 ◽  
Author(s):  
M. Galli
Keyword(s):  
Venous Thrombosis ◽  
Antiphospholipid Antibodies ◽  
Arterial Thrombosis ◽  
Anticardiolipin Antibodies ◽  
Low Molecular Weight ◽  
Obstetrical Complications ◽  
Glycoprotein I ◽  
Long Duration ◽  
Activity Dependent ◽  
Cerebral Arterial Thrombosis

SummaryThe antiphospholipid syndrome (APS) is defined by the association of arterial and/or venous thrombosis and/or pregnancy complications with the presence of at least one among the main antiphospholipid antibodies (aPL) (i. e., Lupus anticoagulants, LA, IgG and/ or IgM anticardiolipin antibodies, aCL, IgG and/or IgM antiβ2-glycoprotein I antibodies, aβ2-GPI). Several clinical studies have consistently reported that LA is a stronger risk factor for both arterial and venous thrombosis compared to aCL and aβ2-GPI. In particular, LA activity dependent on the first domain of β2-GPI and triple aPL positivity are associated with the risk of thrombosis and obstetrical complications.Asymptomatic aPL-positive subjects do not require primary thromboprophylaxis. Venous thromboembolism is the most common initial clinical manifestation of APS. To prevent its recurrence indefinite anticoagulation is recommended. Long duration treatment with warfarin or aspirin is used after a first cerebral arterial thrombosis. Low molecular weight heparin (LMWH) with or without aspirin is recommended to reduce the rate of obstetrical complications of APS pregnant women.

Relationship of Anti β2-giycoprotein I and Anti Prothrombin Antibodies to Thrombosis and Pregnancy Loss in Patients with Antiphospholipid Antibodies

1997 ◽  
Vol 78 (03) ◽  
pp. 1008-1014 ◽  
Author(s):  
Ricardo R Forastiero ◽  
Marta E Martinuzzo ◽  
Graciela S Cerrato ◽  
Lucía C Kordich ◽  
Luis O Carreras
Keyword(s):  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Pregnancy Loss ◽  
Univariate Analysis ◽  
Clinical Importance ◽  
Anticardiolipin Antibodies ◽  
Glycoprotein I ◽  
History Of ◽  
Risk For Thrombosis ◽  
Relationship Of

SummaryThe lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) are clinically relevant because of their association with thrombosis and pregnancy loss. The group of antiphospholipid antibodies (aPL) includes antibodies primarily directed against various phospholipid-binding proteins, mainly β2-glycoprotein I (β2GPI) and prothrombin. Some studies suggest that there is an association between the presence of anti β2GPI antibodies (a(β2GPI) of IgG isotype and thrombosis. Therefore, aPL defined according to the plasma protein to which they are directed appear to be more appropriate for the evaluation of their clinical importance. Using home-made ELISAs we evaluated the presence of a(β2GPI and antiprothrombin antibodies (anti-II) of both isotypes (IgG and IgM) in a group of 233 patients with LA and/or aCL. Forty-four women had a history of pregnancy loss, 45 patients had a history of venous thrombosis (VT) and 32 of arterial thrombosis (AT). Patients from the autoimmune group (systemic lupus erythematosus and antiphospholipid syndrome) had a higher prevalence of aβ2GPI and/or anti-II than those from the miscellaneous group. In the univariate analysis, a significant association was shown between the presence of aβ2GPI-IgG (OR 3.2; 95% Cl 1.5-6.6) and previous VT, but not AT. Anti-II were related to VT but the multivariate analysis showed that aβ2GPI-IgG are the only independent risk factor for VT (OR 3.0; 95% Cl 1.3-6.2). The presence of aβ2GPI-IgM correlates well with a history of pregnancy loss (OR 2.6; 95% Cl 1.1-6.1). The coagulation tests profile showed that the clotting assays were more prolonged in patients having aCL, a(β2GPI or anti-II. But a higher prevalence of abnormal results was only found for the dilute Russell viper venom time in patients with VT, as compared to those without thrombosis (94.4% vs. 58.7%, p <0.02). The measurement of aβ2GPI of both isotypes could help to identify aPL-positive patients with a higher risk for thrombosis and pregnancy loss, although this association should be confirmed by prospective studies.

Antiphosphatidylethanolamine antibodies and the antiphospholipid syndrome

Lupus ◽  
2009 ◽  
Vol 18 (10) ◽  
pp. 920-923 ◽  
Author(s):  
M Sanmarco ◽  
M-C Boffa
Keyword(s):  
Clinical Features ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Lupus Anticoagulant ◽  
Anticardiolipin Antibodies ◽  
Anionic Phospholipids ◽  
Glycoprotein I ◽  
Antiphosphatidylethanolamine Antibodies

The antiphospholipid antibodies included as laboratory criteria of the antiphospholipid syndrome (APS) are antibodies reacting with anionic phospholipids – anticardiolipin antibodies and lupus anticoagulant – and with β2-glycoprotein I. However, antibodies reacting with phosphatidylethanolamine (aPE), a zwitterionic phospholipid, have also been described to be associated with the main features of APS. The objectives of this review are to describe the characteristics of aPE and to bring attention to recent evidence that aPE are correlated with the main clinical features of APS, notably, in the absence of the laboratory criteria of this syndrome.

scholarly journals Antiphospholipid Antibodies in Patients with Covid-19: Trend Over Time

2021 ◽  
Author(s):  
Silvia Mancuso ◽  
Simona Truglia ◽  
Maurizio Sorice ◽  
Cristiano Alessandri ◽  
Flavia Pasquali ◽  
...  
Keyword(s):  
Antiphospholipid Antibodies ◽  
Lupus Anticoagulant ◽  
Anticardiolipin Antibodies ◽  
Risk Of Death ◽  
Glycoprotein I ◽  
D Dimer ◽  
Over Time

Abstract Purpose Aim of the study was to investigate whether aPL positivity correlated with thrombosis in COVID-19 patients and whether it was transient or persistent. Methods We enrolled COVID-19 patients who underwent aPL tests: Lupus Anticoagulant (LA); IgM, IgG, IgA anticardiolipin antibodies (aCL); and IgM, IgG anti-β2-Glycoprotein-I antibodies (aβ2GPI). Results Twenty-eight out of 73 (38.4%) patients resulted positive for at least one aPL assay: 32.8% for IgA aCL, 6.8% for IgM aCL and 4.1% for IgM aβ2GPI. No patients tested positive for IgG aPL or LA at the first determination. Seven (9.6%) patients developed thrombotic events during hospitalization, with 4 of them resulting positive for aPL. In patients with thrombotic events during hospitalization the risk of death was increased 9-fold (LR+8.9, p=0.003). Patients with double positivity for aCL and aβ2GPI IgM had a LR+ of 6.3 to have thrombotic events (p=0.012) and a LR+ of 4.9 to have elevated D-dimer levels (p=0.027). In 10 out of 28 positive patients, aPL was detected in a second occasion at least 12-weeks apart and two patients confirmed the positivity. Conclusion Results suggest that double positivity for aCL and aβ2GPI IgM increases the risk of thrombosis in COVID-19, unlike IgA aCL positivity. APL positivity may be persistent, and it is advisable to monitor it over time.

scholarly journals Genome-Wide Association Study of Antiphospholipid Antibodies

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
M. Ilyas Kamboh ◽  
Xingbin Wang ◽  
Amy H. Kao ◽  
Michael M. Barmada ◽  
Ann Clarke ◽  
...  
Keyword(s):  
Association Study ◽  
Antiphospholipid Antibodies ◽  
Genome Wide Association Study ◽  
Additive Model ◽  
Anticardiolipin Antibodies ◽  
Genome Wide Association ◽  
Nucleotide Polymorphisms ◽  
Glycoprotein I ◽  
Genome Wide ◽  
A Genome

Background. The persistent presence of antiphospholipid antibodies (APA) may lead to the development of primary or secondary antiphospholipid syndrome. Although the genetic basis of APA has been suggested, the identity of the underlying genes is largely unknown. In this study, we have performed a genome-wide association study (GWAS) in an effort to identify susceptibility loci/genes for three main APA: anticardiolipin antibodies (ACL), lupus anticoagulant (LAC), and anti-β2glycoprotein I antibodies (anti-β2GPI).Methods. DNA samples were genotyped using the Affymetrix 6.0 array containing 906,600 single-nucleotide polymorphisms (SNPs). Association of SNPs with the antibody status (positive/negative) was tested using logistic regression under the additive model.Results. We have identified a number of suggestive novel loci withP<E-05. Although they do not meet the conservative threshold of genome-wide significance, many of the suggestive loci are potential candidates for the production of APA. We have replicated the previously reported associations of HLA genes andAPOHwith APA but these were not the top loci.Conclusions. We have identified a number of suggestive novel loci for APA that will stimulate follow-up studies in independent and larger samples to replicate our findings.

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