Reactivity against the Five Domains of β2 Glycoprotein I: A Focus on Systemic Lupus Erythematosus

Objectives IgA antiphospholipid antibodies (aPL) are prevalent in systemic lupus erythematosus (SLE) patients of African American, Afro-Caribbean and South African origin. Nevertheless, data from North Africa are lacking, and most studies use manufacturer-suggested cut-offs based on Caucasian controls. Therefore, we compared aPL isotypes in Sudanese and Swedish SLE patients using nation-based cut-offs. Methods Consecutive SLE patients and age- and sex-matched controls from Sudan ( N = 115/106) and Sweden ( N = 340/318) were included. All patients fulfilled the 1982 American College of Rheumatology SLE classification criteria. Antiphospholipid syndrome–related events were obtained from patients’ records. IgA/G/M anticardiolipin and anti-β2 glycoprotein I (β2GPI) were analysed with two independent assays. IgA anti-β2GPI domain 1 (D1) was also investigated. Manufacturers’ cut-offs and the 95th and 99th percentile cut-offs based on national controls were used. Results Sudanese patients and controls had higher levels and were more often positive for IgA aPL than Swedes when using manufacturers’ cut-offs. In contrast, using national cut-offs, the increase in IgA aPL among Sudanese patients was lost. Occurrence of IgA anti-D1 did not differ between the countries. Venous thromboses were less common among Sudanese patients and did not associate with aPL. No clinical associations were observed with IgA anti-β2GPI in Sudanese patients. Thromboses in Swedes were associated with IgG/M aPL. Fetal loss was associated with aPL in both cohorts. Conclusions IgA anti-β2GPI prevalence was higher among Sudanese compared to Swedish patients when manufacturers’ cut-offs were used. This situation was reversed when applying national cut-offs. Anti-D1 was not increased in Sudanese patients. Previous studies on populations of African origin, which demonstrate a high prevalence of IgA aPL positivity, should be re-evaluated using a similar cut-off approach.

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Screening Tests of Reproductive Immunology in Systemic Lupus Erythematosus

Autoimmune Diseases ◽

10.1155/2012/812138 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Zdenka Ulcova-Gallova ◽

Alice Mockova ◽

Miroslava Cedikova

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Phosphatidyl Ethanolamine ◽

Phosphatidyl Inositol ◽

Phosphatidyl Serine ◽

Sperm Cells ◽

Systemic Lupus ◽

Ethanolamine Phosphatidyl ◽

Glycoprotein I ◽

Beta 2

Female patients in reproductive age with systemic lupus erythematosus and fertility complications together are observed by rheumatologists, gynecologists, and reproductive immunologists. The paper notes the presence of autoantibodies to zona pellucida, to phospholipids (phosphatidyl serine, phosphatidyl ethanolamine, phosphatidyl inositol, phosphatidyl glycerol, phosphatidic acid, annexin V, beta-2 glycoprotein I, and cardiolipin) and of isoantibodies to sperm cells. Isoantibodies to sperm cells are not significantly predominant, but autoimmunity is well expressed in IgG positivity against phosphatidyl inositol, phosphatidyl ethanolamine, phosphatidyl serine, cardiolipin, and beta-2 glycoprotein I, as well as antizona pellucida antibodies in IgG isotype. According to the levels of autoantibodies we have to choose preventive treatment to protect mother and her foetus.

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Association of IgA Anti-ß2 Glycoprotein I with Clinical and Laboratory Manifestations of Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.100568 ◽

2010 ◽

Vol 38 (1) ◽

pp. 64-68 ◽

Cited By ~ 50

Author(s):

TARANEH MEHRANI ◽

MICHELLE PETRI

Keyword(s):

Systemic Lupus Erythematosus ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Lupus Erythematosus ◽

Classification Criteria ◽

Systemic Lupus ◽

Superficial Thrombophlebitis ◽

Glycoprotein I ◽

High Prevalence ◽

Ischemic Attack

Objective.IgA isotypes of anticardiolipin and anti-ß2 glycoprotein I (anti-ß2-GPI) are omitted from the revised antiphospholipid syndrome (APS) classification criteria. Multiple studies have found a high prevalence of IgA anti-ß2-GPI in systemic lupus erythematosus (SLE). We determined the frequency and associations of IgA anti-ß2-GPI in a cohort of patients with SLE.Methods.Anti-ß2-GPI was measured in 796 patients with SLE (93% women, 53% white, 38% African American, mean age 45 yrs). IgA anti-ß2-GPI (> 20 phospholipid units) was found in 20%. Using a cohort database, associations with cumulative thrombotic and other manifestations were determined.Results.Of patients with SLE who demonstrated IgA anti-ß2-GPI positivity, about 6% had transient ischemic attack (p = 0.070), 4% had superficial thrombophlebitis (p = 0.647), 20% had deep venous thrombosis (p = 0.003), 4% had other venous thrombosis (p = 0.827), 12% had stroke (p = 0.050), and 1% had myocardial infarction (p = 0.397).Conclusion.IgG anti-ß2-GPI has the strongest association with thrombosis in SLE. However, IgA anti-ß2-GPI was more strongly associated with deep venous thrombosis and with stroke than was IgM. These results indicate that assessment of IgA anti-ß2-GPI is associated with thrombosis in SLE, and that the classification criteria for APS should be revised to include IgA anti-ß2-GPI in patients with SLE.

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