Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodies
Abstract Objectives Antiphospholipid syndrome (APS) is an autoimmune disease driven by antiphospholipid antibodies (aPL). Currently, APS diagnosis requires a combination of clinical manifestations (thrombosis and/or obstetric morbidity) and the persistent presence of at least one criteria aPL: anti‐...
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Wiley
2024-01-01
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| Series: | Clinical & Translational Immunology |
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| Online Access: | https://doi.org/10.1002/cti2.70021 |
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| author | Daniel Álvarez Hephzibah E Winter Carlos J Velasquez Franco Aleida Susana Castellanos Gutierrez Núria Baños Udo R Markert Ángela P Cadavid Diana M Morales‐Prieto |
| author_facet | Daniel Álvarez Hephzibah E Winter Carlos J Velasquez Franco Aleida Susana Castellanos Gutierrez Núria Baños Udo R Markert Ángela P Cadavid Diana M Morales‐Prieto |
| author_sort | Daniel Álvarez |
| collection | DOAJ |
| description | Abstract Objectives Antiphospholipid syndrome (APS) is an autoimmune disease driven by antiphospholipid antibodies (aPL). Currently, APS diagnosis requires a combination of clinical manifestations (thrombosis and/or obstetric morbidity) and the persistent presence of at least one criteria aPL: anti‐cardiolipin antibodies (aCL), anti‐β2‐glycoprotein I antibodies (aβ2GPI) or lupus anticoagulant (LA). Patients with suggestive obstetric symptoms but lacking criteria aPL face diagnostic challenges. Non‐criteria aPL screening may enhance discrimination. This study proposes a classification incorporating both criteria and non‐criteria antibodies to improve obstetric APS diagnosis. Methods Blood samples from non‐pregnant women (n = 68) with a history of vascular, obstetric, or vascular and obstetric manifestations were analysed. Among them, 30 had previous diagnosis of APS. Healthy women with proven gestational success were included as controls (n = 16). Criteria and non‐criteria (anti‐phosphatidylglycerol, anti‐phosphatidylethanolamine, anti‐phosphatidylinositol, anti‐phosphatidylserine and anti‐phosphatidic acid) IgG aPL were evaluated by ELISA and coagulation tests. Based on the resulting aPL profile, patients were reclassified. Responsiveness to treatment was obtained from medical records. Results Criteria aPL levels marginally differentiated women previously managed as obstetric APS from unexplained/other causes of obstetric morbidity. Including non‐criteria aPL improved separation. The proposed classification identified an obstetric APS group that exhibits non‐criteria aPL and aβ2GPI titres below the cut‐off but higher than healthy women (7.88 vs. 2.47 SGU, P = 0.006). Compared to cases of other causes of obstetric morbidity, these patients retrospectively responded better to aspirin and/or heparin treatment (71.43% vs. 11.11%, P = 0.035). Conclusions Assessing non‐criteria antibodies may identify isolated obstetric APS cases benefiting from established therapies. |
| format | Article |
| id | doaj-art-ae2a0158834f4eaca0ba2cbf21edad36 |
| institution | DOAJ |
| issn | 2050-0068 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
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| series | Clinical & Translational Immunology |
| spelling | doaj-art-ae2a0158834f4eaca0ba2cbf21edad362025-08-20T02:50:47ZengWileyClinical & Translational Immunology2050-00682024-01-011312n/an/a10.1002/cti2.70021Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodiesDaniel Álvarez0Hephzibah E Winter1Carlos J Velasquez Franco2Aleida Susana Castellanos Gutierrez3Núria Baños4Udo R Markert5Ángela P Cadavid6Diana M Morales‐Prieto7Grupo Reproducción, Departamento Microbiología y Parasitología, Facultad de Medicina Universidad de Antioquia UdeA Medellín ColombiaPlacenta Lab, Department of Obstetrics Jena University Hospital Jena GermanyDepartamento de Reumatología Clínica Universitaria Bolivariana Medellín ColombiaPlacenta Lab, Department of Obstetrics Jena University Hospital Jena GermanyBCNatal Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center Barcelona SpainPlacenta Lab, Department of Obstetrics Jena University Hospital Jena GermanyGrupo Reproducción, Departamento Microbiología y Parasitología, Facultad de Medicina Universidad de Antioquia UdeA Medellín ColombiaPlacenta Lab, Department of Obstetrics Jena University Hospital Jena GermanyAbstract Objectives Antiphospholipid syndrome (APS) is an autoimmune disease driven by antiphospholipid antibodies (aPL). Currently, APS diagnosis requires a combination of clinical manifestations (thrombosis and/or obstetric morbidity) and the persistent presence of at least one criteria aPL: anti‐cardiolipin antibodies (aCL), anti‐β2‐glycoprotein I antibodies (aβ2GPI) or lupus anticoagulant (LA). Patients with suggestive obstetric symptoms but lacking criteria aPL face diagnostic challenges. Non‐criteria aPL screening may enhance discrimination. This study proposes a classification incorporating both criteria and non‐criteria antibodies to improve obstetric APS diagnosis. Methods Blood samples from non‐pregnant women (n = 68) with a history of vascular, obstetric, or vascular and obstetric manifestations were analysed. Among them, 30 had previous diagnosis of APS. Healthy women with proven gestational success were included as controls (n = 16). Criteria and non‐criteria (anti‐phosphatidylglycerol, anti‐phosphatidylethanolamine, anti‐phosphatidylinositol, anti‐phosphatidylserine and anti‐phosphatidic acid) IgG aPL were evaluated by ELISA and coagulation tests. Based on the resulting aPL profile, patients were reclassified. Responsiveness to treatment was obtained from medical records. Results Criteria aPL levels marginally differentiated women previously managed as obstetric APS from unexplained/other causes of obstetric morbidity. Including non‐criteria aPL improved separation. The proposed classification identified an obstetric APS group that exhibits non‐criteria aPL and aβ2GPI titres below the cut‐off but higher than healthy women (7.88 vs. 2.47 SGU, P = 0.006). Compared to cases of other causes of obstetric morbidity, these patients retrospectively responded better to aspirin and/or heparin treatment (71.43% vs. 11.11%, P = 0.035). Conclusions Assessing non‐criteria antibodies may identify isolated obstetric APS cases benefiting from established therapies.https://doi.org/10.1002/cti2.70021antiphospholipid antibodiesantiphospholipid syndromeautoimmunityenzyme‐linked immunosorbent assaypregnancy complication |
| spellingShingle | Daniel Álvarez Hephzibah E Winter Carlos J Velasquez Franco Aleida Susana Castellanos Gutierrez Núria Baños Udo R Markert Ángela P Cadavid Diana M Morales‐Prieto Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodies Clinical & Translational Immunology antiphospholipid antibodies antiphospholipid syndrome autoimmunity enzyme‐linked immunosorbent assay pregnancy complication |
| title | Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodies |
| title_full | Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodies |
| title_fullStr | Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodies |
| title_full_unstemmed | Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodies |
| title_short | Improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non‐criteria antibodies |
| title_sort | improving diagnosis in patients with obstetric antiphospholipid syndrome through the evaluation of non criteria antibodies |
| topic | antiphospholipid antibodies antiphospholipid syndrome autoimmunity enzyme‐linked immunosorbent assay pregnancy complication |
| url | https://doi.org/10.1002/cti2.70021 |
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