Antiphosphatidylserine/prothrombin (aPS/PT) antibodies are associated with Raynaud phenomenon and migraine in primary thrombotic antiphospholipid syndrome

Abstract

Objectives Antibodies to phosphatidylserine/prothrombin complex (aPS/PT) detectable in sera of some patients with antiphospholipid syndrome (APS) have been shown to correlate with thrombosis. However, associations of aPS/PT antibodies with APS related disorders remain unclear. Aim To evaluate whether there are any associations between aPS/PT antibodies and Raynaud phenomenon, migraine and/or valvular lesions in primary thrombotic APS (PAPS). Methods We enrolled 67 consecutive patients (56 women) with thrombotic PAPS (VTE in 80.6%), aged 46.2 ± 13.5 years. The exclusion criteria were: acute coronary syndromes or stroke within preceding 6 months, cancer, severe comorbidities and pregnancy. The IgG and IgM aPS/PT antibodies were determined by ELISA with the cut-off of 30 units. We recorded Raynaud phenomenon, migraine and valvular lesions. Results Positive IgM or/and IgG aPS/PT antibodies were observed in 29 patients (43.3%), with a higher prevalence of IgM antibodies ( n = 27, 40.3%) compared with IgG isotype ( n = 12, 17.9%, p = 0.014). aPS/PT antibodies were observed most commonly in patients with triple aPL ( n = 12, 85.7%) compared with those with double ( n = 5, 35.7%) or single aPL antibodies (n = 12, 30.8%, p = 0.03), with no association with demographics, the ANA titre, the type of thrombotic events or medications. Raynaud phenomenon, migraine and valvular lesions were observed in 15% ( n = 10), 30% ( n = 20) and 18% ( n = 12) of the patients, respectively. Raynaud phenomenon and migraine, but not valvular lesions, were markedly more frequent in PAPS patients presenting with positive aPS/PT antibodies ( n = 10, 34.5% vs. n = 0, 0%; p = 0.0001). Conclusions In PAPS patients aPS/PT antibodies are related to the occurrence of both Raynaud phenomenon and migraine.

Molecular Mechanism of the Saposhnikovia divaricata–Angelica dahurica Herb Pair in Migraine Therapy Based on Network Pharmacology and Molecular Docking

“…PIK3CA, PIK3CB, and PIK3CD are important genes involved in cell proliferation, G protein-coupled receptor signal transduction, and cancer gene expression, and they may be related to migraine caused by glial neuron tumors [ 42 ]. To date, it is generally accepted that migraine is associated with primary and secondary coagulation abnormalities [ 43 , 44 ], and F2, as prothrombin, plays a significant role in migraine pathogenesis [ 45 , 46 ]. Abnormal sex hormone receptors can lead to migraine [ 47 ].…”

Pregnancy complicated with adrenal adenoma causing ACTH-independent Cushing’s syndrome, accompanied by obstetric antiphospholipid syndrome and severe pre-eclampsia: case report and literature review

“…Cases with incomplete clinical or laboratory data are classified as obstetric morbidity APS (OMAPS) and NC-OAPS (16,46) (Table 3). Recent studies on the pathogenesis of APS and clinical trials have shown that antiphospholipid antibodies exist outside some classification criteria and are associated with thrombotic events and morbid pregnancy events, including (1) Anti-prothrombin antibodies (47) (2); Anti-b2GPI domain1antibodies (48) (3); IgA anti-b 2GPI antibody and IgA anticardiolipin antibody (49) (4); Anticardiolipin/vimentin antibodies (50) (5); Anti-annexin A2 antibodies/anti-annexin A5 antibodies (51) (6); Antiphospholipid antigen antibody (52) (7); Anti-protein C/protein S antibody (53). In addition, some patients with APS may also have clinical manifestations outside the classification criteria, such as superficial venous thrombosis, thrombocytopenia, renal microvascular disease, cardiac valvular disease, migraine, chorea, epilepsy, and myelitis (50,54).…”

Antiphosphatidylserine/prothrombin complex antibodies as a determinant of prothrombotic plasma fibrin clot properties in patients with antiphospholipid syndrome

“…It has been demonstrated that IgG aPS/PT is associated with the positive LA, IgG aCL, and aβ2GPI antibodies (OR 14.1, 95% CI 6.1‐32.0, OR = 11.9, 95% CI 4.7‐29.5, and OR = 6.0, 95% CI 2.8‐12.9, respectively), and these antibodies have been reported as an independent risk factor for thrombosis in APS . IgM aPS/PT antibodies had only weak or no associations with IgM aCL or aβ2GPI antibodies . Recently, Pengo et al have shown that assessment of aPS/PT, along with aβ2GPI antibodies, in patients with present LA activity can identify two subgroups of patients with different risk of thromboembolism.…”

“…15 IgM aPS/PT antibodies had only weak or no associations with IgM aCL or aβ2GPI antibodies. 16 Recently, Pengo et al 17 have shown that assessment of aPS/PT, along with aβ2GPI antibodies, in patients with present LA activity can identify two subgroups of patients with different risk of thromboembolism.…”