Immunoglobulin A Isotype of Antiphospholipid Antibodies Does Not Provide Added Value for the Diagnosis of Antiphospholipid Syndrome in a Chinese Population

Hu, Chao; Li, Xi; Wang, Qian; Li, Mengtao; Tian, Xin; Zeng, Xiaofeng

doi:10.3389/fimmu.2020.568503

Cited by 10 publications

(14 citation statements)

References 49 publications

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“…However, no other significant association was observed for other clinical features or IgA isotype. Similar results could be observed in a study conducted by us recently in a large cohort with more than 7,000 patients (25). It had been reported that the prevalence of thrombocytopenia was 20 to 46% as a manifestation of primary APS, probably because aCL may bind activated platelet membranes and cause platelet destruction (26).…”

Section: Discussionsupporting

confidence: 88%

Comparison of Different Test Systems for the Detection of Antiphospholipid Antibodies in a Chinese Cohort

Xie

et al. 2021

Front. Immunol.

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BackgroundDiagnosis of antiphospholipid syndrome (APS) is based on the positivity of laboratory criteria antiphospholipid antibodies (aPLs). Test results for aPLs could be contradictory among different detection methods as well as commercial manufacturers. This study aimed to assess and compare the diagnostic and analytic performances of four commercial assays prevalently used in China.MethodsA total of 313 patients including 100 patients diagnosed with primary APS, 52 with APS secondary to SLE, 71 with SLE, and 90 health controls were recruited. Serum IgG, IgM, and IgA for aCL, and aβ2GPI antibodies were detected with two ELISA and two CLIA systems, and test system with the best diagnostic value was explored of its correlation with key clinical features.ResultsCLIA by YHLO Biotech Co. was considered as the system with the best predictive power, where 58.55 and 57.89% of APS patients were positive for aCL or aβ2GPI for at least one antibody (IgG or IgM or IgA). Overall, CLIA showed better performance characteristics than traditional ELISA test systems.ConclusionCLIA was considered as a better platform for aPL detection in APS diagnosis. A combination of other detection platforms could assist in differential diagnosis as well as in identifying high-risk patients.

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Section: Discussionsupporting

confidence: 88%

Comparison of Different Test Systems for the Detection of Antiphospholipid Antibodies in a Chinese Cohort

Xie

et al. 2021

Front. Immunol.

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“…Our own recent study based on a Swedish (mainly Caucasian) SLE population concluded that IgA aPL alone are of additional value only for patients with a high probability of APS, despite negative test outcomes for IgG/IgM aCL, anti-β2GPI and LA ( 23 ). Similar data were recently reported from a large Chinese population ( 24 ).…”

Section: Introductionsupporting

confidence: 91%

Longitudinal Analysis of Anti-cardiolipin and Anti-β2-glycoprotein-I Antibodies in Recent-Onset Systemic Lupus Erythematosus: A Prospective Study in Swedish Patients

et al. 2021

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Background: Anti-phospholipid syndrome (APS) and systemic lupus erythematous (SLE) are autoimmune disorders that often co-occur. Anti-phospholipid antibodies (aPL) are typical of both conditions and may be associated with vascular events and pregnancy-related morbidities. Whereas, aPL-screening is mandatory for individuals with suspected SLE, the clinical value of longitudinal aPL analyses in established SLE is unclear.Methods: We investigated the occurrence and variation of IgG/IgA/IgM anti-cardiolipin (aCL) and anti-β2-glycoprotein-I (anti-β2GPI) antibodies, using both the manufacturer's cut-off and a cut-off based on the 99th percentile of 400 apparently healthy donors, in recent-onset SLE. Furthermore, we evaluated the relationships between aPL levels and SLE/APS manifestations, as well as the pharmacotherapy. Patients with SLE who met validated classification criteria were included in this prospective study (N = 54). Samples were obtained at 0, 6, 12, 24, 36, 48, 60, 72, 84, and 96 months after SLE diagnosis.Results: Depending on the cut-off applied, 61.1 or 44.4% showed a positive result for at least one aPL isotype or the lupus anticoagulant test over time. Median values for all six aPL isotypes numerically decreased from inclusion to last follow-up, but none of the isotypes met statistical significance. Seroconversion (from positive to negative, or the opposite direction) was occasionally seen for both aCL and anti-β2GPI. IgA and IgM anti-β2GPI were the most common isotypes, followed by IgM aCL. Presence of IgG aCL associated significantly with myocardial infarction and miscarriage, and IgG/IgA anti-β2GPI with miscarriage.Conclusion: aPL were common during the first years of SLE. Even though the levels fluctuated over time, the patients tended to remain aPL positive or negative. Repeated aPL testing in the absence of new symptoms seems to be of uncertain value in patients with recent-onset SLE.

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“…Additionally, assessment of the diagnostic performance of aPS/ PT revealed a significant correlation between thrombotic events and pregnancy loss with IgG aPS/PT (25,26), which was confirmed by a recent study (27). Concerning aCL/ab2GpI IgA, a study recently conducted by us in a large Chinese population revealed little added diagnostic value (28). Few studies have explored all of the above non-criteria autoantibodies in the same patient groups, and their relations with more detailed clinical manifestations still need investigation.…”

Section: Introductionsupporting

confidence: 60%

Evaluation of the Diagnostic Value of Non-criteria Antibodies for Antiphospholipid Syndrome Patients in a Chinese Cohort

Xie

et al. 2021

Front. Immunol.

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ObjectiveAlthough specific anti-phospholipid antibodies (aPLs) have been used in the diagnosis of the antiphospholipid syndrome (APS) for years, new biomarkers are required to increase its diagnostic and risk-predictive power. This study aimed to explore the value of several non-criteria aPLs in a Chinese cohort.MethodsA total of 312 subjects, namely, 100 patients diagnosed with primary APS, 51 with APS secondary to SLE, 71 with SLE, and 90 healthy controls, were recruited. Serum anticardiolipin (aCL) IgG/IgM/IgA, anti-β2-glycoprotein I (aβ2GPI) IgG/IgM/IgA, anti-phosphatidylserine/prothrombin antibodies (aPS/PT) IgG/IgM, and anti-annexin A5 antibodies (aAnxV) IgG/IgM were tested using ELISA kits.ResultsOf the total number of patients, 30.46% and 6.62% with APS were positive for aCL or aβ2GPI IgA, respectively, while 39.07% and 24.50% were positive for aAnxV or aPS/PT for at least one antibody (IgG or IgM). The addition test of aCL IgA and aAnxV IgM assists in identifying seronegative APS patients, and IgG aPS/PT was linked to stroke.ConclusionDetection of aCL IgA, aβ2GPI IgA, aAnxV IgG/M, and aPS/PT IgG/M as a biomarker provides additive value in APS diagnosis and would help in risk prediction for APS patients in medical practice.

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Immunoglobulin A Isotype of Antiphospholipid Antibodies Does Not Provide Added Value for the Diagnosis of Antiphospholipid Syndrome in a Chinese Population

Cited by 10 publications

References 49 publications

Comparison of Different Test Systems for the Detection of Antiphospholipid Antibodies in a Chinese Cohort

Comparison of Different Test Systems for the Detection of Antiphospholipid Antibodies in a Chinese Cohort

Longitudinal Analysis of Anti-cardiolipin and Anti-β2-glycoprotein-I Antibodies in Recent-Onset Systemic Lupus Erythematosus: A Prospective Study in Swedish Patients

Evaluation of the Diagnostic Value of Non-criteria Antibodies for Antiphospholipid Syndrome Patients in a Chinese Cohort

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