The Clinical Performance of a New Chemiluminescent Immunoassay in Measuring Anti-β2 Glycoprotein 1 and Anti-Cardiolipin Antibodies

Zhou, Jiaolin; Hou, Xiuzhu; Zhang, Hua; Wang, Tiancheng; Cui, Liyan

doi:10.12659/msm.910369

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…Measurements were performed according to the reagent kit manufacturer’s recommendation. The cut-off recommended by the manufacturer is >20 U/mL [ 41 , 63 , 64 ].…”

Section: Methodsmentioning

confidence: 99%

Determination of Thrombogenicity Levels of Various Antiphospholipid Antibodies by a Modified Thrombin Generation Assay in Patients with Suspected Antiphospholipid Syndrome

Bradacova

Slavík²,

Skoumalová³

et al. 2022

IJMS

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Antiphospholipid syndrome (APS) is a hypercoagulable state accompanied by the presence of heterogeneous antiphospholipid antibodies (aPL), which nonspecifically affect hemostasis by the presence of lupus anticoagulans (LA), anticardiolipin antibodies (aCL), antibodies against β2-glycoprotein-I (anti-β2GPI), but also non-criteria antibodies such as antibodies against β2-glycoprotein-I domain I (anti-DI), anti-phosphatidylserine/prothrombin (anti-PS/PT), anti-annexin V, and many others. The main target of the antibodies is the activated protein C (APC) system, the elimination of which can manifest itself as a thrombotic complication. The aim of this study was to determine the thrombogenicity of antibodies using a modified protein C-activated thrombin generation assay (TGA) on a group of 175 samples suspected of APS. TGA was measured with/without APC and the ratio of both measurements was evaluated (as for APC resistance), where a cut-off was calculated ≤4.5 (90th percentile) using 21 patients with heterozygous factor V Leiden mutation (FV Leiden heterozygous). Our study demonstrates the well-known fact that multiple positivity of different aPLs is a more severe risk for thrombosis than single positivity. Of the single antibody positivity, LA antibodies are the most serious (p value < 0.01), followed by aCL and their subgroup anti-DI (p value < 0.05). Non-criteria antibodies anti-annexin V and anti-PT/PS has a similar frequency occurrence of thrombogenicity as LA antibodies but without statistical significance or anti-β2GPI1 positivity. The modified TGA test can help us identify patients in all groups who are also at risk for recurrent thrombotic and pregnancy complications; thus, long-term prophylactic treatment is appropriate. For this reason, it is proving increasingly beneficial to include the determination antibodies in combination with modified TGA test.

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“…Measurements were performed according to the reagent kit manufacturer’s recommendation. The cut-off recommended by the manufacturer is >20 U/mL [ 41 , 63 , 64 ].…”

Section: Methodsmentioning

confidence: 99%

Determination of Thrombogenicity Levels of Various Antiphospholipid Antibodies by a Modified Thrombin Generation Assay in Patients with Suspected Antiphospholipid Syndrome

Bradacova

Slavík²,

Skoumalová³

et al. 2022

IJMS

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“…Examination of aCL IgG, IgM, anti-β2GPI IgG, IgM, and anti-DI was performed using quantitative chemiluminescence immunoassays (CLIA) and using reagents QUANTA flash (Werfen, Barcelona, Spain) on a BioFlash analyser (Werfen, Barcelona, Spain) [44]. The principle of CLIA is the binding of aPL in the serum/plasma sample under investigation to paramagnetic particles coated with the appropriate surface.…”

Section: Chemiluminescence Immunoassaysmentioning

confidence: 99%

Determining Thrombogenicity: Using a Modified Thrombin Generation Assay to Detect the Level of Thrombotic Event Risk in Lupus Anticoagulant-Positive Patients

Bradáčová,

Slavík,

Úlehlová

et al. 2023

Biomedicines

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The aim of this study was to determine the thrombogenicity of lupus anticoagulant (LA) antibodies using a modified thrombin generation assay (TGA) with the addition of activated protein C (APC) in a group of 85 patients with LA-positive samples. Of these, 58 patients had clinical manifestations of antiphospholipid syndrome (APS) according to the Sydney criteria classification, i.e., each patient had thrombosis or foetal loss, and 27 patients did not show any clinical manifestations of APS. A comparison of the two groups’ TGA results revealed statistically significant differences (Fisher’s test p = 0.0016). The group of patients exhibiting clinical manifestations of APS showed higher thrombogenicity in 56.9% of patients, while the group of patients not yet exhibiting clinical manifestations of APS showed higher thrombogenicity in 25.9% of patients. There were no significant differences in the specificity of the TGA test between the groups of patients exhibiting similar clinical manifestations. Receiver operating characteristic curve analysis showed a more significant relationship (p = 0.0060) for TGA than for LA titre (p = 0.3387). These data suggest that the determination of LA thrombogenicity with the TGA assay leads to an increased prediction of the manifestation of a thromboembolic event. Our findings appear to be particularly relevant for the prediction of thrombotic events in patients with laboratory-expressed APS and no clinical manifestations.

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“…Automated chemiluminescent assays have replaced ELISA for aCL and aβ2GP1 in some centres. The advantages of chemiluminescence include faster turnaround times, random access rather than batched assays, and improved reproducibility of results and inter-and intra-laboratory variation with automation [41]. High-avidity antiprotein C antibodies are associated with resistance to activated protein C and may provide a marker for a severe thrombotic phenotype in APS [42].…”

Section: Which Apl Tests To Do and Whenmentioning

confidence: 99%

Thrombotic antiphospholipid syndrome: A practical guide to diagnosis and management

Sayar

Moll

Isenberg

et al. 2021

Thrombosis Research

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Thrombotic antiphospholipid syndrome (APS) is characterised by venous, arterial or microvascular thrombosis in the context of persistently positive antiphospholipid antibodies (aPL). The diagnosis and management of thrombotic APS continues to prove challenging for clinicians. We provide a practical guide to the diagnosis of APS including who to test for aPL and which tests to do. We also consider clinical practice points on the management of venous, arterial and small vessel thrombosis, in the context of first and recurrent thrombotic events. Non-criteria manifestations of APS are reviewed. An approach to recurrent thrombosis and anticoagulant-refractory APS is discussed, with options including increasing the anticoagulation intensity of vitamin K antagonists, switching to low-molecular-weight-heparin, the use of fondaparinux and/or the addition of antiplatelet treatment. The use of adjunctive options such as vitamin D, hydroxychloroquine and statins are also addressed.

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The Clinical Performance of a New Chemiluminescent Immunoassay in Measuring Anti-β2 Glycoprotein 1 and Anti-Cardiolipin Antibodies

Cited by 8 publications

References 39 publications

Determination of Thrombogenicity Levels of Various Antiphospholipid Antibodies by a Modified Thrombin Generation Assay in Patients with Suspected Antiphospholipid Syndrome

Determination of Thrombogenicity Levels of Various Antiphospholipid Antibodies by a Modified Thrombin Generation Assay in Patients with Suspected Antiphospholipid Syndrome

Determining Thrombogenicity: Using a Modified Thrombin Generation Assay to Detect the Level of Thrombotic Event Risk in Lupus Anticoagulant-Positive Patients

Thrombotic antiphospholipid syndrome: A practical guide to diagnosis and management

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