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Amengual O, Forastiero R, Sugiura-Ogasawara M, Otomo K, Oku K, Favas C, Delgado Alves J, Žigon P, Ambrožič A, Tomšič M, Ruiz-Arruza I, Ruiz-Irastorza G, Bertolaccini ML, Norman GL, Shums Z, Arai J, Murashima A, Tebo AE, Gerosa M, Meroni PL, Rodriguez-Pintó I, Cervera R, Swadzba J, Musial J, Atsumi T. Evaluation of phosphatidylserine-dependent antiprothrombin antibody testing for the diagnosis of antiphospholipid syndrome: results of an international multicentre study. Lupus 2016; 26:266-276. [PMID: 27510605 DOI: 10.1177/0961203316660203] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective A task force of scientists at the International Congress on Antiphospholipid Antibodies recognized that phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT) might contribute to a better identification of antiphospholipid syndrome (APS). Accordingly, initial and replication retrospective, cross-sectional multicentre studies were conducted to ascertain the value of aPS/PT for APS diagnosis. Methods In the initial study (eight centres, seven countries), clinical/laboratory data were retrospectively collected. Serum/plasma samples were tested for IgG aPS/PT at Inova Diagnostics (Inova) using two ELISA kits. A replication study (five centres, five countries) was carried out afterwards. Results In the initial study ( n = 247), a moderate agreement between the IgG aPS/PT Inova and MBL ELISA kits was observed ( k = 0.598). IgG aPS/PT were more prevalent in APS patients (51%) than in those without (9%), OR 10.8, 95% CI (4.0-29.3), p < 0.0001. Sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratio of IgG aPS/PT for APS diagnosis were 51%, 91%, 5.9 and 0.5, respectively. In the replication study ( n = 214), a moderate/substantial agreement between the IgG aPS/PT results obtained with both ELISA kits was observed ( k = 0.630). IgG aPS/PT were more prevalent in APS patients (47%) than in those without (12%), OR 6.4, 95% CI (2.6-16), p < 0.0001. Sensitivity, specificity, LR + and LR- for APS diagnosis were 47%, 88%, 3.9 and 0.6, respectively. Conclusions IgG aPS/PT detection is an easily performed laboratory parameter that might contribute to a better and more complete identification of patients with APS.
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Affiliation(s)
- O Amengual
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - R Forastiero
- 2 Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Departamento de Fisiologia, Hemostasia y Trombosis, Buenos Aires, Argentina
| | - M Sugiura-Ogasawara
- 3 Department of Obstetrics and Gynecology, Nagoya City University, Graduated School of Medical Sciences, Nagoya, Japan
| | - K Otomo
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - K Oku
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - C Favas
- 4 Department of Medicine IV, Fernando Fonseca Hospital, Amadora and CEDOC/NOVA Medical School, Lisbon, Portugal
| | - J Delgado Alves
- 4 Department of Medicine IV, Fernando Fonseca Hospital, Amadora and CEDOC/NOVA Medical School, Lisbon, Portugal
| | - P Žigon
- 5 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - A Ambrožič
- 5 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - M Tomšič
- 5 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - I Ruiz-Arruza
- 6 Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Health Research Institute, Hospital Universitario Cruces, University of The Basque Country, Spain
| | - G Ruiz-Irastorza
- 6 Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Health Research Institute, Hospital Universitario Cruces, University of The Basque Country, Spain
| | - M L Bertolaccini
- 7 Academic Department of Vascular Surgery, Cardiovascular Division, King's College London, UK
| | - G L Norman
- 8 Inova Diagnostics Inc., San Diego, CA, USA
| | - Z Shums
- 8 Inova Diagnostics Inc., San Diego, CA, USA
| | - J Arai
- 9 Medical and Biological Laboratories, Co. Ltd, Nagano, Japan
| | - A Murashima
- 10 Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - A E Tebo
- 11 Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT, USA
| | - M Gerosa
- 12 Department of Clinical Sciences and Community Health, Istituto Auxologico Italiano, University of Milan, Milan, Italy
| | - P L Meroni
- 12 Department of Clinical Sciences and Community Health, Istituto Auxologico Italiano, University of Milan, Milan, Italy
| | - I Rodriguez-Pintó
- 13 Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - R Cervera
- 13 Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - J Swadzba
- 14 Department of Medicine Jagiellonian University, Cracow, Poland
| | - J Musial
- 14 Department of Medicine Jagiellonian University, Cracow, Poland
| | - T Atsumi
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Amengual O, Forastiero R, Sugiura-Ogasawara M, Otomo K, Kenji O, Favas C, Delgado Alves J, Žigon P, Ambrožič A, Tomšič M, Ruiz Arruza I, Ruiz Irastorza G, Bertolaccini M, Norman G, Shums Z, Jiro A, Murashima A, Tebo A, Gerosa M, Meroni P, Rodriguez-Pintό I, Cervera R, Swadzba J, Musial J, Atsumi T. OP0223 Significance of IGG Phosphatidylserine-Dependent Antiprothrombin Antibody Testing for the Diagnosis of Antiphospholipid Syndrome: Results from the Initial and Validation International Multi-Centre Studies. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Amengual O, Forastiero R, Sugiura-Ogasawara M, Oku K, Otomo K, Alves J, Favas C, Žigon P, Ambrožič A, Tomšič M, Ruiz-Irastorza G, Ruiz-Arruza I, Bertolaccini M, Norman G, Shums Z, Arai J, Atsumi T. SAT0202 International Multi-Centre Study to Evaluate the Clinical Significance of Phosphatidylserine-Dependent Antiprothrombin Antibodies for the Diagnosis of Antiphospholipid Syndrome. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Forastiero R, Papalardo E, Watkins M, Nguyen H, Quirbach C, Jaskal K, Kast M, Teodorescu M, Lakos G, Binder W, Shums Z, Nelson V, Norman G, Puig J, Cox A, Vandam W, Hardy J, Pierangeli S. Evaluation of different immunoassays for the detection of antiphospholipid antibodies: Report of a wet workshop during the 13th International Congress on Antiphospholipid Antibodies. Clin Chim Acta 2014; 428:99-105. [DOI: 10.1016/j.cca.2013.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 11/05/2013] [Accepted: 11/06/2013] [Indexed: 01/04/2023]
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Nalli C, Andreoli L, Motta M, Norman GL, Shums Z, Binder WL, Nuzzo M, Frassi M, Lojacono A, Meini A, Medeghini V, Avcin T, Meroni PL, Tincani A. [Fine specificity of anti-β2glycoprotein I antibodies in systemic autoimmune diseases is mostly directed against domain 1]. Reumatismo 2011; 63:91-6. [PMID: 21776445 DOI: 10.4081/reumatismo.2011.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Anti-β2 GPI are a formal laboratory criterion for the antiphospholipid syndrome (APS). They were demonstrated to be a risk factor for thrombosis and fetal losses but can also be detected in patients with systemic autoimmune disease (SAD), in healthy adults individuals and pre-school children. It has been suggested that different subpopulations of anti-β2GPI may carry different pathogenetic potential: autoantibodies against Domain1 seem to be associated with thrombosis; autoantibodies against Domain4/5 have been identified in patients with non-thrombotic conditions. METHODS We studied 48 patients with SAD (32 systemic lupus erythematosus, 16 undifferentiated connettive tissue disease), 64 patients with APS, 57 one-year-old healthy children born to mother with SAD, 33 children with atopic dermatitis. All subjects were IgG anti-β2 GPI positive. The specificity of anti-β2 GPI was investigated using ELISA research products containing recombinant β2 GPI D1 and D4/5 antigens. Cut-off values are calculated as 95th percentile on 100 NHD. IgG anti-β2 GPI were tested at a validated home-made ELISA routinely performed in our laboratory. No thrombotic events were recordered in patients with SAD and in both groups of children. RESULTS Patients with SAD and APS showed prevalent reactivity for D1 while children in both groups preferentially recognize D4/5. CONCLUSIONS IgG anti-β2 GPI against D1 seem to cluster in patients with systemic autoimmune conditions. Their pathogenic potential in determine APS manifestations may be mitigated by adequate prophylaxis.
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Affiliation(s)
- C Nalli
- U.O. Reumatologia e Immunologia Clinica, A.O. Spedali Civili, Piazzale Spedali Civili 1, Brescia, Italia
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Norman GL, Bialek A, Encabo S, Butkiewicz B, Wiechowska-Kozlowska A, Brzosko M, Shums Z, Milkiewicz P. Is prevalence of PBC underestimated in patients with systemic sclerosis? Dig Liver Dis 2009; 41:762-4. [PMID: 19357001 DOI: 10.1016/j.dld.2009.01.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 01/14/2009] [Accepted: 01/27/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND Clinically significant primary biliary cirrhosis occurs in 2.5% of patients with systemic sclerosis. Primary biliary cirrhosis-specific autoantibodies include anti-mitochondrial, anti-glycoprotein 210, and anti-sp100 antibodies. The majority of asymptomatic anti-mitochondrial-positive subjects express histological features of primary biliary cirrhosis. Early detection of primary biliary cirrhosis is important, as timely introduction of ursodeoxycholic acid may improve prognosis. The aim was to assess the prevalence of MIT3 IgG-anti-mitochondrial, gp210, sp100 and other autoantibodies in patients with systemic sclerosis and compare the clinical and biochemical parameters in those who are primary biliary cirrhosis-specific autoantibodies positive and negative. MATERIALS/METHODS Fifty-two consecutive patients with systemic sclerosis were included. Thirty-three suffered from limited skin SS and 19 from diffuse SS. RESULTS Eight (15%) patients with systemic sclerosis tested positive for primary biliary cirrhosis-specific autoantibodies. No significant differences were observed between primary biliary cirrhosis-specific autoantibodies positive and negative subjects in terms of various demographic, clinical or biochemical features. A trend towards increased prevalence of chronic fatigue in primary biliary cirrhosis-specific autoantibodies positive patients was observed. CONCLUSIONS Primary biliary cirrhosis-specific autoantibodies were detected in 15% of the systemic sclerosis patients. Since patients with primary biliary cirrhosis-specific antibodies are at high-risk or do suffer from primary biliary cirrhosis, screening for primary biliary cirrhosis-specific autoantibodies may be considered during routine assessment of systemic sclerosis.
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Affiliation(s)
- G L Norman
- INOVA Diagnostics, San Diego, United States
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