Title | The association between circulating antibodies against domain I of beta2-glycoprotein I and thrombosis: an international multicenter study. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | de Laat B, Pengo V, Pabinger I, Musial J, Voskuyl AE, Bultink IEM, Ruffatti A, Rozman B, Kveder T, de Moerloose P, Boehlen F, Rand J, Ulcova-Gallova Z, Mertens K, De Groot PG |
Journal | J Thromb Haemost |
Volume | 7 |
Issue | 11 |
Pagination | 1767-73 |
Date Published | 2009 Nov |
ISSN | 1538-7836 |
Keywords | Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Antiphospholipid, Antiphospholipid Syndrome, Autoantibodies, beta 2-Glycoprotein I, Epitopes, Female, Humans, Immunoglobulin G, Male, Middle Aged, Pregnancy, Pregnancy Complications, Thrombosis, Young Adult |
Abstract | BACKGROUND: Diagnosis of the antiphospholipid syndrome (APS) is difficult as a result of limited specificity of existing assays for detecting clinically relevant antiphospholipid antibodies. Anti-beta2-glycoprotein I (beta 2GPI) antibodies play a central role in the disease process of APS. OBJECTIVES: We have investigated the relation between antiphospholipid antibodies with specificity for domain I of beta 2GPI and thrombosis/pregnancy morbidity in an international multicenter study. PATIENTS/METHODS: Four hundred and seventy-seven patients derived from nine different centres met the inclusion criterion of having anti-beta 2GPI antibodies in their plasma/serum. Clinical data and results of tests for lupus anticoagulant, anti-cardiolipin antibodies and anti-beta 2GPI antibodies were established at the different centres of inclusion. After being re-tested for the presence of IgG and/or IgM anti-beta 2GPI antibodies, the samples were tested for the presence of IgG-directed against domain I of beta 2GPI and results were correlated with the thrombotic and obstetric history. RESULTS: Re-testing for the presence of anti-beta 2GPI antibodies resulted in inclusion of 442/477 patients. IgG class anti-domain I antibodies were present in plasma of 243/442 patients (55%). 201/243 (83%) had a history of thrombosis. This resulted in an odds ratio of 3.5 (2.3-5.4, 95% confidence interval) for thrombosis. Anti-domain I IgG antibodies were also significantly correlated with obstetric complications [odds ratio: 2.4 (1.4-4.3, 95% confidence interval)]. CONCLUSION: In this multicenter study, the detection of IgG antibodies that are directed against domain I of beta 2GPI proved to be more strongly associated with thrombosis and obstetric complications than those detected using the standard anti-beta 2GPI antibody assay. |
DOI | 10.1111/j.1538-7836.2009.03588.x |
Alternate Journal | J Thromb Haemost |
PubMed ID | 19694946 |
Related Faculty:
Jacob H. Rand, M.D.