Anti-vimentin/cardiolipin IgA in the anti-phospholipid syndrome: A new tool for ‘seronegative’ diagnosis,Clinical & Experimental Immunology

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Anti-vimentin/cardiolipin IgA in the anti-phospholipid syndrome: A new tool for ‘seronegative’ diagnosis
Clinical & Experimental Immunology ( IF 3.4 ) Pub Date : 2021-06-09 , DOI: 10.1111/cei.13633
Antonella Capozzi ₁ , Gloria Riitano ₁ , Silvia Mancuso ₂ , Serena Recalchi ₁ , Valeria Manganelli ₁ , Tina Garofalo ₁ , Cristiano Alessandri ₂ , Agostina Longo ₁ , Roberta Misasi ₁ , Fabrizio Conti ₂ , Simona Truglia ₂ , Maurizio Sorice ₁

Affiliation

Anti-phospholipid syndrome (APS) is a systemic autoimmune disorder defined by the simultaneous presence of vascular clinical events, pregnancy morbidity and anti-phospholipid antibodies (aPL). In clinical practice, it is possible to find patients with APS who are persistently negative for the routine aPL tests (seronegative APS; SN-APS). Recently, the identification of aPL immunoglobulin (Ig)A and/or anti-β2-glycoprotein-I (β2-GPI) IgA was shown to represent a further test in SN-APS patients. In this study we analyzed the presence of anti-vimentin/cardiolipin (aVim/CL) IgA in a large cohort of patients with SN-APS, evaluating their possible association with clinical manifestations of the syndrome. This study includes 60 consecutive SN-APS patients, 30 patients with APS and 40 healthy donors. aVim/CL IgA were detected by enzyme-linked immunosorbent assay (ELISA). Results show that 12 of 30 APS patients (40%) and 16 of 60 SN-APS patients (26.7%) resulted positive for aVim/CL IgA. Interestingly, SN-APS patients who tested positive for aVim/CL IgA showed a higher prevalence of arterial thrombosis (p = 0.017, likelihood positive ratio = 5.7). This study demonstrates for the first time, to our knowledge, the presence of aVim/CL IgA in sera of patients with APS. In particular, they revealed a potential usefulness in identification of a significant proportion of SN-APS patients. Moreover, as patients tested positive for aVim/CL IgA reported a high likelihood ratio to have the clinical features of APS, this test may be considered a suitable approach in the clinical evaluation of SN-APS.

中文翻译：

抗磷脂综合征中的抗波形蛋白/心磷脂 IgA：“血清阴性”诊断的新工具

抗磷脂综合征 (APS) 是一种全身性自身免疫性疾病，定义为同时存在血管临床事件、妊娠发病率和抗磷脂抗体 (aPL)。在临床实践中，有可能发现常规 aPL 检测（血清阴性 APS；SN-APS）持续呈阴性的 APS 患者。最近，aPL 免疫球蛋白 (Ig)A 和/或抗 β2-糖蛋白-I (β2-GPI) IgA 的鉴定被证明代表了对 SN-APS 患者的进一步测试。在这项研究中，我们分析了大量 SN-APS 患者中抗波形蛋白/心磷脂 (aVim/CL) IgA 的存在，评估了它们与该综合征临床表现的可能关联。该研究包括 60 名连续的 SN-APS 患者、30 名 APS 患者和 40 名健康供体。aVim/CL IgA 通过酶联免疫吸附试验 (ELISA) 检测。结果显示，30 名 APS 患者中有 12 名 (40%) 和 60 名 SN-APS 患者中有 16 名 (26.7%) 的 aVim/CL IgA 呈阳性。有趣的是，aVim/CL IgA 检测呈阳性的 SN-APS 患者显示出更高的动脉血栓形成率。p = 0.017，似然正比 = 5.7）。据我们所知，这项研究首次证明了 APS 患者血清中存在 aVim/CL IgA。特别是，他们揭示了在识别大量 SN-APS 患者方面的潜在用途。此外，由于 aVim/CL IgA 检测呈阳性的患者报告具有 APS 临床特征的高似然比，因此该测试可被视为 SN-APS 临床评估的合适方法。

更新日期：2021-06-09

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