Anti-phospholipid IgG Antibodies Detected by Line Immunoassay Differentiate Patients with Anti-phospholipid Syndrome and Other Autoimmune Diseases

Overview

Journal Auto Immun Highlights

Publisher Biomed Central

Date 2018 May 31

PMID 29845583

Citations 12

Authors

Cecilia Nalli

Valentina Somma

Laura Andreoli

Thomas Buttner

Peter Schierack

Michael Mahler

Dirk Roggenbuck

Angela Tincani

Affiliations

Soon will be listed here.

Abstract

Purpose: Anti-phospholipid antibodies (aPL) analyzed by line immunoassay (LIA) can recognize beta-glycoprotein I (βGPI) domain 1 (D1) epitopes depending on βGPI binding to distinct phospholipids. The aPL LIA was compared with consensus ELISA to investigate whether both techniques can discriminate anti-phospholipid syndrome (APS) patients from aPL-positive, systemic autoimmune rheumatic diseases (SARD) patients without clinical symptoms of APS and controls.

Methods: Thirty-four APS patients (14 arterial/venous thrombosis, 16 pregnancy morbidity, and 4 both), 41 patients with SARD lacking clinical APS criteria but demonstrating positivity for anti-βGPI (aβGPI) IgG, and 20 healthy subjects (HS) were tested for aPL to cardiolipin (aCL), phosphatidic acid, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol (aPG), phosphatidylinositol, phosphatidylserine, βGPI, prothrombin, and annexin V by LIA. Samples were also tested for aCL, aβGPI, aβGPI-domain 1 (aD1), and aβGPI-domains 4-5 (aD4-5) by ELISA and for lupus anti-coagulant.

Results: Comparison of LIA with ELISA revealed a good agreement for the consensus criteria aPL aβGPI and aCL IgG (kappa = 0.69, 0.68, respectively) and a moderate agreement for IgM (kappa = 0.52, 0.49, respectively). Regarding ELISA, aD1/aD4-5 demonstrated the best performance of differentiating APS from asymptomatic SARD [area under the curve (AUC): 0.76]. aPG IgG had the best performance by LIA (AUC: 0.72) not significantly different from aD1/aD4-5. There was a good agreement for aPG IgG with aD1/aD4-5 (kappa = 0.71).

Conclusions: aD1/aD4-5 (ELISA) and aPG IgG (LIA) differentiate APS from SARD patients. PG appears to interact with βGPI of APS patients and exposes D1 thereof for disease-specific aPL binding in LIA.

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