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Cited by 170Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsVasculitis and related conditions

Clinical significance of different antiphospholipid antibodies in the WAPS (warfarin in the antiphospholipid syndrome) study

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Galli, Monica, Borrelli, Giovanna, Jacobsen, Eva Marie, Marfisi, Rosa Maria, Finazzi, Guido, Marchioli, Roberto, Wisloff, Finn, Marziali, Stefana +2 more·2007·Blood
DOI 10.1182/blood-2007-01-066043
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Abstract

To assess the clinical significance of lupus anticoagulants (LAs) and antiphospholipid antibodies (aPLs) toward thrombosis and abortions, we measured them in 112 patients whose samples were available at enrollment in the warfarin in the antiphospholipid syndrome (WAPS) study. Enzyme-linked immunosorbent assay (ELISA) and coagulation test values in the highest and lowest tertiles were compared. When considered separately, IgG antibodies to β2-glycoprotein I (aβ2GPI) and prothrombin (aPT) were associated with anamnestic arterial and venous thrombosis, respectively, and those to annexin AV (aAnAV) with abortions. IgM antibodies to protein S and the lupus ratio of the dilute prothrombin time were associated with prospective thrombosis. No other association for IgM antibodies was seen. LA-positive patients who carried aβ2GPI antibodies were at risk of anamnestic arterial and total thrombosis and aPT antibodies to that of anamnestic venous and total thrombosis. LA-positive patients who carried IgG aβ2GPI and aAnAV antibodies were at risk for both anamnestic abortion and prospective thrombosis. Overall, these data support the inclusion of aβ2GPI antibodies in and suggest the removal of anticardiolipin antibodies from the laboratory criteria of the antiphospholipid syndrome. They also suggest that the measurement of aPT and aAnAV antibodies is useful in some selected situations and that there is little role for IgM antibody detection.

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  • A considerable proportion of patients with LA will not develop thrombosis despite the presence of aPL-associated autoantibodies at high titers.

    “Further, a considerable proportion of patients with LA will not develop thrombosis despite the presence of aPL-associated autoantibodies at high titers [7].”

    From Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant (2017) · cites this paper as [7]

    The section on IgG aPL antibodies in LA-positive patients reports that 32 of 38 patients with high aPT levels and 33 of 37 with high anti-β2GPI levels had a history of thrombosis; some in each group therefore had no such history. The Clinical characteristics section reports thrombosis during a median 3.67-year follow-up in 15 of 112 patients, but it does not establish that a considerable proportion of high-titer, LA-positive patients will never develop thrombosis. (LLM, conf=0.81)

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  • While triple positivity has been shown to be a significant thrombotic risk factor in the WAPS study, several more recent prospective cohorts have also observed a lack of association between triple positivity or other LA-related autoantibodies and thrombosis.

    “While triple positivity has been shown to be a significant thrombotic risk factor in the WAPS study [7], several more recent prospective cohorts have also observed a lack of association between triple positivity or other LA-related autoantibodies and thrombosis [30, 32, 33].”

    From Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant (2017) · cites this paper as [7]

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Research works printed but not linked: 5

  1. de Laat BH, Derksen RHWM, Urbanus RT, Roest M, de Groot PG. ␤2GPI-dependent lupus antico- agulant activity highly correlates with thrombosis in the antiphospholipid syndrome. Blood. 2004; 104:3598-3602.
  2. Oosting JD, Derksen RHWM, Bobbink IWG, Hackeng TM, Bouma BN, de Groot PG. Antiphos- pholipid antibodies directed against a combina- tion of phospholipids with prothrombin, protein C or protein S: an explanation for their pathogenic mechanisms? Blood. 1993;81:2618-2625.
  3. Brandt JT, Triplett DA, Alving B, Scharrer I. Crite- ria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost. 1995;74:1185-1190.
  4. Harris EN, Gharavi AE, Patel SP, Hughes GVR. Evaluation of the anticardiolipin antbody test: re- port of a standardization workshop, held April 4 th , 1986. Clin Exp Immunol. 1987;68:215-222.
  5. Van Heerde WL, Lap P, Schoormans S, de Groot PG, Reutelingsperger CPM, Vroom TM. Localiza- tion of annexin A5 in human tissues. Annexins. 2004;1:56-62.

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Authors
Galli, M., Borrelli, G., Jacobsen, E. M., Marfisi, R. M., Finazzi, G., Marchioli, R., Wisloff, F., Marziali, S., Morboeuf, O., & Barbui, T.
Affiliations
  • Divisione di Ematologia, Ospedali Riuniti, Bergamo, Italy;
  • Mario Negri Sud Foundation (IT)
  • Ulleval Hospital, Oslo, Norway;
  • Stago (France) (FR)
ORCID
Venue
Blood
Publisher
American Society of Hematology
Published
2007-08-15
Volume
110
Issue
4
Pages
1178-1183
ISSN
  • 0006-4971 (ISSN-L)
  • 1528-0020
DOI
10.1182/blood-2007-01-066043
OpenAlex
W2084234423
Cited by
170
References
37
Citations by year
2025: 5 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 8 · 2019: 7 · 2018: 8 · 2017: 7 · 2016: 11 · 2015: 8 · 2014: 14 · 2013: 7 · 2012: 8
FWCI
13.30
Type
journal article
Language
en
Open access
Locations
  • Blood (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
Keywords
antiphospholipid syndrome, antiphospholipid antibodies, lupus anticoagulant, anti-beta2-glycoprotein I antibodies, anticardiolipin antibodies, arterial thrombosis, venous thrombosis, miscarriage, thrombosis risk
MeSH terms
Abortion, Habitual, Adult, Aged, Aged, 80 and over, Female, Humans, Immunoglobulin G, Immunoglobulin M, Male, Middle Aged, Pregnancy, Pregnancy Complications, Hematologic, Prospective Studies, Risk Factors, Thromboembolism, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Antibodies, Anticardiolipin, beta 2-Glycoprotein I

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