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Factor XIII in primary antiphospholipid syndrome.
Paul R J Ames1, Luigi Iannaccone, Jose Delgado Alves
1Academic Department of Rheumatology, Leeds General Infirmary, Leeds, UK. paxmes@aol.com
The Journal of Rheumatology
|June 9, 2005
Summary
Elevated factor XIII (FXIII) activity is linked to atherothrombosis in primary antiphospholipid syndrome (APS). This FXIII activation, potentially driven by antiphospholipid antibodies, contributes to clotting risks in APS patients.
Area of Science:
- Hematology
- Immunology
- Cardiovascular Medicine
Background:
- Primary antiphospholipid syndrome (APS) is an autoimmune disorder associated with an increased risk of thrombosis.
- Factor XIII (FXIII) plays a crucial role in fibrin clot stabilization.
- The specific contribution of FXIII to the pathophysiology of APS remains to be fully elucidated.
Purpose of the Study:
- To investigate the clinical significance and activity levels of factor XIII (FXIII) in patients with primary APS.
- To explore the correlation between FXIII activity and key clinical parameters, including antiphospholipid antibodies (aPL) and intima-media thickness (IMT).
Main Methods:
- A cross-sectional study involving patients with primary APS, carriers of aPL, thrombotic controls, and healthy individuals.
- Measurement of FXIII activity, fibrinogen, antiphospholipid antibodies (IgG aCL, IgG anti-beta2-GPI), PAI, and paraoxonase activity.
- Assessment of carotid artery intima-media thickness (IMT) using high-resolution sonography.
Main Results:
- FXIII activity was significantly higher in primary APS patients compared to controls, particularly those with multiple thrombotic events.
- FXIII activity positively correlated with PAI and fibrinogen levels in both primary APS and thrombotic control groups.
- In primary APS, FXIII activity showed strong associations with IgG aCL and IgG anti-beta2-GPI, and correlated with IMT of carotid arteries.
Conclusions:
- Enhanced FXIII activity may promote atherothrombosis in primary APS through increased fibrin cross-linking.
- While FXIII activation is also observed in other thrombotic conditions, IgG aPL may potentiate FXIII activation in primary APS.
- These findings highlight a potential therapeutic target for managing thrombotic risk in APS.