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Laboratory evaluation of antiphospholipid antibodies in patients with venous thromboembolism

J Hirmerova1, Z Ulcova-Gallova, J Seidlerova

  • 12nd Department of Internal Medicine, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic. hirmerova@fnplzen.cz

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|February 18, 2009
PubMed

Insights

This study found that IgM-antiphosphatidylethanolamine antibodies were more prevalent in patients with venous thromboembolism. This suggests their potential role in diagnosing antiphospholipid syndrome when other criteria antibodies are absent.

Area of Science:

  • Immunology
  • Hematology
  • Rheumatology

Background:

  • Antiphospholipid syndrome (APS) is characterized by recurrent thrombosis and specific antiphospholipid antibodies.
  • Current diagnostic criteria focus on anticardiolipin and anti-beta 2 glycoprotein I antibodies.
  • The role of non-criteria antiphospholipid antibodies in venous thromboembolism (VTE) without systemic autoimmune disease requires further investigation.

Purpose of the Study:

  • To evaluate the significance of an extended antiphospholipid antibody profile in patients with VTE but no systemic autoimmune disease.
  • To identify non-criteria antiphospholipid antibodies that are significantly more prevalent in VTE patients.
  • To assess the overlap between criteria and non-criteria antiphospholipid antibodies in this cohort.

Main Methods:

  • Enzyme-linked immunosorbent assays (ELISA), both commercial and in-house, were employed.
  • The study included 140 patients with VTE and 136 control participants.
  • A comprehensive panel of antibodies was tested, including anticardiolipin, anti-beta 2 glycoprotein I (anti-beta2-GPI), and non-criteria antibodies such as antiphosphatidic acid, antiphosphatidylethanolamine, antiphosphatidylglycerol, antiphosphatidylinositol, and antiphosphatidylserine.

Main Results:

  • Immunoglobulin (Ig) M-anticardiolipin antibodies (12.9%), IgG-anti-beta2-GPI (16.4%), and IgM-antiphosphatidylethanolamine (14.3%) showed significantly higher prevalence in VTE patients compared to controls.
  • Of the non-criteria antibodies tested, only IgM-antiphosphatidylethanolamine demonstrated a statistically significant higher prevalence in the VTE group (P = 0.014).
  • These three significantly prevalent antibodies exhibited minimal overlap in their presence among the patients.

Conclusions:

  • Antiphosphatidylethanolamine antibodies are significantly more prevalent in patients with VTE, even in the absence of criteria antiphospholipid antibodies.
  • These findings suggest that antiphosphatidylethanolamine antibodies may hold clinical utility in suspecting antiphospholipid syndrome.
  • The study highlights the potential diagnostic value of investigating non-criteria antiphospholipid antibodies, particularly antiphosphatidylethanolamine, in specific clinical scenarios.

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