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Moyamoya Angiopathy and Antiphospholipid Antibodies: A Coincidental Association?
Lina Grosset1, Alain Stepanian2, Marc-Antoine Labeyrie3
1APHP-Hôpital Lariboisière-CERVCO, INSERM-U1141, FHU-NeuroVasc-Université Paris-Cité, France (L.G., H.C., D.H.).
Background:
The presence of antiphospholipid antibodies (aPL) has been suggested as a potential cause of moyamoya angiopathy (MMA), but this remains uncertain. In this case-control study, we aimed to compare the prevalence of circulating aPL in patients with MMA and in non-MMA cerebrovascular controls.
Methods:
For comparison, we included 95 patients with MMA from the French National Referral Centre for this condition and 182 age- and sex-matched non-MMA controls with a different cerebrovascular disease, all younger than 55 years. Anticardiolipin antibodies, anti-β2-glycoprotein I antibodies, and lupus anticoagulant were assessed using the guidelines of the International Society on Thrombosis and Haemostasis.
Results:
aPL prevalence was 22% in patients with MMA and 25% in controls (P=0.74) with no differences in aPL subtypes between the 2 groups. The prevalence of transient ischemic attacks, ischemic stroke, and hemorrhagic stroke did not differ between patients with aPL-positive and aPL-negative MMA.
Conclusions:
The prevalence of aPL in patients with MMA is comparable to that in non-MMA controls. The present results do not support any causal relationship between aPL and MMA.
Insights
Antiphospholipid antibodies (aPL) prevalence is similar in moyamoya angiopathy (MMA) patients and controls. This study found no evidence to support a causal link between aPL and MMA, suggesting other factors are involved.
Area of Science:
- Neurology
- Immunology
- Vascular Medicine
Background:
- Moyamoya angiopathy (MMA) is a rare cerebrovascular disorder.
- Antiphospholipid antibodies (aPL) have been hypothesized as a potential cause of MMA.
- The association between aPL and MMA requires further investigation.
Purpose of the Study:
- To compare the prevalence of circulating antiphospholipid antibodies (aPL) in patients with moyamoya angiopathy (MMA).
- To compare aPL prevalence in MMA patients versus non-MMA cerebrovascular controls.
- To investigate the potential causal relationship between aPL and MMA.
Main Methods:
- A case-control study was conducted.
- Included 95 MMA patients and 182 age- and sex-matched non-MMA cerebrovascular controls.
- Assessed anticardiolipin antibodies, anti-β2-glycoprotein I antibodies, and lupus anticoagulant.
Main Results:
- aPL prevalence was 22% in MMA patients and 25% in controls (P=0.74).
- No significant differences in aPL subtypes were observed between groups.
- No differences in stroke types (ischemic, hemorrhagic) were found between aPL-positive and aPL-negative MMA patients.
Conclusions:
- The prevalence of aPL in MMA patients is comparable to that in non-MMA controls.
- Current findings do not support a causal relationship between antiphospholipid antibodies and moyamoya angiopathy.
- Further research may explore other etiological factors for MMA.
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