Abstract
PurposeTo explore the role of plasmatic platelet-activating factor acetylhydrolase (PAF-AH), a marker of cardiovascular risk, in patients with anti-phospholipid antibodies (aPL).MethodsPAF-AH activity was assessed in a series of 167 unselected patients screened for aPL in a context of thrombotic events, risk of thrombosis or obstetric complications and in 77 blood donors.Results116/167 patients showed positive results for at least one aPL among IgG/IgM anti-prothrombin/phosphatidylserine (aPS/PT), anti-cardiolipin (aCL), anti-beta2-glycoprotein I (aβ2GPI) or lupus anticoagulant (LAC), while 51/167 patients resulted aPL-negative. LAC+ patients disclosed higher PAF-AH than LAC-negative (22.1 ± 6.4 nmol/min/ml vs. 19.5 ± 4.1 nmol/min/ml; p = 0.0032), and aPL-negative patients (p = 0.03). Patients presenting positive IgG aβ2GPI disclosed higher PAF-AH than patients with only IgM aβ2GPI-positive antibodies (23.1 ± 7.2 nmol/min/ml vs. 20.1 ± 5.3 nmol/min/ml; p = 0.035), as well as than patients showing only isolated LAC, aCL or aPS/PT (16.9 ± 3.8 nmol/min/ml; p = 0.003).ConclusionsPAF-AH plasmatic activity is particularly up-regulated in LAC+ and in aβ2GPI IgG+ patients, possibly representing an alternative prognostic biomarker for the therapeutic management of APS patients.
Highlights
Anti-phospholipid syndrome (APS) is a hypercoagulable disorder clinically displayed by venous or arterial thrombosis and/or adverse obstetric events, accompanied by persistent and elevated levels of anti-phospholipid antibodies [1]
Purpose To explore the role of plasmatic platelet-activating factor acetylhydrolase (PAF-AH), a marker of cardiovascular risk, in patients with anti-phospholipid antibodies
PAF-AH plasmatic activity is upregulated in lupus anticoagulant (LAC)? and in anti-beta2 glycoprotein I (ab2GPI) IgG? patients, possibly representing an alternative prognostic biomarker for the therapeutic management of APS patients
Summary
Anti-phospholipid syndrome (APS) is a hypercoagulable disorder clinically displayed by venous or arterial thrombosis and/or adverse obstetric events, accompanied by persistent and elevated levels of anti-phospholipid antibodies (aPL) [1]. According to the 2006 revised international classification criteria [2], patients with definite diagnosis of APS are those presenting positive lupus anticoagulant (LAC) and/or one among anti-cardiolipin (aCL) IgG or IgM or anti-beta glycoprotein I (ab2GPI) IgG or IgM antibodies. During the last international congress on aPL antibodies, the major experts defined the role of other so-called ‘‘non criteria’’ antibodies, contributing to assess the risk of thrombosis or the identification of potential seronegative APS, such as the antiprothrombin/phosphatidylserine antibodies (aPS/PT) [3]. No definite recommendations are available to guide the therapeutic approach in patients positive only for aPS/PT antibodies
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