Abstract
Antiphosphatidylethanolamine antibodies (aPE) represent one type of antiphospholipid antibody (aPL) directed against the neutral phospholipids - phosphatidylethanolamines. The aim of this study was to evaluate levels and avidities of aPE in several groups of patients and compare them with conventional aPLs. aPE were analysed in a cohort consisting of 68 hospitalized patients. The other cohort comprised 22 patients with immunologically-mediated diseases. The control group consisted of 20 healthy persons. ELISA methods were used for determination of aPL. Avidities of aPE were tested by modified ELISA with urea as a chaotropic agent. aPE IgG/IgM were significantly higher in the group of patients with venous thromboembolism than those with non-thrombotic internal disorders (P=0.02 for both Ig classes). aPE IgG/IgM elevated above cut-off values were found in 10.8% of patients with venous thromboembolism and as a single aPL in 6.5%. Levels of aPE IgG higher than our limit (>6 U/mL) were detected in 29% of patients with immunologically-mediated diseases with other positive aPL. Low-, intermediate- and high-avidity aPE IgG were found in patients of both cohorts. The avidities of aPE IgG differed from those of anticardiolipin antibodies IgG. Neither aPE IgG levels nor avidity dynamics significantly changed during follow-up. aPE may be related to venous thromboembolism and may be part of the repertoire of aPL in immunologically-mediated diseases. There are patients with thrombosis negative for conventional aPL but positive for aPE. aPE IgG may have different avidities.
Highlights
Antiphospholipid antibodies include a heterogeneous group of antibodies directed especially against negatively charged phospholipids alone and/or their complexes with various plasma proteins1,2. aPL contribute to various types of thrombotic and obstetric complications such as pregnancy loss, pre-eclampsia or placental insufficiency and are placed in context with valvular disease and some hematological disorders[1]
Levels of various types of antiphospholipid antibodies also include those reacting with phosphatidylethanolamine (aPE) IgG/IgM and against the phosphatidylserine-prothrombin complex (aPS/PT) IgG/IgM were analysed by ELISA kits
Levels of tested aPL in patients with thromboembolism The comparison of non-criteria aPL antibodies showed significant differences for aPE IgG and IgM between groups of patients with venous thromboembolism and those with non-thrombotic internal diseases (Fig. 1A−F). These antibodies were significantly higher in patients with venous thromboembolism
Summary
Antiphospholipid antibodies (aPL) include a heterogeneous group of antibodies directed especially against negatively charged phospholipids alone and/or their complexes with various plasma proteins1,2. aPL contribute to various types of thrombotic and obstetric complications such as pregnancy loss, pre-eclampsia or placental insufficiency and are placed in context with valvular disease and some hematological disorders[1]. Antiphospholipid antibodies (aPL) include a heterogeneous group of antibodies directed especially against negatively charged phospholipids alone and/or their complexes with various plasma proteins. Testing is recommended for all of these antibodies, as patients with triple aPL-positivity are at a higher risk of thrombosis or pregnancy complications than double or single-positive cases[5,6]. Patients with clinical symptoms of APS but without an increase in any of recommended aPLs were identified. This group of patients was classified as seronegative APS (SN-APS) (ref.). Recent studies suggest that the addition of aPS/PT to the recommended aPL could improve the estimation of thrombotic risk[9,10]. Non-criteria aPL tested in patients with APS include those reacting with phosphatidylethanolamine (aPE) (ref.[11])
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