Practical approaches to laboratory assessment of risk of reсcurent thrombosis in antiphospholipid syndrome

Abstract

Antiphospholipid antibodies (aPLs) are a heterogenous group of auto‑ antibodies that interact with phospholipids (PL), phospholipid‑protein complexes and phospholipid‑binding proteins. aPLs are pathogenic and associated with the development of thrombosis and pregnancy pathology. The detection of aPLs as a diagnostic indicator is included in the criteria for antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) SLISS 2012. Also, aPLs is found in patients with other autoimmune, infectious diseases and cancer, in 10–12 % of elderly and 1–5 % healthy young people, but do not lead to the development of thrombosis and/or miscarriage. Simultaneous detection of aPLs with different tests indicate bad prognosis and a higher risk of clinical manifestation of APS. Triple positivity for classical markers of disease is found in patients with oncoming thrombosis. Another concept is the Global APS Score (GAPSS) that also takes into account the aPL profile as well as conventional cardiovascular risk factor and also some autoantibodies found in systemic disease. Currently, enzyme‑linked immunosorbent analysis (ELISA) are most widely used test for detection of aPLs. The advantage of new methods for detecting aPLs is to improve the parameters of sorption of antigens, automation, multiplex approach. Thus, new techniques can serve as a tool for the detection of aPLs and contribute to improving the quality of diagnosis of autoimmune diseases.