Antiphospholipid Antibodies In Patients Research Articles

Serum Antiphospholipid Antibody Levels in Pseudoexfoliation

To evaluate the levels of serum antiphospholipid antibodies in patients with pseudoexfoliation syndrome (PXS), pseudoexfoliation glaucoma (PXG), primary open-angle glaucoma, and healthy controls. This prospective study included 17 patients with PXS, 19 patients with pseudoexfoliation glaucoma, 15 patients with primary open-angle glaucoma, and 19 normal individuals. Venous blood samples were obtained in the morning after an overnight 8-hour fasting. Anticardiolipin antibodies, isotypes IgG and IgM were measured by means of an enzyme-linked immunosorbent assay. Lupus anticoagulant antibodies were measured by dilute Russell viper venom time screen test. Mean±standard mean of error of anticardiolipin antibody IgG levels in patients with PXS and PEG were significantly higher than those of the controls (P<0.05). The mean lupus anticoagulant antibody levels of the controls were not statistically different from the levels of patients with PXS, pseudoexfoliation glaucoma, and primary open-angle glaucoma (P>0.05). The anticardiolipin antibody IgG concentrations above the cutoff value of 15 GPL/mL were found in 8 patients (21.05%) with pseudoexfoliation. There was no individual in the control group having anticardiolipin antibody IgG level above the cutoff value (P<0.05). Elevated serum antiphospholipid antibodies, a risk factor for cardiovascular and cerebrovascular disease, is more common in patients with PXS and pseudoexfoliation glaucoma than in the healthy controls and in patients with primary open-angle glaucoma.

Significance of antiphospholipid syndrome and antiphospholipid antibodies in patients with systemic lupus erythematosus in estimation of risk of subclinical atherosclerosis development

Atherosclerosis is an important clinical problem in patients with systemic lupus erythematosus (SLE), because of very severe cardiovascular and central nervous system manifestations. Estimation if antiphospholipid syndrome (APS) and antiphospholipid antibodies (aPL) are risk factors for subclinical atherosclerosis in patients with SLE. We examined 103 patients with SLE and 30 healthy volunteers, included as the control group. Coexistence of APS was confirmed in 35 patients. Evaluation of subclinical atherosclerosis was done on the basis of measurement of intima-media thickness (IMT) in B-mode ultrasound examination. We considered classical atherosclerotic risk factors and determined profile of aPL: anti-cardiolipine antibodies (aCL), anti beta2 glycoprotein-I antibodies, antiprothrombin antibodies (aPT), anti-oxidized low-density lipoprotein antibodies and lupus anticoagulant (LA). Statistical analysis was performed with chi2 Yates, chi2 Pearson and R rang Spearman tests. Multivariate regression analysis was also done. Thickened IMT was significantly more frequent in patients with SLE than in controls (p = 0.0002). We found that coexistence of APS is a risk factor for moderate thickening of IMT (OR: 3.41; 95% CI: 1.0-11.5). We also confirmed that the presence of aPL is significantly correlated with IMT ranging from 0.66 to 0.86 mm. The highest risk was found in patients with the presence of aPT IgA (OR: 5.50; 95% CI: 1.1-30.2), aCL IgM (OR: 4.36; 95% CI: 1.1-20.7), LA (OR: 4.02; 95% CI: 1.1-19.4) and aCL IgG (OR: 2.99; 95% CI: 1.1-9.7). Moreover, we found that ischaemic heart disease, nephropathy and myocardial infarction were significantly more frequent in patients with thickened IMT. Patients with SLE develop subclinical atherosclerosis significantly more frequent than the general population. Coexistence of APS and presence of aPL are risk factors for subclinical atherosclerosis development in patients with SLE. Thickened intima-media in patients with SLE is significantly associated with an increased risk of cardiovascular manifestations.

Antinuclear and antiphospholipid antibodies in patients with multiple sclerosis

The prevalence of autoantibodies in multiple sclerosis (MS) patients and their clinical associations differ between various studies. This study investigated antiphospholipid and antinuclear antibodies in 85 patients with multiple sclerosis (MS) and clinically isolated syndrome (CIS) with regard to their association with demographic features, MS specific clinical features and symptoms of connective tissue diseases. Autoantibodies tested included antinuclear antibodies (ANA) with their specificities and anticardiolipin (aCL) and anti-beta-2-glycoprotein I (anti-β2GPI) antibodies. Antinuclear antibodies were more prevalent in MS patients than in controls (63.5% vs. 3.3%; p < 0.01) and in 19% of patients specific antinuclear antibodies were detected. Anti-β2GPI IgM antibodies were more frequent in MS patients than in the control group (20% vs. 3.3%; p < 0.05). The frequency of anticardiolipin antibodies did not differ between MS patients and controls. MS patients seropositive for ANA and extractable nuclear antigens (ENA) had significantly shorter disease duration than seronegative patients (p < 0.05) and a lower disability score (Expanded Disability Status Score; EDSS) (p < 0.05). Anti-β2GPI antibodies were more frequent in patients with secondary progressive MS (SP-MS) and specific ANA antibodies were more frequent in patients with clinically isolated syndrome (CIS) (p < 0.05). The presence of autoantibodies was not associated with the predominant site of neurological involvement or the clinical features of connective tissue diseases.

Antiphospholipid antibodies in patients with persistent Lyme disease symptoms

Antiphospholipid antibodies in patients with persistent Lyme disease symptoms

Clinical and immunological relevance of antiphospholipid antibodies in patients with lymphoma

To explore the prevalence, clinical and prognostic significance of anticardiolipin (aCL) IgG/M/A antibodies and anti-β(2)-glycoprotein I (2-GPI) IgG/M/A antibodies in patients with lymphoma. ACL IgG/M/A antibodies and anti-β(2)-GPI IgG/M/A antibodies were determined by enzyme-linked immunosorbent assay (ELISA) in 129 lymphoma patients, 46 SLE patients, 38 rheumatoid arthritis (RA) patients, 24 primary Sjögren's syndrome (pSS) patients and 58 healthy controls. Laboratory and clinical features (thrombosis, event-free-survival time, etc.) were analyzed retrospectively from the clinical database. (1) Elevated APL level was found in 52/129 lymphoma patients (40.3%): aCL IgG/M/A antibodies in 11.6% (15/129) and anti-β(2)-GPI IgG/M/A antibodies in 32.6% (42/129) of lymphoma patients. There were significant differences between the prevalence and level of APL in lymphoma patients and healthy controls. But no difference was found between the lymphoma patients and SLE, RA or pSS patients. (2) APL was correlated with lymphoma derived from T or NK/T cells (P < 0.05). (3) No difference was found between the incidence of thrombosis in lymphoma patients with or without APL. (4) A strong negative correlation was found between the elevated APL and the event-free survival. APL is elevated in 40.3% of lymphoma patients. And it is significantly higher than that in healthy controls and similar with that in SLE, RA or pSS patients. APL is correlated with lymphoma cell origin and shortened event-free survival.

The Presence of IgM Antiphospholipid Antibodies in Patients With Henoch-Sch önlein Purpura and Recurrent Palpable Purpura

The Presence of IgM Antiphospholipid Antibodies in Patients With Henoch-Sch önlein Purpura and Recurrent Palpable Purpura

Increased Risk for Heart Valve Disease Associated With Antiphospholipid Antibodies in Patients With Systemic Lupus Erythematosus

Background— Heart valve disease (HVD) is frequent in patients with systemic lupus erythematosus (SLE), and the role of antiphospholipid antibodies (aPL) is controversial. Thus, our objective was to estimate the risk of HVD, including Libman-Sacks endocarditis, associated with aPL in patients with SLE. Methods and Results— Studies were selected if they investigated the association between aPL and HVD in SLE patients and if aPL-negative patients were included for comparison. Data sources were MEDLINE, Embase, Cochrane Library, hand search, contact with investigators, and reference lists of studies, without language restrictions. Data on study and patient characteristics, risk estimates, and study quality were independently extracted by 2 investigators. Pooled effect estimates were obtained by using the DerSimonian-Laird method. Of 234 identified abstracts, 23 primary studies (15 cross-sectional, 7 cohort, 1 case-control) met inclusion criteria, including 1656 SLE patients and 508 cases of HVD. Compared with SLE patients without aPL (n=988), the overall pooled odds ratios for HVD and Libman-Sacks endocarditis in aPL-positive patients (n=668) were 3.13 (95% confidence interval, 2.31 to 4.24) and 3.51 (95% confidence interval, 1.93 to 6.38), respectively. The risk of HVD depending on aPL subtypes was the highest for lupus anticoagulant at 5.88 (95% confidence interval, 2.92 to 11.84) and IgG anticardiolipin antibodies at 5.63 (95% confidence interval, 3.53 to 8.97). Conclusions— Overall, the presence of aPL in SLE patients is significantly associated with an increased risk for HVD including Libman-Sacks endocarditis. The risk conferred by IgG anticardiolipin antibodies is as strong as by lupus anticoagulant. Systematic echocardiographic examinations in SLE patients with aPL should be performed.

Antiphospholipid antibodies in patients with purported ‘chronic Lyme disease’

Antiphospholipid antibody (aPL) positive patients and patients with purported chronic Lyme disease ('CLD') share many clinical features. After identifying significant aPL in sera of several index patients with 'CLD', we performed aPL tests on all patients referred in whom 'CLD' was suspected, diagnosed or treated. All patients with suspected, diagnosed or treated 'CLD' and reportedly 'positive' Lyme assays were studied. aPL testing included anticardiolipin antibodies (aCL), anti-beta-2-glycoprotein-1 antibodies (anti-β2GP1) and lupus anticoagulant (LAC). Patients were classified into four newly described categories of CLD and data was analyzed. One hundred and six patients were evaluated, of whom 82% had neurologic symptoms and 51% rheumatologic symptoms. Eighty-eight of 106 (83%) patients had positive Lyme serologies (enzyme-linked immunosorbent assay [ELISA] 62/106, 58.4%; western blot [WB] 64/106, 60%), while 18/106 (16.9%) were negative or equivocal. aPL was found in all 'CLD' categories. aCL and/or anti-β2GP1 were positive in 85/106 (80%), with aCL present in 69/106 (65%) and anti-β2GP1 present in 69/106 (65%). For all assays, IgM isotypes predominated: WB 55/64 (85%), aCL 63/69 (91%), anti-β2GP1 52/69 (75%), aCL and/or anti-β2GP1 74/85 (87%). Anti-β2GP1 assays occurred in higher titer than aCL: 36/69 (52%) versus 63/69 (91%), p<0.001. Seventeen patients had aPL-related events. Only 12/106 (11.3%) had true post-Lyme syndromes (PLS), category IV, or late Lyme disease (LLD). Most patients had been treated for Lyme: 82/106 (79%). aPL occurs frequently in patients with 'CLD'. IgM anti-β2GP1, IgM aCL and IgM WB were frequently found. Documented PLS or LLD was uncommon. The role of aPL in patients with 'CLD' needs further investigation.

Antibodies to Domain I of β 2Glycoprotein I are in close relation to patients risk categories in Antiphospholipid Syndrome (APS)

Introduction Antiphospholipid Syndrome (APS) is characterized by the presence of circulating antiphospholipid antibodies in patients with thrombosis or pregnancy morbidity. Antibodies involved in these disorders are mainly those directed against β 2-Glycoprotein I (β 2GPI) with the major epitope apparently located on discontinuous antigen with several parts of Domain I (DmI) involved. The relation between anti-DmI antibodies and patients’ risk categories is unknown. Materials and Methods The synthetic full-length and correctly-folded DmI (1–64) to set up a competitive inhibition enzyme-linked immunoadsorbent assays (ELISA) was used. Plasma of 22 patients with APS and triple positivity [Lupus Anticoagulant positive (LAC+), IgG anti-cardiolipin positive (aCL+), IgG anti-β 2GPI positive (a β 2GPI +)], 15 with double positivity (IgG aCL+, IgG aβ 2GPI+), 9 with single positivity (IgG aβ 2GPI+) and 20 controls were evaluated. Results Median of percentage inhibition was 25.5% [interquartile range (IQR)17.2-33.0] in triple positive patients. Significantly lower inhibition was observed in patients with double positivity, median inhibition 5.0% (IQR 0.0-27.0) and in patients with single positivity median inhibition was 2.0% (IQR 0.5-8.0) (p < 0.0001). No inhibition was detected in control subjects or using β 2GPI peptides (40–52 and 57–70), or when antithrombin, an insignificant control protein was used. Conclusions High risk patients with APS and triple laboratory positivity as compared with double and single positivity patients have significantly higher titre of anti-DmI antibodies as evaluated by an inhibition test.

Nephropathy associated with antiphospholipid antibodies in patients with systemic lupus erythematosus

Nephropathy associated with antiphospholipid antibodies (aPL) has been proposed as a risk factor of worse renal prognosis in patients with systemic lupus erythematosus (SLE). The purpose of the current study was to evaluate the prevalence of aPL-associated nephropathy (aPLN) among patients with lupus nephritis and to describe their functional renal outcome. A total of 79 renal biopsies from 77 patients followed at the Hospital Clinic, Spain were analysed. Each renal biopsy was evaluated by a pathologist who was blinded to the aPL status. Thrombotic microangiopathy (TMA), fibrous intimal hyperplasia (FIH), fibrocellular arterial occlusion (FAO), focal cortical atrophy (FCA), and tubular thyroidization as lesions suggestive of aPLN were identified. aPLN was found in nine (11.4%) biopsies. TMA was found in three (33.3%) cases whereas chronic aPLN, represented by FIH and FCA, was found in four (44.4%) and three (33.3%) cases, respectively. A significant association between the presence of aPL and aPLN was found (p = 0.003). Patients with lupus anticoagulant (LA) plus IgG anticardiolipin antibodies (aCL) showed an increased prevalence of aPLN (OR: 3.61, 95% CI 1.28-5.14; p = 0.002). Creatinine levels were significantly increased in patients with aPLN compared with those with aPL without aPLN (p = 0.038). However, no significant difference in complete remission, partial remission, not response, and established renal damage between groups was observed at the end of follow-up. The aPL have an important role in the pathogenesis of renal lesions in SLE patients. Prospective studies are needed to address the role of aPLN in the long-term outcome of SLE patients with positive aPL.

Antiphospholipid antibodies in patients with paroxysmal nocturnal haemoglobinuria receiving eculizumab

Antiphospholipid antibodies in patients with paroxysmal nocturnal haemoglobinuria receiving eculizumab

Correlation of Livedo Racemosa, Cutaneous Inflammatory Plaques, and Antiphospholipid Antibodies in Patients With Cutaneous Polyarteritis Nodosa

We examined the prevalence of various cutaneous symptoms including livedo racemosa and inflammatory plaques, lupus anticoagulant (LA), anticardiolipin (aCL) antibodies (Abs), and anti-phosphatidylserine-prothrombin complex (anti-PS/PT) Abs in patients with cutaneous polyarteritis nodosa (PAN) to determine if any of them correlate with the clinical and/or serologic features. If such correlations exist, the clinical and serologic features of the cutaneous manifestations could aid in the early diagnosis and/or treatment of cutaneous PAN. We retrospectively investigated the clinical and serologic features, direct immunofluorescence findings, and treatment methods used in 50 patients with cutaneous PAN seen at our Department of Dermatology between 2003 and 2009. Subcutaneous nodules were observed in all 50 patients, 44 (88.0%) had livedo racemosa, 30 (60.0%) had skin ulcers, and 14 (28.0%) had inflammatory plaques. Levels of serum IgM anti-PS/PT Abs were significantly higher in patients with livedo racemosa than in patients without livedo racemosa. Serum IgG anti-PS/PT Ab levels differed significantly between patients with inflammatory plaques (12.86 ± 13.16 U/mL) and those without inflammatory plaques (6.53 ± 5.92 U/mL). Similar trends were seen with respect to IgG aCL Ab levels. In contrast, levels of IgM anti-PS/PT Abs were significantly lower in patients with inflammatory plaques compared to patients without them. Inflammatory plaques were significantly more prevalent in patients with skin ulcers. Warfarin and prednisolone were selected as the primary therapy at a significantly higher rate in patients with inflammatory plaques and skin ulcers than in patients without them. We suggest that a variety of antiphospholipid Abs could influence the cutaneous patterns of cutaneous PAN. In particular, IgG anti-PS/PT Abs and/or IgG aCL Abs could indicate the presence of inflammatory plaques as a specific cutaneous manifestation of cutaneous PAN.

Bilan biologique de thrombophilie chez le sujet très âgé

Few data are available regarding biological risk factors for venous thromboembolism in the elderly who are at high risk of thrombosis. In the present study, we assessed the prevalence of antithrombin, protein C, protein S deficiency, G1691A factor V Leiden and G20210A prothrombin (FII) gene variant, and antiphospholipid antibodies in patients over 75years who were referred to us for thrombophilia testing and who presented with unprovoked recurrent venous thromboembolic disease or venous thrombosis at unusual site. Seventy-eight patients, mean aged 86years, were included in the cohort. No deficiency in natural coagulation inhibitors was found. Ten patients (12.8%) and 6patients (7.7%) were found heterozygous carriers of the factor V Leiden and of the G20210A FII mutation, respectively. One patient was a double heterozygote. Two patients were diagnosed with antiphospholipid syndrome. These results are discussed along with those obtained in cohorts of elderly patients or in cohorts of younger patients presenting with idiopathic venous thromboembolic disease, either recurrent or not. Our results trend to confirm the recently published French recommendations regarding inherited thrombophilia screening in the elderly: in patients aged 60years or older, testing should be limited given the weak impact of this finding on the anticoagulation management.

The association of anti-parvovirus B19-VP1 unique region antibodies with antiphospholipid antibodies in patients with antiphospholipid syndrome

Human parvovirus B19 (B19) infection has been identified as a trigger of antiphospholipid syndrome (APS). However, the precise role of B19-VP1 unique region (VP1u) in patients with antiphospholipid syndrome remains unclear. IgM and IgG against B19-VP, and serum levels of antibodies directed against cardiolipin (CL), beta2-glycoprotein-I (beta2GPI) and phospholipid (PhL) were determined using ELISA in 45 APS patients. Humoral responses of anti-B19-VP1u were assessed by Western blot and B19 DNA was detected by nested PCR. Absorption experiments were performed using B19-VP1u protein to determine the binding specificity of antiphospholipid antibodies (aPL). One and 18 of 45 APS patients had detectable levels of anti-B19-VP IgM and anti-B19-VP IgG, indicating recent and past infection respectively. All serum samples from APS patients with diagnostic pattern DNA(-)/IgM(-)/IgG(+) had anti-B19-VP1u activity. APS patients with anti-B19-VP1u antibody had a 4-fold increased risk for recurrent vascular thrombosis compared with those without anti-B19-VP1u antibody. The binding inhibition of CL, beta2GPI, and PhL by absorption with B19-VP1u ranged from 31.4% to 91.1%, 0.8% to 59.8% and 20.2% to 72.1% respectively. Significantly higher inhibition to beta2GPI by B19-VP1u absorption was observed in APS patients with anti-B19-VP1u antibody than in those without anti-B19-VP1u antibody. We show a close association of B19 infection with aPL production and suggest B19-VP1u may be of pathogenetic importance in some patients with APS.

Antiphospholipid antibodies in critical illness

The antiphospholipid syndrome is defined by the presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism or pregnancy morbidity. Antithrombotic therapies are the mainstay of treatment to reduce the risk of recurrent thromboembolism. Among patients with antiphospholipid antibodies, the absolute risk of new thrombosis developing is low in healthy patients without previous thrombotic events. However, the risk of recurrent thrombosis appears to be high in patients with a history of arterial or venous thrombosis. Compared with placebo or untreated control, anticoagulation with warfarin administered to achieve an international normalized ratio of 2.0 to 3.0 probably reduces the risk of recurrence of thrombotic events. Aspirin and moderate-intensity warfarin appear equally effective for preventing recurrent stroke in patients with a single positive antiphospholipid antibody test result and previous stroke. It is unknown how best to prevent first stroke in patients found to be persistently positive for the antiphospholipid syndrome. The catastrophic variant of the antiphospholipid syndrome is a condition characterized by multiple vascular occlusive events, usually affecting small vessels and evolving over a short period of time. This condition has a very high mortality rate. First-line treatment with therapeutic anticoagulation, corticosteroids, plasma exchange, and intravenous immunoglobulin seems to be effective in reducing mortality and risk of catastrophic thrombotic events in these patients. In conclusion, moderate-intensity warfarin is effective for preventing recurrent thrombotic events in patients with venous thrombosis. Aspirin appears to be as effective as moderate-intensity warfarin for preventing recurrent stroke in patients with previous stroke and a single positive test result for antiphospholipid antibody. The optimal treatment of other clinical manifestations of antiphospholipid syndrome needs to be addressed in well-designed prospective studies.

Autoimmunity and Recurrent Pregnancy Losses

The relationship between autoimmunity and reproduction has long been recognized. This relationship is bidirectional and includes many diverse issues, but in this review article, we focus on which autoimmune disturbances are the basic cause of recurrent pregnancy losses in patients with autoimmune diseases. The antiphospholipid antibodies seem to be clearly associated with recurrent miscarriage. Although there is no agreement on the mechanisms of recurrent pregnancy losses in patients with these antibodies, vasculopathy of the terminal spiral arteries may be implicated and there is a general consensus to routinely screen for antiphospholipid antibodies in patients with recurrent miscarriage. Well-designed diagnostic studies are needed to estimate the true association between other specific autoantibodies and recurrent miscarriage.

Laboratory Evaluation of Antiphospholipid Antibodies in Patients With Venous Thromboembolism

The objective of our study was to evaluate the significance of extended antiphospholipid profile in patients with venous thromboembolism without any systemic autoimmune disease. In 140 patients (age 18-69 years; 47.1% men) with venous thromboembolism and 136 control participants we tested anticardiolipin antibodies, anti-beta 2 glycoprotein I (anti-beta2-GPI) and also non-criteria antiphospholipid antibodies: antiphosphatidic acid, antiphosphatidylethanolamine, antiphosphatidylglycerol, antiphosphatidylinositol, antiphosphatidylserine. Commercial and in-house enzyme-linked immunosorbent assays were used. The antibodies with significantly higher prevalence in patients (compared to controls) were: immunoglobulin (Ig) M-anticardiolipin antibodies (12.9%; P = 0.035), IgG-anti-beta2-GPI (16.4%; P = 0.0032), IgM-antiphosphatidylethanolamine (14.3%; P = 0.014). In most cases, these three antibodies did not overlap. In conclusion, of non-criteria antiphospholipid antibodies, only antiphosphatidylethanolamine were significantly more prevalent in patients with venous thromboembolism, with only minor overlapping with the criteria antiphospholipid antibodies. Our results suggest the possible utility of searching for antiphosphatidylethanolamine in the clinical suspicion of antiphospholipid syndrome and the absence of criteria antiphospholipid antibodies.

Circulating osteoprotegerin levels are elevated and correlated with antiphospholipid antibodies in patients with systemic lupus erythematosus

Patients with antiphospholipid syndrome (APS) have an increased risk for the development of thrombotic complications. Recent studies indicate that osteoprotegerin (OPG) acts as an important molecule in the development of vascular diseases. The aim of the present study was to examine the association between serum OPG levels and APS manifestations in patients with SLE. Seventy-nine patients with SLE and ninety-two healthy controls, matched for age and sex, were included in this study. Serum levels of OPG, monocyte chemoattractant protein(MCP)-1 and soluble E-selectin were determined by ELISA. At the time of serum sampling, various clinical and laboratory parameters were assessed. We found that serum levels of OPG were significantly higher in patients with SLE than in healthy controls (1236 +/- 82 vs 967 +/- 37 pg/mL, P = 0.003). Particularly, serum OPG levels were significantly higher in SLE patients with APS than those without (1615 +/- 191 vs 1171 +/- 91 pg/mL, P = 0.006). Serum OPG levels correlated with titres of IgG anti-cardiolipin antibody (P = 0.026) and anti-beta(2)-glycoprotein I antibody (P < 0.001). Moreover, serum OPG also correlated with serum levels of sE-selectin (P = 0.002), which is an endothelial cell activation marker, and MCP-1 (P = 0.003), a well known chemokine implicated in thrombogenesis. Collectively, serum OPG levels were increased in SLE patients with APS and correlated with titres of antiphospholipid antibodies, suggesting that OPG might be linked to the development of APS.

Carotid Intima-Media Thickness and Anti-Phospholipid Antibodies in Patients with Systemic Lupus Erythematosus

An increase in mortality due to accelerated atherosclerosis has been reported in patients affected with Systemic Lupus Erythematosus (SLE). Anti-phospholipid antibodies (aPA) may play a pathogenetic role in the development of atherosclerosis. We measured carotid intima-media thickness (IMT), as a surrogate parameter of atherosclerosis, by B-mode ultrasound examination in 42 patients affected with SLE (11 men and 31 women) and in 42 healthy age- and sex-matched subjects. Lupus Anticoagulant (LA) (APTT sensitive, silica clotting time, DRVVT), Anti-cardiolipin antibodies (ACA) IgG and IgM, anti-β2glycoprotein 1 (anti-β2GP1) IgG and IgM and anti-prothrombin (anti-PT) IgG and IgM in ELISA (Orgentec Bouty) were also detected. IMT was 0.538±0.128 mm (0.310–0.866 mm) in SLE vs 0.473±0.084 mm in healthy subjects (-p 0.003–). IMT correlated with patients’ age (p&lt;0.005) and with C Reactive Protein (CRP) (p&lt;0.005), but not with years of disease, hypertension, number of anti-hypertensive drugs, total cholesterol, serum creatinine and proteinuria. Sixteen patients (38%) had aPL: 12 LA, 6 ACA IgG, 4 ACA IgM, 4 anti-β2GP1 IgG, 3 anti-β2GP1 IgM, 2 anti-PT IgG and 1 anti-PT IgM. IMT was not statistically correlated with aPA. Positive and negative aPA patients only differed as regards glomerular filtration rate (76 ml/min vs 113 ml/min - p&lt;0.01–). Frequency of aPA positivity was 50% in Patients with IMT &gt;0.600 mm and 33.3% in those with IMT &lt;0.600 mm. If LA positivity was considered separately, it was 41.6% in patients with IMT &gt;0.600 mm and 23.3% in patients with IMT &lt;0.600 mm. Among the 5 patients with IMT &gt;0.7 mm, 2 had LA positivity (40%) vs 10/37 (27%) of those with minor carotid thickness. In conclusion, IMT, a surrogate parameter of atherosclerosis, was correlated with Patients’ age and CRP and not with presence of aPA, even though, in the group of patients with greater IMT, there was a non-significant higher proportion of positivity for anti-phospholipid antibodies, in particular for Lupus Anticoagulant.

IgA Anticardiolipin in Patients with Gastroenteric Tumor

Recently the presence of antiphospholipid antibodies in patients with cancer has been demonstrated, suggesting an involvement of autoimmune response in neoplastic conditions. The presence of antiphospholipid antibodies in tumor disease is highly correlated with the risk of developing thrombotic complications, which represents a significant cause of morbidity and mortality in cancer patients. Interestingly, it has been highlighted that high levels of IgM and IgG anticardiolipin antibodies are more often produced in patients with gastroenteric tumor than in patients with either ovarian or breast tumor. Thus far, there are no data looking into the role or measurements of IgA in patients with solid cancer. Our preliminary results, in this study, demonstrate that testing only for IgG and IgM anticardiolipin antibodies may increase the incidence of false positive because 44% who were IgA positive and IgG and IgM negative had high titres of CA19.9 and CEA. We suggest that taking into account the role of IgA could substantially improve the detection of antiphospholipids antibodies in subjects with solid cancer, and this detection may allow us for better prevention and management of thrombotic complications in these patients.