Anzeige
Anzeige
Anzeige

Complement activation in patients with isolated antiphospholipid antibodies or primary antiphospholipid syndrome

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: http://dx.doi.org/10.1160/TH11-08-0554
Issue: 2012: 107/3 (Mar) pp. 397-599
Pages: 423-429

Complement activation in patients with isolated antiphospholipid antibodies or primary antiphospholipid syndrome

K. A. Breen (1), P. Seed (2), K. Parmar (1, 2), G. W. Moore (1), S. E. Stuart-Smith (1), B. J. Hunt (1, 2)

(1) Guy’s and St.Thomas’ NHS Foundation Trust, London, UK; (2) King’s College, London, UK

Summary

The antiphospholipid syndrome (APS) is the association of thrombosis and recurrent pregnancy loss and/or pregnancy morbidity with persistent antiphospholipid antibodies (aPL). Increased complement activation has been implicated in the pathogenesis of APS in animal models. It was our objective to evaluate complement activation in patients with aPL or primary antiphospholipid syndrome (PAPS). We measured complement activation products, fragments Bb and C3a-desArg by ELISA in 186 aPL/PAPS patients and 30 healthy controls. All patients with aPL had significantly increased levels of complement activation products. Fragment Bb levels (mean, 95% CI); (thrombotic APS 0.54 units/ml, 0.31–0.83, obstetric APS 0.60 units/ml,0.39–1.02, isolated aPL 0.48 units/ml, 0.29–0.85, overall 0.39 units/ml, 0.33–0.47) and C3a-desArg levels (mean, 95% CI): (thrombotic APS 261 ng/ml, 219–311, obstetric APS 308 ng/ml, 243–391, isolated aPL 258 ng/ml, 193–337, overall 225 ng/ml, 202–251) were significantly higher compared to controls (fragment Bb 0.06 units/ml, 0.03–0.11, C3a-desArg 69 ng/ml, 50–92). There were correlations between Fragment Bb and C3a-desArg levels in all patients with aPL. Receiver operator characteristic (ROC) analysis showed increased fragment Bb and C3a-desArg levels had strong associations with the presence of persistent lupus anticoagulant (area under ROC: Bb 0.89, and C3a-desArg 0.90), dual and triple aPL positivity (Bb 0.71–0.82, C3a-desArg 0.71–0.80) but not with high titre anti-cardiolipin antibodies (Bb 0.62, C3a-desArg 0.65), or anti β2-glycoprotein 1 antibodies (Bb 0.66, C3a-desArg 0.67). Complement activation is present in all patient groups within this large cohort of patients aPL. This suggests it may have a major role in the pathogenesis of APS and merits further study.

Keywords

antiphospholipid syndrome, Antiphospholipid antibodies, complement activation

DOI

http://dx.doi.org/10.1160/TH11-08-0554

You may also be interested in...

1.

F. Bergmann, M. Hempel

Hämostaseologie 2008 28 3: 141-149

2.

Marielle Sanmarco1, Stéphane Gayet1, Marie-Christine Alessi2, Marie Audrain3, Emmanuel de Maistre4, Jean-Christophe Gris5, Philip G. de Groot6, Eric Hachulla7, Jean-Robert Harlé1, Pierre Sié8, Marie-Claire Boffa9

Thromb Haemost 2007 97 6: 949-954

http://dx.doi.org/10.1160/TH06-10-0604

3.
A systematic review

Online Supplementary Material

S. Sciascia (1, 2), G. Sanna (3), V. Murru (1), D. Roccatello (2), M. A. Khamashta (1, 3), M. L. Bertolaccini (1)

Thromb Haemost 2014 111 2: 354-364

http://dx.doi.org/10.1160/TH13-06-0509



Thrombosis News

Mobile technology identifies people with unknown atrial fibrillation at high risk of stroke – article published in Thrombosis and Haemostasis

The article “Feasibility and cost effectiveness of stroke prevention through community screening...

TH 111.4

The April 2014 TH 111.4 issue of Thrombosis and Haemostasis is a Theme Issue by Guest Editor B....

TH 111.3

Women with atrial fibrillation have a much higher risk for thromboembolic stroke than men suffering...