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Clinical performance of antibodies to prothrombin and thrombin in Chinese patients with antiphospholipid syndrome: potential interest in discriminating patients with thrombotic events and non-thrombotic events

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Abstract

A hallmark feature of antiphospholipid syndrome (APS) is the presence of a wide spectrum of antiphospholipid antibodies. In this study, we evaluated the clinical relevance of antibodies to prothrombin (PT) (aPT) and thrombin (aThr) in Chinese patients with APS. A total of 229 subjects were tested, including 86 patients with APS [35 patients with primary APS (PAPS), 51 patients with APS associated with other diseases (APSAOD)], 104 patients with non-APS diseases (disease controls), and 39 healthy controls. Serum IgG/IgM/IgA aPT and aThr were determined by ELISA. The levels of both IgG/IgM/IgA aPT and IgG/IgM/IgA aThr were significantly increased in patients with PAPS and APSAOD compared with patients with non-APS thrombosis and non-APS PRM, and HC. Both IgG aPT and IgG aThr exhibited promising diagnostic potentials for APS with sensitivities and specificities of 16.3 and 95.8% (IgG aPT), and 19.8 and 99.3% (IgG aThr), respectively. Importantly, both IgG aPT (OR 4.06; 95% CI 1.49–11.05) and IgG aThr (OR 4.49; 95% CI 1.62–12.45) were significantly correlated with arterial, but not venous, thrombotic events. Our findings highlighted that IgG aPT and IgG aThr could serve as promising biomarkers to identify patients at risk of arterial thrombosis in China.

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Acknowledgements

This work was supported in part by the National Natural Science Foundation of China Grant Nos. 81373188, 81172857 (to Y.L.), 81302592 (to S.Z.), the Chinese National High Technology Research and Development Program, Ministry of Science and Technology Grant No. 2011AA02A113, the National Science Technology Pillar Program in the 12th Five-year Plan No. 2014BAI07B00, the Capital Health Research and Development of Special Grant No. 2014-1-4011 (to Y.L.).

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    Authors and Affiliations

    1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuai Fu Yuan, Eastern District, Beijing, 100730, China

      Shulan Zhang, Ziyan Wu, Jing Li, Ping Li, Xiaoting Wen, Liubing Li, Wen Zhang, Jiuliang Zhao, Fengchun Zhang & Yongzhe Li

    2. Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China

      Si Chen

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    1. Shulan Zhang
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    Correspondence to Yongzhe Li.

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    Study protocols were reviewed and approved by the Ethical Committee of Peking Union Medical College Hospital (PUMCH), and informed consents were obtained from all participants.

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    Shulan Zhang, Ziyan Wu, and Jing Li contributed equally to this work.

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    Zhang, S., Wu, Z., Li, J. et al. Clinical performance of antibodies to prothrombin and thrombin in Chinese patients with antiphospholipid syndrome: potential interest in discriminating patients with thrombotic events and non-thrombotic events. Rheumatol Int 37, 579–584 (2017). https://doi.org/10.1007/s00296-016-3594-0

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