Ariadna Anunciación-Llunell, Cándido Muñoz, Dirk Roggenbuck, Stefano Frasca, Josep Pardos-Gea, Enrique Esteve-Valverde, Jaume Alijotas-Reig, Francesc Miró-Mur, Institut Català de la Salut, [Anunciación-Llunell A, Miró-Mur F] Àrea de Malalties Autoimmunes Sistèmiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Muñoz C] Centre for Rheumatology Research, University College of London, London, UK. [Roggenbuck D] Faculty of Health Sciences Brandenburg, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany. GA Generic Assays GmbH, Dahlewitz, Germany. [Frasca S] GA Generic Assays GmbH, Dahlewitz, Germany. [Pardos-Gea J] Àrea de Malalties Autoimmunes Sistèmiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Àrea de Malalties Autoimmunes Sistèmiques, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Esteve-Valverde E] Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain. [Alijotas-Reig J] Àrea de Malalties Autoimmunes Sistèmiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Àrea de Malalties Autoimmunes Sistèmiques, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus
Antiphospholipid antibodies; Obstetric antiphospholipid syndrome; Thrombotic antiphospholipid syndrome Anticuerpos antifosfolípidos; Síndrome antifosfolípido obstétrico; Síndrome antifosfolípido trombótico Anticossos antifosfolípids; Síndrome antifosfolípid obstètric; Síndrome antifosfolípid trombòtic Antiphospholipid syndrome (APS) is a systemic autoimmune condition characterised by the presence of antiphospholipid antibodies (aPL) associated with vascular thrombosis and/or pregnancy complications. In a cohort of 74 yet diagnosed APS individuals fulfilling Sydney laboratory criteria (twice positive for lupus anticoagulant, anticardiolipin, aCL, and/or anti-β2glycoprotein I, aβ2GPI), 33 out of 74 were obstetric APS (OAPS) and 41 thrombotic APS (TAPS) patients. 39% of TAPS patients were women. Although aPL detection was persistent, we observed an oscillatory aPL positivity in 56.7% and a transient seroconversion in 32.4% of APS patients at enrolment. Thus, we tested their sera in a line immunoassay that simultaneously detected IgG or IgM for criteria (aCL and aβ2GPI) and non-criteria (anti-phosphatidylserine, aPS; anti-phosphatidic acid, aPA; anti-phosphatidylinositol, aPI; anti-annexin 5, aA5; anti-prothrombin, aPT; anti-phosphatidylethanolamine; anti-phosphatidylglycerol, and anti-phosphatidylcholine) aPL. OAPS and TAPS patients displayed different but overlapping clusters based on their aPL reactivities. Specifically, while OAPS patients showed higher aPA, aPS, aA5, aβ2GPI and aPT IgM levels than TAPS patients, the latter displayed higher reactivity in aCL, aPI and aA5 IgG. Eventually, with a cut-off of the 99th percentile established from a population of 79 healthy donors, TAPS patients significantly tested more positive for aCL and aA5 IgG than OAPS patients, who tested more positive for aPA, aPS and aβ2GPI IgM. Transiently seronegative APS patients showed non-criteria aPL positivity twice in sera obtained 3 months apart. Overall, our data show that APS patients presented clusters of aPL that define different profiles between OAPS and TAPS, and persistent non-criteria aPL positivity was observed in those who are transiently seronegative. This research was funded by Fundació Ona Futura (ONA-JAR-2021; Port d’Alcudia, Balearic Islands, Spain); and Gravida Fertilitat Avançada (GRA-JAR-2021; Barcelona, Spain).