Detection of IgG anti-Domain I beta2 Glycoprotein I antibodies by chemiluminescence immunoassay in primary antiphospholipid syndrome

Clin Chim Acta. 2015 Jun 15:446:201-5. doi: 10.1016/j.cca.2015.04.033. Epub 2015 Apr 30.

Abstract

Background: IgG anti-Domain I (anti-DI) β2 Glycoprotein I (β2GPI) antibodies are associated to thrombotic risk in antiphospholipid syndrome (APS), but their detection is technically difficult. In this study, a chemiluminescent immunoassay (CLIA) was used to evaluate the clinical significance of IgG anti-DI in a large cohort of patients with primary APS (PAPS).

Methods: The study population included 88 patients with PAPS, 63 ELISA-negative subjects and 166 controls. IgG anti-DI, IgG anticardiolipin (aCL) and IgG anti-β2GPI antibodies were assayed using CLIA (HemosIL AcuStar®).

Results: The sensitivity and specificity of IgG anti-DI antibodies were comparable to those of IgG aCL and IgG anti-β2GPI antibodies. There was a significant agreement, association and titre correlation between IgG anti-DI and IgG aCL as well as IgG anti-β2GPI antibodies (p<0.001 for all). IgG anti-DI antibody showed lesser prevalence and mean titres in the pregnancy morbidity than in thrombotic and PAPS patients with both involvements (p<0.001). Regarding the conventional aPL antibody profiles, the triple positivity group had higher prevalence and mean titres than single and double positivity ones (p<0.001).

Conclusions: This study provides further evidence that anti-DI antibodies can be considered a promising biomarker for risk assessment particularly in patients having vascular thrombosis and triple conventional aPL positivity.

Keywords: Anti-Domain I antibodies; Anti-β2 Glycoprotein I antibodies; Anticardiolipin antibodies; Antiphospholipid syndrome; Chemiluminescence immunoassay.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Anticardiolipin / blood*
  • Antiphospholipid Syndrome / blood
  • Antiphospholipid Syndrome / diagnosis*
  • Antiphospholipid Syndrome / immunology
  • Antiphospholipid Syndrome / pathology
  • Case-Control Studies
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoassay / methods*
  • Immunoglobulin G / blood*
  • Luminescent Measurements
  • Male
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / immunology
  • Pregnancy Complications / pathology
  • Protein Structure, Tertiary
  • Sensitivity and Specificity
  • Thrombosis / blood
  • Thrombosis / diagnosis*
  • Thrombosis / immunology
  • Thrombosis / pathology
  • beta 2-Glycoprotein I / antagonists & inhibitors
  • beta 2-Glycoprotein I / blood
  • beta 2-Glycoprotein I / immunology

Substances

  • Antibodies, Anticardiolipin
  • Immunoglobulin G
  • beta 2-Glycoprotein I