Performance Evaluation and Clinical Associations of Immunoassays That Detect Antibodies to Negatively Charged Phospholipids Other Than Cardiolipin

Am J Clin Pathol. 2018 Mar 29;149(5):401-411. doi: 10.1093/ajcp/aqy003.

Abstract

Objectives: We evaluate the performance characteristics of antiphosphatidylserine (anti-PS), antiphosphatidylinositol (anti-PI), and antiphospholipid mixture (APhL) enzyme-linked immunosorbent assays (ELISAs) compared with anticardiolipin (aCL) and anti-β2 glycoprotein I (anti-β2GPI) in a large group of patients with antiphospholipid (aPL)-related diseases.

Methods: Serum samples from 548 patients from the Hopkins and Jamaican systemic lupus erythematosus cohorts, the PROMISSE cohort, and the Antiphospholipid Standardization Laboratory were examined for immunoglobulin G (IgG)/immunoglobulin M (IgM) positivity in aCL, anti-β2GPI, anti-PS, anti-PI, and APhL ELISA assays.

Results: All IgG assays were associated with one or more thrombotic and/or obstetric manifestations, with an increased risk associated with higher antibody titers. Analytical performance was similar among assays, but IgG assays performed better than IgM counterparts.

Conclusions: Increasing titers of APhL, anti-PS, and anti-PI antibodies could indicate an increased risk of thrombotic and/or obstetric aPL-related manifestations. These assays may be promising biomarkers for particular APS manifestations.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Antibodies, Antiphospholipid / immunology*
  • Biomarkers / blood
  • Cardiolipins / immunology
  • Cohort Studies
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Female
  • Humans
  • Immunoglobulin G / blood*
  • Immunoglobulin M / blood
  • Lupus Erythematosus, Systemic / immunology*
  • Male
  • Middle Aged
  • Phospholipids / immunology*
  • Thrombosis / immunology*
  • beta 2-Glycoprotein I / immunology

Substances

  • Antibodies, Antiphospholipid
  • Biomarkers
  • Cardiolipins
  • Immunoglobulin G
  • Immunoglobulin M
  • Phospholipids
  • beta 2-Glycoprotein I