학술논문
Deciphering the clinical significance of longitudinal antiphospholipid antibody titers.
Document Type
Academic Journal
Author
Chighizola CB; Department of Clinical Sciences and Community Health, University of Milan, Pediatric Rheumatology Unit, ASST G. Pini - CTO, Milan, Italy. Electronic address: cecilia.chighizola@unimi.it.; Willis R; University of Texas Medical Branch, Internal Medicine, Galveston, USA.; Maioli G; Department of Clinical Sciences and Community Health, University of Milan, Clinical Rheumatology Unit, ASST G. Pini - CTO, Milan, Italy.; Sciascia S; University of Turin, Department of Clinical and Biological Sciences, Turin, Italy.; Andreoli L; Rheumatology and Clinical Immunology Unit - ERN ReCONNET, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.; Amengual O; Hokkaido University, Department of Rheumatology, Endocrinology and Nephrology Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan.; Radin M; University of Turin, Department of Clinical and Biological Sciences, Turin, Italy.; Gerosa M; Department of Clinical Sciences and Community Health, University of Milan, Clinical Rheumatology Unit, ASST G. Pini - CTO, Milan, Italy.; Atsumi T; Hokkaido University, Department of Rheumatology, Endocrinology and Nephrology Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan.; de Jesus G; Universidade do Estado do Rio de Janeiro, Department of Obstetrics, Rio de Janeiro, Brazil.; Trespidi L; Department of Obstetrics and Gynaecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.; Branch DW; Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, UT, USA.; Caporali R; Department of Clinical Sciences and Community Health, University of Milan, Pediatric Rheumatology Unit, ASST G. Pini - CTO, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Clinical Rheumatology Unit, ASST G. Pini - CTO, Milan, Italy.; Andrade D; University of Sao Paulo, Reumatologia, Sao Paulo, Brazil.; Roubey R; Department of Rheumatology, University of North Carolina, Chapel Hill, NC, USA.; Petri M; Johns Hopkins University School of Medicine, Rheumatology, Baltimore, MD, USA.; Bertolaccini ML; Academic Department of Surgery, SCMMS, King's College London, London, United Kingdom.
Source
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101128967 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-0183 (Electronic) Linking ISSN: 15689972 NLM ISO Abbreviation: Autoimmun Rev Subsets: MEDLINE
Subject
Language
English
Abstract
In antiphospholipid syndrome (APS), the risk of clinical manifestations increases with higher titers of antiphospholipid antibodies (aPL). Despite the adoption of aPL titers in the classification approach to aPL-positive subjects, the value of longitudinal monitoring of those titers in the follow-up is still debated, being well studied only in systemic lupus erythematosus (SLE). The literature suggests that the rate of aPL positivity decreases during follow-up in primary APS, estimating that seroconversion occurs in between 8.9 and 59% of patients over time. Negativisation of aPL occurs more frequently in asymptomatic aPL carriers than in patients with full-blown APS as well as in subjects with single aPL positivity or low aPL antibody titers. In patients with SLE, aPL typically behave fluctuating from positive to negative and back again in the course of follow-up. The few studies assessing the longitudinal course of aPL positivity with no associated systemic connective tissue disease reported a progressive decrement of aPL titers over time, in particular of antibodies against β2 glycoprotein I (antiβ2GPI) and cardiolipin (aCL) of IgG isotype. After a thrombotic event, aPL titers tend to decrease, as emerged from cohorts of both primary and secondary APS. Hydroxychloroquine has been identified as the most effective pharmacological agent to reduce aPL titers, with multiple studies demonstrating a parallel reduction in thrombosis rate. This review addresses available evidence on the significance of aPL titer fluctuation from clinical, therapeutic and pathogenic perspectives.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)