Autoantibodies to domain 1 of beta 2 glycoprotein I determined using a novel chemiluminescence immunoassay demonstrate association with thrombosis in patients with antiphospholipid syndrome

Abstract

Introduction

Antibodies to the domain 1 of beta 2 glycoprotein I (β₂GPI–D1) have been suggested as a risk marker for thrombosis in patients with the antiphospholipid syndrome (APS). This cross-sectional study aimed to analyze the clinical utility of a novel chemiluminescence assay for the detection of anti-β₂GPI–D1 antibodies.

Patients and methods

Sera collected from patients with primary or secondary APS (n = 106; 72 with and 34 without history of thrombosis) and controls (n = 272) were tested for anti-β₂GPI–D1 IgG by chemiluminescence assay (QUANTA Flash) and by two anti-β₂GPI IgG assays (QUANTA Lite and QUANTA Flash β₂GPI IgG).

Results

Anti-β₂GPI–D1 IgG titers were significantly higher in patients with thrombosis (P = 0.0032) than those without. At the cut-off of 20 units, which yielded a 99.5% specificity, 24 of 72 (34.9%) patients with thrombosis and four of 34 (11.8%) without thrombosis were anti-β₂GPI–D1 IgG positive (odds ratio, OR = 4.0). By further optimizing the cut-off specifically for correlation with thrombosis, 20.8% of the patients with thrombosis and 2.9% of the patients without thrombosis were positive (OR = 8.7). The ORs were significantly lower for antibodies to the full-length β₂GPI by either the chemiluminescence assay or ELISA. Using the anti-β₂GPI chemiluminescence assay, the OR was 2.3 (recommended cut-off of 20 CU) or 4.1 (optimal cut-off 164.6 CU). Using the anti-β₂GPI ELISA, the OR was 2.7 (recommended cut-off of 20 units) or 3.7 (optimal cut-off 7.6 units).

Conclusion

These data indicate that anti-β₂GPI–D1 IgG are present more frequently and in higher titers in APS patients with thrombotic complications than in those without.The novel β₂GPI–D1 chemiluminescence assay appears to be superior to full-length β₂GPI assays for the risk assessment of thrombotic events in APS patients.

Keywords

Autoantibodies beta 2 glycoprotein I Domain 1 antiphospholipid syndrome thrombosis

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