ANTIPHOSPHOLIPID, ANTI-BETA-2-GLYCOPROTEIN-I AND ANTI-OXIDIZED-LOW-DENSITY-LIPOPROTEIN ANTIBODIES IN ANTIPHOSPHOLIPID SYNDROME

Antiphospholipid antibodies (aPL), anti-beta 2-glycoprotein I (anti-be ta 2-GPI) and anti-oxidized-low-density lipoprotein (LDL) antibodies a ve all implicated in the pathogenesis of antiphospholipid syndrome. To investigate whether different autoantibodies or combinations thereof produced distinct effects related to their antigenic specificities, we examined the frequencies of antiphospholipid syndrome (APS)-related f eatures in the presence of different antibodies [aPL, beta 2-GPI, anti -oxidized low density lipoprotein (LDL)] in 125 patients with APS. Med ian follow-up was 72 months: 58 patients were diagnosed as primary APS and 67 as APS pins systemic lupus erythematosus (SLE). Anticardiolipi n antibodies (aCL), anti-beta 2-GPI and anti-oxidized LDL antibodies w ere determined by ELISA; lupus anticoagulant (LA) by standard coagulom etric methods. Univariate analysis showed that patients positive for a nti-beta 2-GPI had a higher risk of recurrent thrombotic events (OR = 3.64, 95%CI, p = 0.01) and pregnancy loss (OR = 2.99, 95%CI, p = 0.004 ). Patients positive for anti-oxidized LDL antibodies had a 2.24-fold increase in the risk of arterial thrombosis (2.24, 95%CI, p = 0.03) an d lower risk of thrombocytopenia (OR = 0.41 95%CI, p = 0.04). Patients positive for aCL antibodies had a higher risk of pregnancy loss (OR = 4.62 95%CI, p = 0.001). When these data were tested by multivariate l ogistic regression, the association between anti-beta 2-GPI and pregna ncy loss and the negative association between anti-oxidized LDL antibo dies and thrombocytopenia disappeared.