Association of autoantibodies against the phosphatidylserine-prothrombin complex with manifestations of the antiphospholipid syndrome and with the presence of lupus anticoagulant

Objective. To clarify the association of autoantibodies against prothrombin with the clinical manifestations of the antiphospholipid syndrome (APS) an d with the presence of lupus anticoagulant (LAC). Methods. We examined 265 patients who visited our autoimmune disease clinic . IgG and IgM antiprothrombin antibodies were tested by enzyme-linked immun osorbent assay (ELISA) as either antiphosphatidylserine-prothrombin complex (aPS/PT) antibodies or as antibodies against prothrombin coated on irradia ted ELISA plates (as antigen) (aPT). IgG, IgM, and IgA anticardiolipin (aCL ) antibodies and their beta(2)-glycoprotein I (beta(2)GPI) dependency were also evaluated by ELISA. LAC was tested by 3 different methods. Results. The presence of aPS/PT, but not of aPT, significantly correlated w ith the clinical manifestations of APS (odds ratio [OR] 4.39, 95% confidenc e interval [95% CI] 2.06-9.38), and aPS/PT antibodies were as specific as b eta(2)GPI-dependent aCL for APS (93.1% for both). IgG aPS/PT strongly corre lated with the presence of LAC as detected using the dilute Russell viper v enom time test (OR 38.2, 95% CI 13.4-109.1). Conclusion. Antiprothrombin antibodies are heterogeneous and their clinical relevance depends on the method of detection applied. Positive results on the aPS/PT test can serve as a marker of thrombotic events in patients with autoimmune diseases.