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Cabrera-Marante O, Garcinuño S, Pleguezuelo DE, Gil-Etayo FJ, Tenica I, Rodríguez de Frías E, Zafra D, Castro N, Paz-Artal E, Serrano A, Serrano M. Quantification of Antiphospholipid Antibodies: The Importance of Using an Appropriate Methodology for Each Clinical Profile. Int J Mol Sci 2023; 24:17373. [PMID: 38139202 PMCID: PMC10743765 DOI: 10.3390/ijms242417373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
The presence of antiphospholipid antibodies (aPLs) is associated with antiphospholipid syndrome (APS), characterized by thrombosis and obstetric morbidity. aPLs included in APS classification criteria are lupus anticoagulant, anti-cardiolipin and anti-beta-2-glycoprotein-I of IgG or IgM isotypes. Enzyme-linked immunosorbent assay is the most used diagnostic technique to determine aPLs. Recently, new automated technologies mainly based in antigen-coated beads have been developed. The aim is to compare a fluorescence enzyme immunoassay (M1) and an antigen-coated bead assay (M2) in obstetric and thrombotic APS patients. All samples from the first 1020 patients received in the Immune Service Laboratory (Hospital 12 de Octubre) during the recruitment period, without exclusions, were analysed for aPLs. The weighted kappa for both methods in all the patients was 0.39 (0.30-0.47). Agreement increased to 0.56 (0.38-0.73) in patients with autoimmune disease. Sensitivity and specificity obtained for M1 were 17.1% and 89.3%, respectively, and 12.7% and 91.4% for M2. The sensibility and specificity of IgG isotypes were higher than the IgM ones. Regarding obstetric patients, M1 obtained significant diagnostic performance and had more sensitivity 23.75 (14.95-34.58) compared to M2 12.50 (6.16-21.79). In conclusion, clinical suspicion-based method selection for aPLs should be considered. To identify obstetric APS patients, solid phase methods remain more preferable.
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Affiliation(s)
- Oscar Cabrera-Marante
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (O.C.-M.); (D.E.P.); (F.J.G.-E.); (E.R.d.F.); (E.P.-A.); (M.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Sara Garcinuño
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Daniel Enrique Pleguezuelo
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (O.C.-M.); (D.E.P.); (F.J.G.-E.); (E.R.d.F.); (E.P.-A.); (M.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Francisco J. Gil-Etayo
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (O.C.-M.); (D.E.P.); (F.J.G.-E.); (E.R.d.F.); (E.P.-A.); (M.S.)
- Department of Haematology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
| | - Iulian Tenica
- Department of Occupational Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
| | - Edgard Rodríguez de Frías
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (O.C.-M.); (D.E.P.); (F.J.G.-E.); (E.R.d.F.); (E.P.-A.); (M.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Denis Zafra
- Department of Haematology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (D.Z.); (N.C.)
| | - Nerea Castro
- Department of Haematology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (D.Z.); (N.C.)
| | - Estela Paz-Artal
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (O.C.-M.); (D.E.P.); (F.J.G.-E.); (E.R.d.F.); (E.P.-A.); (M.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Antonio Serrano
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (O.C.-M.); (D.E.P.); (F.J.G.-E.); (E.R.d.F.); (E.P.-A.); (M.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
- Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Manuel Serrano
- Department of Immunology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (O.C.-M.); (D.E.P.); (F.J.G.-E.); (E.R.d.F.); (E.P.-A.); (M.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
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