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Dr. Adrian Man
Risk of recurrent thrombosis related to antiphospholipid antibodies, soluble CD40L and P selectin serum levels in patients with antiphospholipid syndrome secondary to systemic lupus eritematosus C Gavriş, M Anghel, M Rădoi, E Gheorghiţă, L Duca, G Pamfil, E Bobescu, G I Pandele
Abstract: Antiphospholipid antibodies (aPL) are often associated with thrombosis, defining the antiphospholipid syndrome (APS) but it remains unclear why many subjects who are positive for aPL do not develop thrombosis. Experimental observations suggest that the platelet is an important player in the pathogenesis of the APS, and CD62P (P selectin) and soluble CD40L (sCD40L) are independent markers of platelet activation. Objectives: to evaluate the significance of P selectin and sCD40L serum levels for an evolution accompanied with venous and arterial recurrent thrombosis in patients with APS secondary to systemic lupus erythematosus (SLE). The secondary aim was to identify the clinical and serological risk factors for the evolution with recurrent thrombotic events. Methods: 20 patients with APS secondary to SLE, diagnosed according to the revised Sapporo classification for APS criteria, whose mean age was 48 ± 11 years, and of which 16 were women, were evaluated for a history of thrombosis and followed-up 24 month for an evolution with new thrombotic events. Serum IgG or IgM anticardiolipin antibodies (aCL), serum P selectin and sCD40L levels were assessed at baseline (V1) and after 12 months (V2) using standardized ELISA methods (R&D Minneapolis USA). Statistics: t test /ANOVA, logistic regression. Results: APS patients with a history of thrombosis had higher P selectin levels compared to APS patients without a history of thrombosis (256.63 ± 145.79 versus 121.85 ± 101.47ng/dL; p=0.04). V1 P selectin levels were significantly higher in patients with arterial recurrent events compared to patients without a history of arterial thrombosis (256.63 ± 145.79 versus 121.85 ± 101.47 ng/dL; p=0.04). V2 sCD40L levels were significantly higher in patients with venous recurrent events compared to patients without a history of venous thrombosis (13433.2 ± 8249.39 versus 5004.72 ± 3769.62 pg/dL; p=0.015). Conclusions: Platelet activation assessed by P selectin and sCD40L is significantly increased in APS secondary to SLE patients compared to controls. P selectin is significantly increased in patients with a history of recurrent thrombosis. Keywords: thrombosis,antiphospholipid syndrome,P selectin,sCD40L |
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Gavriş C, Anghel M, Rădoi M, Gheorghiţă E, Duca L, Pamfil G, et al. Risk of recurrent thrombosis related to antiphospholipid antibodies, soluble CD40L and P selectin serum levels in patients with antiphospholipid syndrome secondary to systemic lupus eritematosus. Rev Romana Med Lab. 2010;18(3):23-30
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