tetano
Editor, Senior Moderator
Front Immunol
. 2020 Oct 15;11:584241.
doi: 10.3389/fimmu.2020.584241. eCollection 2020.
Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome
Maria Orietta Borghi[SUP] 1 2 [/SUP], Asmaa Beltagy[SUP] 1 3 [/SUP], Emirena Garrafa[SUP] 4 5 [/SUP], Daniele Curreli[SUP] 1 [/SUP], Germana Cecchini[SUP] 6 [/SUP], Caterina Bodio[SUP] 1 [/SUP], Claudia Grossi[SUP] 1 [/SUP], Simonetta Blengino[SUP] 7 [/SUP], Angela Tincani[SUP] 8 [/SUP], Franco Franceschini[SUP] 8 [/SUP], Laura Andreoli[SUP] 8 [/SUP], Maria Grazia Lazzaroni[SUP] 8 [/SUP], Silvia Piantoni[SUP] 8 [/SUP], Stefania Masneri[SUP] 8 [/SUP], Francesca Crisafulli[SUP] 8 [/SUP], Duilio Brugnoni[SUP] 5 [/SUP], Maria Lorenza Muiesan[SUP] 9 [/SUP], Massimo Salvetti[SUP] 9 [/SUP], Gianfranco Parati[SUP] 7 [/SUP], Erminio Torresani[SUP] 6 [/SUP], Michael Mahler[SUP] 10 [/SUP], Francesca Heilbron[SUP] 7 [/SUP], Francesca Pregnolato[SUP] 1 [/SUP], Martino Pengo[SUP] 7 [/SUP], Francesco Tedesco[SUP] 1 [/SUP], Nicola Pozzi[SUP] 11 [/SUP], Pier Luigi Meroni[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Critically ill patients with coronavirus disease 2019 (COVID-19) have a profound hypercoagulable state and often develop coagulopathy which leads to organ failure and death. Because of a prolonged activated partial-thromboplastin time (aPTT), a relationship with anti-phospholipid antibodies (aPLs) has been proposed, but results are controversial. Functional assays for aPL (i.e., lupus anticoagulant) can be influenced by concomitant anticoagulation and/or high levels of C reactive protein. The presence of anti-cardiolipin (aCL), anti-beta2-glycoprotein I (anti-β[SUB]2[/SUB]GPI), and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies was not investigated systematically. Epitope specificity of anti-β[SUB]2[/SUB]GPI antibodies was not reported.
Objective: To evaluate the prevalence and the clinical association of aPL in a large cohort of COVID-19 patients, and to characterize the epitope specificity of anti-β[SUB]2[/SUB]GPI antibodies.
Methods: ELISA and chemiluminescence assays were used to test 122 sera of patients suffering from severe COVID-19. Of them, 16 displayed major thrombotic events.
Results: Anti-β[SUB]2[/SUB]GPI IgG/IgA/IgM was the most frequent in 15.6/6.6/9.0% of patients, while aCL IgG/IgM was detected in 5.7/6.6% by ELISA. Comparable values were found by chemiluminescence. aPS/PT IgG/IgM were detectable in 2.5 and 9.8% by ELISA. No association between thrombosis and aPL was found. Reactivity against domain 1 and 4-5 of β[SUB]2[/SUB]GPI was limited to 3/58 (5.2%) tested sera for each domain and did not correlate with aCL/anti-β[SUB]2[/SUB]GPI nor with thrombosis.
Conclusions: aPL show a low prevalence in COVID-19 patients and are not associated with major thrombotic events. aPL in COVID-19 patients are mainly directed against β[SUB]2[/SUB]GPI but display an epitope specificity different from antibodies in antiphospholipid syndrome.
Keywords: COVID-19; anti-phospholipid antibodies; autoimmunity; prothrombin; thrombosis; β2-glycoprotein I.
. 2020 Oct 15;11:584241.
doi: 10.3389/fimmu.2020.584241. eCollection 2020.
Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome
Maria Orietta Borghi[SUP] 1 2 [/SUP], Asmaa Beltagy[SUP] 1 3 [/SUP], Emirena Garrafa[SUP] 4 5 [/SUP], Daniele Curreli[SUP] 1 [/SUP], Germana Cecchini[SUP] 6 [/SUP], Caterina Bodio[SUP] 1 [/SUP], Claudia Grossi[SUP] 1 [/SUP], Simonetta Blengino[SUP] 7 [/SUP], Angela Tincani[SUP] 8 [/SUP], Franco Franceschini[SUP] 8 [/SUP], Laura Andreoli[SUP] 8 [/SUP], Maria Grazia Lazzaroni[SUP] 8 [/SUP], Silvia Piantoni[SUP] 8 [/SUP], Stefania Masneri[SUP] 8 [/SUP], Francesca Crisafulli[SUP] 8 [/SUP], Duilio Brugnoni[SUP] 5 [/SUP], Maria Lorenza Muiesan[SUP] 9 [/SUP], Massimo Salvetti[SUP] 9 [/SUP], Gianfranco Parati[SUP] 7 [/SUP], Erminio Torresani[SUP] 6 [/SUP], Michael Mahler[SUP] 10 [/SUP], Francesca Heilbron[SUP] 7 [/SUP], Francesca Pregnolato[SUP] 1 [/SUP], Martino Pengo[SUP] 7 [/SUP], Francesco Tedesco[SUP] 1 [/SUP], Nicola Pozzi[SUP] 11 [/SUP], Pier Luigi Meroni[SUP] 1 [/SUP]
Affiliations
- PMID: 33178218
- PMCID: PMC7593765
- DOI: 10.3389/fimmu.2020.584241
Abstract
Background: Critically ill patients with coronavirus disease 2019 (COVID-19) have a profound hypercoagulable state and often develop coagulopathy which leads to organ failure and death. Because of a prolonged activated partial-thromboplastin time (aPTT), a relationship with anti-phospholipid antibodies (aPLs) has been proposed, but results are controversial. Functional assays for aPL (i.e., lupus anticoagulant) can be influenced by concomitant anticoagulation and/or high levels of C reactive protein. The presence of anti-cardiolipin (aCL), anti-beta2-glycoprotein I (anti-β[SUB]2[/SUB]GPI), and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies was not investigated systematically. Epitope specificity of anti-β[SUB]2[/SUB]GPI antibodies was not reported.
Objective: To evaluate the prevalence and the clinical association of aPL in a large cohort of COVID-19 patients, and to characterize the epitope specificity of anti-β[SUB]2[/SUB]GPI antibodies.
Methods: ELISA and chemiluminescence assays were used to test 122 sera of patients suffering from severe COVID-19. Of them, 16 displayed major thrombotic events.
Results: Anti-β[SUB]2[/SUB]GPI IgG/IgA/IgM was the most frequent in 15.6/6.6/9.0% of patients, while aCL IgG/IgM was detected in 5.7/6.6% by ELISA. Comparable values were found by chemiluminescence. aPS/PT IgG/IgM were detectable in 2.5 and 9.8% by ELISA. No association between thrombosis and aPL was found. Reactivity against domain 1 and 4-5 of β[SUB]2[/SUB]GPI was limited to 3/58 (5.2%) tested sera for each domain and did not correlate with aCL/anti-β[SUB]2[/SUB]GPI nor with thrombosis.
Conclusions: aPL show a low prevalence in COVID-19 patients and are not associated with major thrombotic events. aPL in COVID-19 patients are mainly directed against β[SUB]2[/SUB]GPI but display an epitope specificity different from antibodies in antiphospholipid syndrome.
Keywords: COVID-19; anti-phospholipid antibodies; autoimmunity; prothrombin; thrombosis; β2-glycoprotein I.