Lupus & antiphospholipid syndrome
Anti–Neutrophil Extracellular Trap Antibodies in Antiphospholipid Antibody–Positive Patients: Results From the Antiphospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Clinical Database and Repository
Authors' conclusion
These data reveal high levels of anti-NET antibodies in 45% of aPL-positive patients, where they potentially activate the complement cascade.
Study context
- Population
- Multinational cohort of antiphospholipid (aPL)-positive patients without lupus (APS ACTION Clinical Database and Repository)308 met APS classification criteria
- Participants
- 389 participants
- Outcome
- Presence of elevated anti-NET IgG/IgM levels
Methodological detailsmultinational cohort, multivariate logistic regression with best variable model selection, autoantigen microarray (subset)
- Multinational cohort
- Multivariate logistic regression with best variable model selection
- Autoantigen microarray (subset)
Main finding
As reported in the abstract
Elevated anti-NET IgG and/or IgM
Elevated anti-NET IgG and/or IgM in aPL-positive patients
45%
Observational data: associations, not effects.
Further findings
Associations of anti-NET antibodies
- High anti-NET levels associated with more circulating MPO-DNA complexes (NET biomarker)
- Positive anti-NET IgG associated with brain white matter lesions, even after adjusting for demographics and aPL profiles
- Anti-NET IgM tracked with complement consumption after controlling for aPL profiles; high anti-NET IgM sera efficiently deposited C3d on NETs
Autoantibody profiles by autoantigen microarray (subset)
- Anti-NET IgG positivity associated with autoantibodies to citrullinated histones, heparan sulfate proteoglycan, laminin, MPO-DNA complexes and nucleosomes
- Anti-NET IgM positivity associated with autoantibodies to ssDNA, dsDNA and proliferating cell nuclear antigen
- n = 214
Original publication
Anti–Neutrophil Extracellular Trap Antibodies in Antiphospholipid Antibody–Positive Patients: Results From the Antiphospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Clinical Database and Repository. Arthritis Rheumatol. Published 18 May 2023. doi:10.
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