Biomedical
Antiphospholipid antibodies in patients with antiphospholipid syndrome
Abstract
Highlights • Antiphospholipid syndrome is a rare systemic autoimmune disease characterized by recurrent pregnancy morbidity or thrombosis in combination with the persistent presence of antiphospholipid antibodies in plasma/serum • Specialists in laboratory medicine should take responsibility for the entire analytical process, so that possible interferences are minimized, and physicians obtain reliable results of the patient’s laboratory findings in a timely manner • Due to possible problems in performing tests on aPLs for a more reliable (optimal) interpretation of laboratory findings, a close cooperation between laboratory specialists and clinical specialists is needed Antiphospholipid syndrome (APS) is a rare systemic autoimmune disease characterized by recurrent pregnancy morbidity or thrombosis in combination with the persistent presence of antiphospholipid antibodies (aPLs) in plasma/serum. Antiphospholipid antibodies are a heterogeneous, overlapping group of autoantibodies, of which anti-β2-glycoprotein I (aβ2GPI), anticardiolipin (aCL) antibodies and antibodies that prolong plasma clotting time in tests in vitro known as lupus anticoagulant (LAC) are included in the laboratory criteria for the diagnosis of APS. The presence of LAC antibodies in plasma is indirectly determined by measuring the length of coagulation in two tests - activated partial thromboplastin time (aPTT) and diluted Russell’s viper venom time (dRVVT). The concentration of aβ2GPI and aCL (immunglobulin G (IgG) and immunoglobulin M (IgM) isotypes) in serum is directly determined by solid-phase immunoassays, either by enzyme-linked immunosorbent assay (ELISA), fluoroimmunoassay (FIA), immunochemiluminescence (CLIA) or multiplex flow immunoassay (MFIA). For patient safety, it is extremely important to control all three phases of laboratory testing, i.e. preanalytical, analytical and postanalytical phase. Specialists in laboratory medicine must be aware of interferences in all three phases of laboratory testing, in order to minimize these interferences. The aim of this review was to show the current pathophysiological aspects of APS, the importance of determining aPLs-a in plasma/serum, with an emphasis on possible interferences that should be taken into account when interpreting laboratory findings.
Key Questions
1. What is the primary objective of the study?
The study aims to explore the significance of aPLs in APS, discussing their role in disease development and their utility in diagnostic processes.
2. What methodology was employed in the research?
The authors conducted a comprehensive review of existing literature to evaluate the impact of aPLs on APS, focusing on their diagnostic value and implications for patient management.
3. What were the main findings of the study?
The study highlights that aPLs, including anti-β2-glycoprotein I (aβ2GPI) and anticardiolipin (aCL) antibodies, are crucial in the pathogenesis of APS. The presence of these antibodies is essential for diagnosing APS, as they are part of the laboratory criteria for the disease. The authors emphasize the need for standardized testing methods to accurately detect aPLs, thereby improving diagnostic accuracy and patient outcomes.
Summary
Dodig and Čepelak (2024) provide a comprehensive overview of the role of aPLs in APS, underscoring their importance in both the pathogenesis and diagnosis of the syndrome. The review calls for standardized testing protocols to enhance diagnostic precision and facilitate effective patient management.
