Arthritis & rheumatology (Hoboken, N.J.) · 2026
The Role of Anti-Phosphatidylserine/Prothrombin Antibodies and the Lectin Complement Pathway in Anti-Phospholipid Antibody-Associated Preterm Delivery.
СтатьяНазвание и аннотация: Перевод в очереди
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Da Via Arianna, Borghi Maria O, Trespidi Laura, Ghezzi Lucia M, Bodio Caterina, Grossi Claudia, Carbone Erika, Raschi Elena, Erra Roberta, Di Simone Nicoletta, Gerosa Maria, Gazzola Federica G, Locati Federica, Caporali Roberto F, Cetin Irene, Lubrano Chiara, Bulla Roberta, Agostinis Chiara, Pegoraro Silvia, Tedesco Francesco, Meroni PierLuigi, Lonati Paola A
Аннотация
OBJECTIVE: Antiphospholipid antibodies (aPL) may directly affect placentation and trigger local complement-mediated inflammation/thrombosis. Obstetric complications in the antiphospholipid syndrome (APS) are still frequent despite therapy/close monitoring, and the identification of new risk biomarkers is an unmet need. We aimed to prospectively investigate the prognostic value of classification/nonclassification laboratory APS criteria and markers of complement activation for pregnancy complications, in particular preterm delivery (PTD).
METHODS: We observed 60 women prospectively during pregnancy and postpartum: 33 aPL-positive (20 APS and 13 aPL-carriers) and 27 aPL-negative (5 systemic lupus erythematosus, 11 rheumatoid arthritis and 11 undifferentiated connective tissue diseases). aPL criteria tests, anti-phosphatidylserine/prothrombin (anti-PS/PT) IgG/IgM and anti-β2glycoprotein I-Domain I IgG, complement products (C3, C4, C3a, C5a, sC5b-9, MBL) and complement pathway activity (classical pathway [CP], alternative pathway [AP], and lectin pathway [LP]) were measured in 231 available specimens.
RESULTS: PTD was experienced in 21% of aPL-positive and 15% of aPL-negative women. Anti-PS/PT IgG/IgM titers were significantly higher in PTD versus non-PTD women (P < 0.05) at almost all time points. At variance with CP and AP, LP activity in aPL-positive PTD was lower than in non-PTD, reaching a statistically significant difference compared with aPL-negative PTD patients (P < 0.05). Moreover, LP activity significantly correlated with anti-PS/PT IgG/IgM titers, both measured in the first trimester (P < 0.05), and all of them significantly correlated with the week of gestation at delivery (P < 0.05).
CONCLUSION: The reduced LP activity and the higher anti-PS/PT IgG/IgM titers in PTD aPL-positive women during the first trimester suggest their use as early prognostic tools for PTD in aPL-positive pregnant women.
METHODS: We observed 60 women prospectively during pregnancy and postpartum: 33 aPL-positive (20 APS and 13 aPL-carriers) and 27 aPL-negative (5 systemic lupus erythematosus, 11 rheumatoid arthritis and 11 undifferentiated connective tissue diseases). aPL criteria tests, anti-phosphatidylserine/prothrombin (anti-PS/PT) IgG/IgM and anti-β2glycoprotein I-Domain I IgG, complement products (C3, C4, C3a, C5a, sC5b-9, MBL) and complement pathway activity (classical pathway [CP], alternative pathway [AP], and lectin pathway [LP]) were measured in 231 available specimens.
RESULTS: PTD was experienced in 21% of aPL-positive and 15% of aPL-negative women. Anti-PS/PT IgG/IgM titers were significantly higher in PTD versus non-PTD women (P < 0.05) at almost all time points. At variance with CP and AP, LP activity in aPL-positive PTD was lower than in non-PTD, reaching a statistically significant difference compared with aPL-negative PTD patients (P < 0.05). Moreover, LP activity significantly correlated with anti-PS/PT IgG/IgM titers, both measured in the first trimester (P < 0.05), and all of them significantly correlated with the week of gestation at delivery (P < 0.05).
CONCLUSION: The reduced LP activity and the higher anti-PS/PT IgG/IgM titers in PTD aPL-positive women during the first trimester suggest their use as early prognostic tools for PTD in aPL-positive pregnant women.