The Clinical Significance of Non-Criteria Antiphospholipid Antibodies in Atypical Antiphospholipid Syndrome.

Abstract

Objective: To analyse the correlation between non-criteria antiphospholipid antibodies (non-criteria aPLs) and clinical symptoms (recurrent miscarriage) in patients with seronegative antiphospholipid syndrome (SNAPS).Methods:Ninety-four SNAPS patients who were treated in the First Affiliated Hospital of Soochow University from May 2022 to May 2024 were included. Chemiluminescence immunoassay was used to detect anti-β2 glycoprotein I antibody (aβ2GPI), anti-cardiolipin antibody (aCL), and lupus anticoagulant. ELISA was used to detect the levels of anti-annexin A5 (ANXA5), anti-phosphatidylethanolamine antibody (aPE), anti-prothrombin IgG antibody (aPT IgG), anti-prothrombin IgM antibody (aPT IgM), anti-phosphatidylserine/prothrombin IgG antibody (aPS/PT IgG), and anti-phosphatidylserine/prothrombin IgM antibody (aPS/PT IgM). The correlation between non-criteria antiphospholipid antibodies and clinical events was analysed.

Results: Compared with the non-criteria antibody-negative group, the positive group had a higher rate of positive antinuclear antibodies (p < 0.05). The proportion of recurrent miscarriage in the positive non-criteria antibody group was significantly higher than in the negative group (p = 0.002). Compared with the negative group, patients with positive anti-annexin A5 antibody and aPT IgM were more likely to have recurrent miscarriage (p < 0.05). Compared with the aPE-negative group, those with aPE-positive were more likely to experience early miscarriage (p = 0.039). Both aPT IgM subtype (p = 0.004) and ANXA5 (p = 0.013) antibodies were the risk factors for recurrent miscarriage. Patients with positive ANXA5, aPT IgG, and aPT/PS IgM antibodies showed a significant decrease in antibody titers after treatment (p < 0.05).

Conclusion: Detection of non-criteria aPLs contributes to improving the diagnosis of SNAPS, assessing its development trends, and intervening promptly to prevent recurrent miscarriage.