Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome.
Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome.
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DOI：
10.3389/fimmu.2020.584241
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发表时间：
2020
影响因子：
7.3
通讯作者：
Meroni PL
中科院分区：
文献类型：
--
作者：
Borghi MO;Beltagy A;Garrafa E;Curreli D;Cecchini G;Bodio C;Grossi C;Blengino S;Tincani A;Franceschini F;Andreoli L;Lazzaroni MG;Piantoni S;Masneri S;Crisafulli F;Brugnoni D;Muiesan ML;Salvetti M;Parati G;Torresani E;Mahler M;Heilbron F;Pregnolato F;Pengo M;Tedesco F;Pozzi N;Meroni PL
2019 年冠状病毒病 (COVID-19) 危重患者具有严重的高凝状态，经常出现凝血病，导致器官衰竭和死亡。由于活化部分凝血活酶时间（aPTT）延长，有人提出与抗磷脂抗体（aPL）有关，但结果存在争议。 aPL（即狼疮抗凝剂）的功能测定可能会受到伴随抗凝和/或高水平 C 反应蛋白的影响。尚未系统研究抗心磷脂 (aCL)、抗 β2-糖蛋白 I (抗 β2GPI) 和抗磷脂酰丝氨酸/凝血酶原 (aPS/PT) 抗体的存在。抗β2GPI抗体的表位特异性尚未报道。评估大量 COVID-19 患者中 aPL 的患病率和临床关联，并表征抗 β2GPI 抗体的表位特异性。采用 ELISA 和化学发光检测方法检测了 122 名重症 COVID-19 患者的血清。其中，16 例出现严重血栓事件。抗-β2GPI IgG/IgA/IgM 在 15.6/6.6/9.0% 的患者中最常见，而 ELISA 检测到 aCL IgG/IgM 的比例为 5.7/6.6%。通过化学发光发现了可比较的值。通过 ELISA 可检测到 2.5% 和 9.8% 的 aPS/PT IgG/IgM。未发现血栓形成与 aPL 之间存在关联。针对 β2GPI 的结构域 1 和 4-5 的反应性仅限于每个结构域的 3/58 (5.2%) 测试血清，并且与 aCL/抗 β2GPI 或血栓形成无关。 aPL 在 COVID-19 患者中的患病率较低，并且与重大血栓事件无关。 COVID-19患者中的aPL主要针对β2GPI，但表现出与抗磷脂综合征中的抗体不同的表位特异性。
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-β2GPI), and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies was not investigated systematically. Epitope specificity of anti-β2GPI antibodies was not reported. 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-β2GPI antibodies. ELISA and chemiluminescence assays were used to test 122 sera of patients suffering from severe COVID-19. Of them, 16 displayed major thrombotic events. Anti-β2GPI 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 β2GPI was limited to 3/58 (5.2%) tested sera for each domain and did not correlate with aCL/anti-β2GPI nor with thrombosis. 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 β2GPI but display an epitope specificity different from antibodies in antiphospholipid syndrome.
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