Morrisroe, KB and Stevens, W and Nandurkar, H and Prior, D and Thakkar, V and Roddy, J and Zochling, J and Sahhar, J and Tymms, K and Sturgess, A and Major, G and Kermeen, F and Hill, C and Walker, J and Nash, P and Gabbay, E and Youssef, P and Proudman, SM and Nikpour, M, The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis, Clinical and Experimental Rheumatology, 32, (Suppl 86) pp. S133-S137. ISSN 0392-856X (2014) [Refereed Article]
Copyright 2014 Clinical and Experimental Rheumatology
Official URL: http://www.clinexprheumatol.org/abstract.asp?a=742...
METHODS: Nine hundred and forty SSc patients were tested for APLA using an ELISA assay at recruitment. Clinical manifestations were defined as present, if ever present from SSc diagnosis. Logistic regression analysis was used to determine the associations of APLA.
RESULTS: One or more types of APLA were present in 226 (24.0%) patients. Anticardiolipin (ACA) IgG (ACA-IgG) antibodies were associated with right heart catheter-diagnosed pulmonary arterial hypertension (PAH), with higher titres corresponding with a higher likelihood of PAH (moderate titre (20-39 U/ml) ACA-IgG odds ratio [OR] 1.70, 95% CI: 1.01-2.93, p=0.047; high titre (>40 U/ml) ACA-IgG OR 4.60, 95% CI:1.02-20.8, p=0.047). Both ACA-IgM (OR 2.04, 95% CI: 1.4-3.0, p<0.0001) and ACA-IgG (OR 1.84, 95% CI: 1.2-2.8, p=0.005) were associated with interstitial lung disease (ILD). Increasing ACA-IgM and IgG titres were associated with increased likelihood of ILD. ACA-IgG was a marker of coexistent pulmonary hypertension and ILD (ILD-PH) (OR 2.10, 95% CI: 1.1-4.2, p=0.036). We also found an association between ACA-IgG and digital ulcers (OR 1.76, 95% CI: 1.16-2.67, p=0.008) and ACA-IgM and Raynaud's phenomenon (OR 2.39, 95% CI: 1.08-5.27, p=0.031). There was no association between APLA and SSc disease subtype, peak skin score, presence of other autoantibodies, mortality or other disease manifestations.
CONCLUSIONS: The association of APLA with PAH, ILD, ILD-PH, Raynaud's phenomenon and digital ulcers suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features.
|Item Type:||Refereed Article|
|Keywords:||scleroderma; pulmonary hypertension; antiphospholipid antibodies|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Rheumatology and Arthritis|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Skeletal System and Disorders (incl. Arthritis)|
|Author:||Zochling, J (Dr Jane Zochling)|
|Web of Science® Times Cited:||7|
|Deposited By:||Menzies Institute for Medical Research|
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