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"New" antigenic targets and methodological approaches for refining laboratory diagnosis of antiphospholipid syndrome.

Misasi R, Capozzi A, Longo A, Recalchi S, Lococo E, Alessandri C, Conti F, Valesini G, Sorice M - J Immunol Res (2015)

Bottom Line: A special focus has been dedicated on "seronegative" APS, that is, those patients with a clinical profile suggestive of APS (thromboses, recurrent miscarriages, or foetal loss), who are persistently negative for the routinely used aPL.Recent findings suggest that, in sera from patients with SN-APS, antibodies may be detected using "new" antigenic targets (mainly vimentin/cardiolipin) or methodological approaches different from traditional techniques (TLC immunostaining).Thus, APS represents a mosaic, in which antibodies against different antigenic targets may be detected thanks to the continuously evolving new technologies.

View Article: PubMed Central - PubMed

Affiliation: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.

ABSTRACT
Antiphospholipid antibodies (aPLs) are a heterogeneous group of antibodies directed against phospholipids or protein/phospholipid complexes. Currently, aPLs are assessed using either "solid-phase" assays that identify anticardiolipin antibodies and anti-β2-glycoprotein I antibodies or "liquid-phase" assay that identifies lupus anticoagulant. However, in the last few years, "new" antigenic targets and methodological approaches have been employed for refining laboratory diagnosis of antiphospholipid syndrome (APS). In this review the potential diagnostic value of antibodies to domains of β2-GPI, prothrombin/phosphatidylserine, vimentin/cardiolipin, protein S, protein C, annexin A2, annexin A5, and phospholipid antigens is discussed. Moreover, new technical approaches, including chemiluminescence, multiline dot assay, and thin layer chromatography (TLC) immunostaining, which utilize different supports for detection of aPL, have been developed. A special focus has been dedicated on "seronegative" APS, that is, those patients with a clinical profile suggestive of APS (thromboses, recurrent miscarriages, or foetal loss), who are persistently negative for the routinely used aPL. Recent findings suggest that, in sera from patients with SN-APS, antibodies may be detected using "new" antigenic targets (mainly vimentin/cardiolipin) or methodological approaches different from traditional techniques (TLC immunostaining). Thus, APS represents a mosaic, in which antibodies against different antigenic targets may be detected thanks to the continuously evolving new technologies.

No MeSH data available.


Related in: MedlinePlus

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Mentions: We can conclude that APS is still an evolving field and that, ultimately, a more holistic approach to the diagnosis of APS is needed. New technologies may represent useful tools for diagnosis of immunological disorders, contributing to a better efficiency and accuracy in the diagnosis of autoimmune diseases. The new diagnostic approaches should point out the risk stratification of the disease, taking into account first the potential combinations/panels of available aPL tests, including the issues of different entities of “seropositive” APS, “seronegative” APS, and non-APS aPL-positivity. This can be achieved also thanks to the various technologies that allow us to identify “new” epitopes, revealed through the typology of antigen presentation (Figure 1). Moreover, it will allow us to review new treatment strategies for APS that may target different pathways of coagulation and immunomodulation.


"New" antigenic targets and methodological approaches for refining laboratory diagnosis of antiphospholipid syndrome.

Misasi R, Capozzi A, Longo A, Recalchi S, Lococo E, Alessandri C, Conti F, Valesini G, Sorice M - J Immunol Res (2015)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4383493&req=5

Mentions: We can conclude that APS is still an evolving field and that, ultimately, a more holistic approach to the diagnosis of APS is needed. New technologies may represent useful tools for diagnosis of immunological disorders, contributing to a better efficiency and accuracy in the diagnosis of autoimmune diseases. The new diagnostic approaches should point out the risk stratification of the disease, taking into account first the potential combinations/panels of available aPL tests, including the issues of different entities of “seropositive” APS, “seronegative” APS, and non-APS aPL-positivity. This can be achieved also thanks to the various technologies that allow us to identify “new” epitopes, revealed through the typology of antigen presentation (Figure 1). Moreover, it will allow us to review new treatment strategies for APS that may target different pathways of coagulation and immunomodulation.

Bottom Line: A special focus has been dedicated on "seronegative" APS, that is, those patients with a clinical profile suggestive of APS (thromboses, recurrent miscarriages, or foetal loss), who are persistently negative for the routinely used aPL.Recent findings suggest that, in sera from patients with SN-APS, antibodies may be detected using "new" antigenic targets (mainly vimentin/cardiolipin) or methodological approaches different from traditional techniques (TLC immunostaining).Thus, APS represents a mosaic, in which antibodies against different antigenic targets may be detected thanks to the continuously evolving new technologies.

View Article: PubMed Central - PubMed

Affiliation: Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Viale Regina Elena 324, 00161 Roma, Italy.

ABSTRACT
Antiphospholipid antibodies (aPLs) are a heterogeneous group of antibodies directed against phospholipids or protein/phospholipid complexes. Currently, aPLs are assessed using either "solid-phase" assays that identify anticardiolipin antibodies and anti-β2-glycoprotein I antibodies or "liquid-phase" assay that identifies lupus anticoagulant. However, in the last few years, "new" antigenic targets and methodological approaches have been employed for refining laboratory diagnosis of antiphospholipid syndrome (APS). In this review the potential diagnostic value of antibodies to domains of β2-GPI, prothrombin/phosphatidylserine, vimentin/cardiolipin, protein S, protein C, annexin A2, annexin A5, and phospholipid antigens is discussed. Moreover, new technical approaches, including chemiluminescence, multiline dot assay, and thin layer chromatography (TLC) immunostaining, which utilize different supports for detection of aPL, have been developed. A special focus has been dedicated on "seronegative" APS, that is, those patients with a clinical profile suggestive of APS (thromboses, recurrent miscarriages, or foetal loss), who are persistently negative for the routinely used aPL. Recent findings suggest that, in sera from patients with SN-APS, antibodies may be detected using "new" antigenic targets (mainly vimentin/cardiolipin) or methodological approaches different from traditional techniques (TLC immunostaining). Thus, APS represents a mosaic, in which antibodies against different antigenic targets may be detected thanks to the continuously evolving new technologies.

No MeSH data available.


Related in: MedlinePlus