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Anti-protein C antibodies and acquired protein C resistance in SLE: novel markers for thromboembolic events and disease activity?
- Source :
-
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2021 Mar 02; Vol. 60 (3), pp. 1376-1386. - Publication Year :
- 2021
-
Abstract
- Objectives: Risk factors for thromboembolism in SLE are poorly understood. We hypothesized a possible role for protein C, based on its dual activity in inflammation and haemostasis and on the evidence of an association between acquired activated protein C (APC) resistance (APCR) and high-avidity anti-protein C antibodies (anti-PC) with a severe thrombotic phenotype in venous thrombosis APS patients.<br />Methods: In a cross-sectional study of 156 SLE patients, the presence and avidity of IgG anti-PC was established by in house-ELISA, and APCR to exogenous recombinant human APC (rhAPC) and Protac (which activates endogenous protein C) was assessed by thrombin generation-based assays. Associations with aPL profile, thrombotic history and disease activity (BILAG and SLEDAI-2K) were also established.<br />Results: Anti-PC were detected in 54.5% of patients and APCR in 59%. Anti-PC positivity was associated with APCR to both rhAPC (P <0.0001) and Protac (P =0.0001). High-avidity anti-PC, detected in 26.3% of SLE patients, were associated with APCR in patients with thrombosis only (P <0.05), and with the development of thrombosis over time (range: 0-52 years; P =0.014). High-avidity anti-PC levels correlated with SLEDAI-2K (P =0.033) and total BILAG (P =0.019); SLEDAI-2K correlated inversely with APCR to Protac (P =0.004).<br />Conclusion: Anti-PC occur in patients with SLE, independently of aPL profile, and are associated with APCR. High-avidity anti-PC are associated with thrombosis and with active disease and might prove a novel marker to monitor the risk of thrombosis and disease progression in SLE.<br /> (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Activated Protein C Resistance blood
Activated Protein C Resistance complications
Activated Protein C Resistance etiology
Biomarkers blood
Cross-Sectional Studies
Female
Humans
Lupus Erythematosus, Systemic complications
Male
Middle Aged
Risk Factors
Thrombin metabolism
Thromboembolism etiology
Activated Protein C Resistance immunology
Autoantibodies immunology
Lupus Erythematosus, Systemic immunology
Protein C immunology
Thromboembolism immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1462-0332
- Volume :
- 60
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Rheumatology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 32964932
- Full Text :
- https://doi.org/10.1093/rheumatology/keaa509