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Front. Med. | doi: 10.3389/fmed.2019.00211

IgG Anti-High-Density Lipoproteins Antibodies Discriminate Between Arterial and Venous Events in Thrombotic Antiphospholipid Syndrome Patients

 Savino Sciascia1, 2,  Irene Cecchi1, 2, Massimo Radin1, 2, Elena Rubini1, 2, Ana Suárez3, Dario Rocatello1, 2 and  Javier Rodríguez-Carrio3*
  • 1Ospedale San Giovanni Bosco, Italy
  • 2University of Turin, Italy
  • 3Universidad de Oviedo, Spain

Introduction: Recurrent thrombotic events are a hallmark of Antiphospholipid Syndrome (APS). However, biomarkers to identify if a patient with antiphospholipid antibodies (aPL) is at higher risk to develop an arterial or a venous event are lacking. Recently, the pathogenic role of anti-high-density lipoproteins antibodies (anti-HDL) in the occurrence of cardiovascular disease in autoimmunity has emerged. The aim of the present study was to evaluate the presence of IgG anti-HDL antibodies in a cohort of thrombotic APS patients and to investigate their association with clinical outcomes.
Methods: Serum levels of IgG anti-HDL antibodies, total IgG and complete aPL profile were assessed in 60 APS patients and 80 healthy donors (HDs) by immunoassays.
Results: Higher levels of IgG anti-HDL were found in APS patients compared to HDs (p<0.001), even after correcting for total IgG levels (p<0.001). No associations with treatments or traditional cardiovascular risk factors, except for smoking habit (p<0.0001), were found. Patients who experienced at least one arterial event (n=30) had significantly higher levels of anti-HDL antibodies when compared to patients with venous thrombosis (n=30, p=0.046), this difference being stronger when adjusting for total IgG (p=0.007). Additionally, patients tested positive for antiphosphatidylserine/prothrombin (IgG/IgM) antibodies had significantly higher levels of anti-HDL antibodies (p=0.045).
Conclusions: Increased levels of IgG anti-HDL antibodies can be found in APS, mainly in patients with arterial thrombosis, independently of aPL antibodies and traditional risk factors. These findings point to a role of anti-HDL antibodies in APS and support their use as a potential biomarker for arterial thrombotic events.

Keywords: Antiphosholipid antibody syndrome, Autoimmunity, Autoantibodies, HDL, Thrombosis - immunology, etiology

Received: 05 Jul 2019; Accepted: 13 Sep 2019.

Copyright: © 2019 Sciascia, Cecchi, Radin, Rubini, Suárez, Rocatello and Rodríguez-Carrio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Javier Rodríguez-Carrio, Universidad de Oviedo, Oviedo, 33003, Asturias, Spain, rodriguezcjavier@uniovi.es