PMID- 32741301
OWN - NLM
STAT- MEDLINE
DCOM- 20210707
LR  - 20210707
IS  - 1477-0962 (Electronic)
IS  - 0961-2033 (Print)
IS  - 0961-2033 (Linking)
VI  - 29
IP  - 11
DP  - 2020 Oct
TI  - High IgA antiphospholipid autoantibodies in healthy Sudanese explain the 
      increased prevalence among Sudanese compared to Swedish systemic lupus 
      erythematosus patients.
PG  - 1412-1422
LID - 10.1177/0961203320945387 [doi]
AB  - OBJECTIVES: IgA antiphospholipid antibodies (aPL) are prevalent in systemic lupus 
      erythematosus (SLE) patients of African American, Afro-Caribbean and South 
      African origin. Nevertheless, data from North Africa are lacking, and most 
      studies use manufacturer-suggested cut-offs based on Caucasian controls. 
      Therefore, we compared aPL isotypes in Sudanese and Swedish SLE patients using 
      nation-based cut-offs. METHODS: Consecutive SLE patients and age- and sex-matched 
      controls from Sudan (N = 115/106) and Sweden (N = 340/318) were included. All 
      patients fulfilled the 1982 American College of Rheumatology SLE classification 
      criteria. Antiphospholipid syndrome-related events were obtained from patients' 
      records. IgA/G/M anticardiolipin and anti-beta(2) glycoprotein I (beta(2)GPI) were 
      analysed with two independent assays. IgA anti-beta(2)GPI domain 1 (D1) was also 
      investigated. Manufacturers' cut-offs and the 95th and 99th percentile cut-offs 
      based on national controls were used. RESULTS: Sudanese patients and controls had 
      higher levels and were more often positive for IgA aPL than Swedes when using 
      manufacturers' cut-offs. In contrast, using national cut-offs, the increase in 
      IgA aPL among Sudanese patients was lost. Occurrence of IgA anti-D1 did not 
      differ between the countries. Venous thromboses were less common among Sudanese 
      patients and did not associate with aPL. No clinical associations were observed 
      with IgA anti-beta(2)GPI in Sudanese patients. Thromboses in Swedes were associated 
      with IgG/M aPL. Fetal loss was associated with aPL in both cohorts. CONCLUSIONS: 
      IgA anti-beta(2)GPI prevalence was higher among Sudanese compared to Swedish 
      patients when manufacturers' cut-offs were used. This situation was reversed when 
      applying national cut-offs. Anti-D1 was not increased in Sudanese patients. 
      Previous studies on populations of African origin, which demonstrate a high 
      prevalence of IgA aPL positivity, should be re-evaluated using a similar cut-off 
      approach.
FAU - Elbagir, Sahwa
AU  - Elbagir S
AUID- ORCID: 0000-0003-2515-7066
AD  - Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, 
      Sweden.
FAU - Elshafie, Amir I
AU  - Elshafie AI
AD  - Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, 
      Sweden.
FAU - Elagib, Elnour M
AU  - Elagib EM
AD  - Rheumatology Unit, Military Hospital, Omdurman, Sudan.
FAU - Mohammed, NasrEldeen A
AU  - Mohammed NA
AD  - Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan.
FAU - Aledrissy, Mawahib Ie
AU  - Aledrissy MI
AD  - Rheumatology Unit, Alribat University Hospital, Khartoum, Sudan.
FAU - Manivel, Vivek Anand
AU  - Manivel VA
AD  - Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, 
      Sweden.
FAU - Pertsinidou, Eleftheria
AU  - Pertsinidou E
AD  - Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, 
      Sweden.
FAU - Nur, Musa Am
AU  - Nur MA
AD  - Rheumatology Unit, Alribat University Hospital, Khartoum, Sudan.
FAU - Gunnarsson, Iva
AU  - Gunnarsson I
AD  - Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Svenungsson, Elisabet
AU  - Svenungsson E
AD  - Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Ronnelid, Johan
AU  - Ronnelid J
AD  - Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, 
      Sweden.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20200802
PL  - England
TA  - Lupus
JT  - Lupus
JID - 9204265
RN  - 0 (Antibodies, Antiphospholipid)
RN  - 0 (Immunoglobulin A)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Immunoglobulin M)
RN  - 0 (beta 2-Glycoprotein I)
SB  - IM
MH  - Adult
MH  - Antibodies, Antiphospholipid/*blood/immunology
MH  - Antiphospholipid Syndrome/complications/*immunology
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Immunoglobulin A/*blood/immunology
MH  - Immunoglobulin G/*blood/immunology
MH  - Immunoglobulin M/*blood/immunology
MH  - Lupus Erythematosus, Systemic/*blood/immunology
MH  - Male
MH  - Middle Aged
MH  - Sudan
MH  - Sweden
MH  - Venous Thrombosis/immunology/pathology
MH  - beta 2-Glycoprotein I/immunology
PMC - PMC7536526
OTO - NOTNLM
OT  - Africa
OT  - IgA
OT  - Sudan
OT  - Sweden
OT  - Systemic lupus erythematosus
OT  - anti-beta2-glycoprotein I
OT  - antiphospholipid antibodies
EDAT- 2020/08/04 06:00
MHDA- 2021/07/08 06:00
PMCR- 2020/10/06
CRDT- 2020/08/04 06:00
PHST- 2020/08/04 06:00 [pubmed]
PHST- 2021/07/08 06:00 [medline]
PHST- 2020/08/04 06:00 [entrez]
PHST- 2020/10/06 00:00 [pmc-release]
AID - 10.1177_0961203320945387 [pii]
AID - 10.1177/0961203320945387 [doi]
PST - ppublish
SO  - Lupus. 2020 Oct;29(11):1412-1422. doi: 10.1177/0961203320945387. Epub 2020 Aug 2.