PMID- 34621272
OWN - NLM
STAT- MEDLINE
DCOM- 20211126
LR  - 20211126
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 12
DP  - 2021
TI  - Antiphospholipid Antibody Assays in 2021: Looking for a Predictive Value in 
      Addition to a Diagnostic One.
PG  - 726820
LID - 10.3389/fimmu.2021.726820 [doi]
LID - 726820
AB  - Antiphospholipid antibodies (aPL) are mandatory for the diagnosis but are also a 
      risk factor for the antiphospholipid syndrome (APS) clinical manifestations. 
      Lupus anticoagulant (LA), anticardiolipin (aCL), and anti-beta2 glycoprotein I 
      (beta(2)GPI) assays are the formal laboratory classification/diagnostic criteria. 
      Additional nonclassification assays have been suggested; among them, 
      antiphosphatidylserine-prothrombin (aPS/PT) and antidomain 1 beta(2)GPI antibodies 
      are the most promising ones although not yet formally accepted. aPL represent the 
      example of a laboratory test that moved from dichotomous to quantitative results 
      consistent with the idea that reporting quantitative data offers more 
      diagnostic/prognostic information for both vascular and obstetric manifestations. 
      Although the general rule is that the higher the aPL titer, the higher the test 
      likelihood ratio, there is growing evidence that this is not the case for 
      persistent low titers and obstetric events. LA displays the highest 
      diagnostic/prognostic power, although some isolated LAs are apparently not 
      associated with APS manifestations. Moreover, isotype characterization is also 
      critical since IgG aPL are more diagnostic/prognostic than IgA or IgM. aPL are 
      directed against two main autoantigens: beta(2)GPI and PT. However, anti-beta(2)GPI 
      antibodies are more associated with the APS clinical spectrum. In addition, there 
      is evidence that anti-beta(2)GPI domain 1 antibodies display a stronger 
      diagnostic/prognostic value. This finding supports the view that antigen and even 
      epitope characterization represents a further step for improving the assay value. 
      The strategy to improve aPL laboratory characterization is a lesson that can be 
      translated to other autoantibody assays in order to improve our diagnostic and 
      prognostic power.
CI  - Copyright (c) 2021 Meroni and Borghi.
FAU - Meroni, Pier Luigi
AU  - Meroni PL
AD  - Istituto Auxologico Italiano, IRCCS, Immunorheumatology Research Laboratory, 
      Milan, Italy.
FAU - Borghi, Maria Orietta
AU  - Borghi MO
AD  - Istituto Auxologico Italiano, IRCCS, Immunorheumatology Research Laboratory, 
      Milan, Italy.
AD  - Department of Clinical Science and Community Health, University of Milan, Milan, 
      Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20210921
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Antibodies, Antiphospholipid)
SB  - IM
MH  - Animals
MH  - Antibodies, Antiphospholipid/*analysis
MH  - Antiphospholipid Syndrome/*diagnosis/immunology
MH  - Biological Assay
MH  - Humans
MH  - Predictive Value of Tests
PMC - PMC8490700
OTO - NOTNLM
OT  - antiphospholipid antibodies
OT  - miscarriages
OT  - prothrombin
OT  - thrombosis
OT  - beta2-glycoprotein I
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/10/09 06:00
MHDA- 2021/11/27 06:00
PMCR- 2021/01/01
CRDT- 2021/10/08 07:07
PHST- 2021/06/17 00:00 [received]
PHST- 2021/09/01 00:00 [accepted]
PHST- 2021/10/08 07:07 [entrez]
PHST- 2021/10/09 06:00 [pubmed]
PHST- 2021/11/27 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2021.726820 [doi]
PST - epublish
SO  - Front Immunol. 2021 Sep 21;12:726820. doi: 10.3389/fimmu.2021.726820. eCollection 
      2021.