The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis

K. B. Morrisroe; W. Stevens; H. Nandurkar; D. Prior; V. Thakkar; J. Roddy; J. Zochling; J. Sahhar; K. Tymms; A. Sturgess; G. Major; F. Kermeen; C. Hill; J. Walker; P. Nash; E. Gabbay; P. Youssef; S. M. Proudman; M. Nikpour

The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis

K. B. Morrisroe, W. Stevens, H. Nandurkar, D. Prior, V. Thakkar, J. Roddy, J. Zochling, J. Sahhar, K. Tymms, A. Sturgess, G. Major, F. Kermeen, C. Hill, J. Walker, P. Nash, E. Gabbay, P. Youssef, S. M. Proudman, M. Nikpour

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Abstract

OBJECTIVES: To determine the prevalence and correlates of antiphospholipid antibodies (APLA) in systemic sclerosis (SSc).

METHODS: Nine hundred and forty SSc patients were tested for APLA using an ELISA assay at recruitment. Clinical manifestations were defined as present, if ever present from SSc diagnosis. Logistic regression analysis was used to determine the associations of APLA.

RESULTS: One or more types of APLA were present in 226 (24.0%) patients. Anticardiolipin (ACA) IgG (ACA-IgG) antibodies were associated with right heart catheter-diagnosed pulmonary arterial hypertension (PAH), with higher titres corresponding with a higher likelihood of PAH (moderate titre (20-39 U/ml) ACA-IgG odds ratio [OR] 1.70, 95% CI: 1.01-2.93, p=0.047; high titre (>40 U/ml) ACA-IgG OR 4.60, 95% CI:1.02-20.8, p=0.047). Both ACA-IgM (OR 2.04, 95% CI: 1.4-3.0, p<0.0001) and ACA-IgG (OR 1.84, 95% CI: 1.2-2.8, p=0.005) were associated with interstitial lung disease (ILD). Increasing ACA-IgM and IgG titres were associated with increased likelihood of ILD. ACA-IgG was a marker of coexistent pulmonary hypertension and ILD (ILD-PH) (OR 2.10, 95% CI: 1.1-4.2, p=0.036). We also found an association between ACA-IgG and digital ulcers (OR 1.76, 95% CI: 1.16-2.67, p=0.008) and ACA-IgM and Raynaud's phenomenon (OR 2.39, 95% CI: 1.08-5.27, p=0.031). There was no association between APLA and SSc disease subtype, peak skin score, presence of other autoantibodies, mortality or other disease manifestations.

CONCLUSIONS: The association of APLA with PAH, ILD, ILD-PH, Raynaud's phenomenon and digital ulcers suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features.

Original language	English
Pages (from-to)	S-133-7
Journal	Clinical and Experimental Rheumatology
Volume	32
Issue number	6
Publication status	Published - 1 Nov 2014
Externally published	Yes

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Morrisroe, K. B., Stevens, W., Nandurkar, H., Prior, D., Thakkar, V., Roddy, J., Zochling, J., Sahhar, J., Tymms, K., Sturgess, A., Major, G., Kermeen, F., Hill, C., Walker, J., Nash, P., Gabbay, E., Youssef, P., Proudman, S. M., & Nikpour, M. (2014). The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis. Clinical and Experimental Rheumatology, 32(6), S-133-7.

@article{dac5aadbf415419d80f4488d08cb684b,

title = "The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis",

abstract = "OBJECTIVES: To determine the prevalence and correlates of antiphospholipid antibodies (APLA) in systemic sclerosis (SSc).METHODS: Nine hundred and forty SSc patients were tested for APLA using an ELISA assay at recruitment. Clinical manifestations were defined as present, if ever present from SSc diagnosis. Logistic regression analysis was used to determine the associations of APLA.RESULTS: One or more types of APLA were present in 226 (24.0%) patients. Anticardiolipin (ACA) IgG (ACA-IgG) antibodies were associated with right heart catheter-diagnosed pulmonary arterial hypertension (PAH), with higher titres corresponding with a higher likelihood of PAH (moderate titre (20-39 U/ml) ACA-IgG odds ratio [OR] 1.70, 95% CI: 1.01-2.93, p=0.047; high titre (>40 U/ml) ACA-IgG OR 4.60, 95% CI:1.02-20.8, p=0.047). Both ACA-IgM (OR 2.04, 95% CI: 1.4-3.0, p<0.0001) and ACA-IgG (OR 1.84, 95% CI: 1.2-2.8, p=0.005) were associated with interstitial lung disease (ILD). Increasing ACA-IgM and IgG titres were associated with increased likelihood of ILD. ACA-IgG was a marker of coexistent pulmonary hypertension and ILD (ILD-PH) (OR 2.10, 95% CI: 1.1-4.2, p=0.036). We also found an association between ACA-IgG and digital ulcers (OR 1.76, 95% CI: 1.16-2.67, p=0.008) and ACA-IgM and Raynaud's phenomenon (OR 2.39, 95% CI: 1.08-5.27, p=0.031). There was no association between APLA and SSc disease subtype, peak skin score, presence of other autoantibodies, mortality or other disease manifestations.CONCLUSIONS: The association of APLA with PAH, ILD, ILD-PH, Raynaud's phenomenon and digital ulcers suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features.",

author = "Morrisroe, {K. B.} and W. Stevens and H. Nandurkar and D. Prior and V. Thakkar and J. Roddy and J. Zochling and J. Sahhar and K. Tymms and A. Sturgess and G. Major and F. Kermeen and C. Hill and J. Walker and P. Nash and E. Gabbay and P. Youssef and Proudman, {S. M.} and M. Nikpour",

year = "2014",

month = nov,

day = "1",

language = "English",

volume = "32",

pages = "S--133--7",

journal = "Clinical and Experimental Rheumatology",

issn = "0392-856X",

publisher = "Clinical and Experimental Rheumatology S.A.S.",

number = "6",

}

Morrisroe, KB, Stevens, W, Nandurkar, H, Prior, D, Thakkar, V, Roddy, J, Zochling, J, Sahhar, J, Tymms, K, Sturgess, A, Major, G, Kermeen, F, Hill, C, Walker, J, Nash, P, Gabbay, E, Youssef, P, Proudman, SM & Nikpour, M 2014, 'The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis', Clinical and Experimental Rheumatology, vol. 32, no. 6, pp. S-133-7.

TY - JOUR

T1 - The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis

AU - Morrisroe, K. B.

AU - Stevens, W.

AU - Nandurkar, H.

AU - Prior, D.

AU - Thakkar, V.

AU - Roddy, J.

AU - Zochling, J.

AU - Sahhar, J.

AU - Tymms, K.

AU - Sturgess, A.

AU - Major, G.

AU - Kermeen, F.

AU - Hill, C.

AU - Walker, J.

AU - Nash, P.

AU - Gabbay, E.

AU - Youssef, P.

AU - Proudman, S. M.

AU - Nikpour, M.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - OBJECTIVES: To determine the prevalence and correlates of antiphospholipid antibodies (APLA) in systemic sclerosis (SSc).METHODS: Nine hundred and forty SSc patients were tested for APLA using an ELISA assay at recruitment. Clinical manifestations were defined as present, if ever present from SSc diagnosis. Logistic regression analysis was used to determine the associations of APLA.RESULTS: One or more types of APLA were present in 226 (24.0%) patients. Anticardiolipin (ACA) IgG (ACA-IgG) antibodies were associated with right heart catheter-diagnosed pulmonary arterial hypertension (PAH), with higher titres corresponding with a higher likelihood of PAH (moderate titre (20-39 U/ml) ACA-IgG odds ratio [OR] 1.70, 95% CI: 1.01-2.93, p=0.047; high titre (>40 U/ml) ACA-IgG OR 4.60, 95% CI:1.02-20.8, p=0.047). Both ACA-IgM (OR 2.04, 95% CI: 1.4-3.0, p<0.0001) and ACA-IgG (OR 1.84, 95% CI: 1.2-2.8, p=0.005) were associated with interstitial lung disease (ILD). Increasing ACA-IgM and IgG titres were associated with increased likelihood of ILD. ACA-IgG was a marker of coexistent pulmonary hypertension and ILD (ILD-PH) (OR 2.10, 95% CI: 1.1-4.2, p=0.036). We also found an association between ACA-IgG and digital ulcers (OR 1.76, 95% CI: 1.16-2.67, p=0.008) and ACA-IgM and Raynaud's phenomenon (OR 2.39, 95% CI: 1.08-5.27, p=0.031). There was no association between APLA and SSc disease subtype, peak skin score, presence of other autoantibodies, mortality or other disease manifestations.CONCLUSIONS: The association of APLA with PAH, ILD, ILD-PH, Raynaud's phenomenon and digital ulcers suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features.

AB - OBJECTIVES: To determine the prevalence and correlates of antiphospholipid antibodies (APLA) in systemic sclerosis (SSc).METHODS: Nine hundred and forty SSc patients were tested for APLA using an ELISA assay at recruitment. Clinical manifestations were defined as present, if ever present from SSc diagnosis. Logistic regression analysis was used to determine the associations of APLA.RESULTS: One or more types of APLA were present in 226 (24.0%) patients. Anticardiolipin (ACA) IgG (ACA-IgG) antibodies were associated with right heart catheter-diagnosed pulmonary arterial hypertension (PAH), with higher titres corresponding with a higher likelihood of PAH (moderate titre (20-39 U/ml) ACA-IgG odds ratio [OR] 1.70, 95% CI: 1.01-2.93, p=0.047; high titre (>40 U/ml) ACA-IgG OR 4.60, 95% CI:1.02-20.8, p=0.047). Both ACA-IgM (OR 2.04, 95% CI: 1.4-3.0, p<0.0001) and ACA-IgG (OR 1.84, 95% CI: 1.2-2.8, p=0.005) were associated with interstitial lung disease (ILD). Increasing ACA-IgM and IgG titres were associated with increased likelihood of ILD. ACA-IgG was a marker of coexistent pulmonary hypertension and ILD (ILD-PH) (OR 2.10, 95% CI: 1.1-4.2, p=0.036). We also found an association between ACA-IgG and digital ulcers (OR 1.76, 95% CI: 1.16-2.67, p=0.008) and ACA-IgM and Raynaud's phenomenon (OR 2.39, 95% CI: 1.08-5.27, p=0.031). There was no association between APLA and SSc disease subtype, peak skin score, presence of other autoantibodies, mortality or other disease manifestations.CONCLUSIONS: The association of APLA with PAH, ILD, ILD-PH, Raynaud's phenomenon and digital ulcers suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features.

UR - http://www.scopus.com/inward/record.url?scp=85006257675&partnerID=8YFLogxK

M3 - Article

SN - 0392-856X

VL - 32

SP - S-133-7

JO - Clinical and Experimental Rheumatology

JF - Clinical and Experimental Rheumatology

IS - 6

ER -

The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis

Abstract

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