Independent association of low IFNλ1 gene expression and type I IFN score/IFNλ1 ratio with obstetric manifestations and triple antiphospholipid antibody positivity in primary antiphospholipid syndrome

2019 ◽  
Vol 209 ◽  
pp. 108265 ◽  
Author(s):  
Christina-Maria Flessa ◽  
Stelios Vlachiotis ◽  
Adrianos Nezos ◽  
Evangelos Andreakos ◽  
Clio P. Mavragani ◽  
...  
2016 ◽  
Vol 76 (2) ◽  
pp. 450-457 ◽  
Author(s):  
Robert C Grenn ◽  
Srilakshmi Yalavarthi ◽  
Alex A Gandhi ◽  
Nayef M Kazzaz ◽  
Carlos Núñez-Álvarez ◽  
...  

ObjectivesPatients with antiphospholipid syndrome (APS) are at risk for subclinical endothelial injury, as well as accelerated atherosclerosis. In the related disease systemic lupus erythematosus, there is a well-established defect in circulating endothelial progenitors, which leads to an accrual of endothelial damage over time. This defect has been at least partially attributed to exaggerated expression of type I interferons (IFNs). We sought to determine whether these pathways are important in APS.MethodsWe studied 68 patients with primary APS. Endothelial progenitors were assessed by flow cytometry and functional assay. Type I IFN activity was determined by a well-accepted bioassay, while peripheral blood mononuclear cells were scored for expression of IFN-responsive genes.ResultsEndothelial progenitors from patients with APS demonstrated a marked defect in the ability to differentiate into endothelial cells, a phenotype which could be mimicked by treating control progenitors with APS sera. Elevated type I IFN activity was detected in the circulation of patients with APS (a finding that was then replicated in an independent cohort). While IgG depletion from APS sera did not rescue endothelial progenitor function, the dysfunction was successfully reversed by a type I IFN receptor-neutralising antibody.ConclusionsWe describe, for the first time to our knowledge, an IFN signature in primary APS and show that this promotes impaired endothelial progenitor function. This work opens the door to novel approaches that may mitigate vascular damage in APS, such as anti-IFN drugs.


Lupus ◽  
2019 ◽  
Vol 28 (7) ◽  
pp. 868-877 ◽  
Author(s):  
A Högdén ◽  
A Antovic ◽  
E Berg ◽  
K Bremme ◽  
R Chaireti

Introduction: Previous studies suggested different obstetric outcomes between patients with thrombotic or obstetric antiphospholipid syndrome, but the data are inconclusive. Aims: To investigate obstetric outcomes and their relation to the antiphospholipid antibody profile in primary thrombotic or obstetric antiphospholipid syndrome patients and compare those to a control population. Materials and methods: A retrospective single-centre study on a cohort of 30 pregnant women with primary antiphospholipid syndrome treated at Karolinska University Hospital Solna, Sweden between 2000 and 2016. The pregnancy outcomes were compared to the outcomes of all pregnancies in Stockholm County during the same period. Results: Preeclampsia ( p < 0.001), low birth weight at delivery ( p = 0.001), Apgar < 7 at 5 minutes ( p < 0.001) and small infants ( p < 0.001) were more common in antiphospholipid syndrome patients compared to controls. Obstetric antiphospholipid syndrome patients had a higher incidence of small infants ( p = 0.023), lower birth weight ( p = 0.013) and infants born with complications ( p=0.004) compared to thrombotic antiphospholipid syndrome. Mothers with triple antibody positivity had a higher incidence of preeclampsia ( p = 0.03), preterm delivery ( p = 0.011), small infants ( p=0.002) and infants born with complications ( p = 0.012). Conclusions: Patients with primary antiphospholipid syndrome, especially those with obstetric antiphospholipid syndrome and triple antibody positivity, are at higher risk for adverse pregnancy outcomes, even under antithrombotic treatment. More frequent antenatal controls in high-risk patients can further improve outcomes.


2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Stathis Tsiakas ◽  
Chrysanthi Skalioti ◽  
Paraskevi Kotsi ◽  
Ioannis Boletis ◽  
Smaragdi Marinaki

ABSTRACT Antiphospholipid syndrome (APS) is a systemic autoimmune disease defined by the presence of antiphospholipid antibodies in association with thrombotic events and/or obstetric complications. Renal involvement is not infrequent in both primary and secondary APS. Kidney manifestations comprise a wide range of clinical features, including hypertension, major renal vessel thrombosis or microvascular endothelial injury, also described as APS nephropathy. In the absence of a thrombotic event, clinical manifestations of APS are often non-specific. We recently encountered a case of primary APS in a young male with newly diagnosed hypertension and renal impairment. The diagnosis of APS was initially suspected by his kidney biopsy findings, when electron microscopy examination showed the features of chronic microangiopathy, and was later confirmed by a triple positive antiphospholipid antibody profile and multiple organ involvement.


2017 ◽  
Vol 216 (5) ◽  
pp. 525.e1-525.e12 ◽  
Author(s):  
Gabriele Saccone ◽  
Vincenzo Berghella ◽  
Giuseppe Maria Maruotti ◽  
Tullio Ghi ◽  
Giuseppe Rizzo ◽  
...  

2019 ◽  
Vol 18 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Michelle Remião Ugolini-Lopes ◽  
Giovana Tardin Torrezan ◽  
Ana Paula Rossi Gândara ◽  
Eloisa Helena Ribeiro Olivieri ◽  
Iana Souza Nascimento ◽  
...  

2018 ◽  
Vol 24 (8) ◽  
pp. 490-500 ◽  
Author(s):  
Nam V Nguyen ◽  
James T Tran ◽  
David Jesse Sanchez

This study investigates the modulation of Type I IFN induction of an antiviral state by HIV. IFNs, including IFN-α, are key innate immune cytokines that activate the JAK/STAT pathway leading to the expression of IFN-stimulated genes. IFN-stimulated gene expression establishes the antiviral state, limiting viral infection in IFN-α-stimulated microenvironments. Our previous studies have shown that HIV proteins disrupt the induction of IFN-α by degradation of IFN-β promoter stimulator-1, an adaptor protein for the up-regulation and release of IFN-α into the local microenvironment via the retinoic acid-inducible gene 1-like receptor signaling pathway. However, IFN-α is still released from other sources such as plasmacytoid dendritic cells via TLR-dependent recognition of HIV. Here we report that the activation of the JAK/STAT pathway by IFN-α stimulation is disrupted by HIV proteins Vpu and Nef, which both reduce IFN-α induction of STAT1 phosphorylation. Thus, HIV would still be able to avoid antiviral protection induced by IFN-α in the local microenvironment. These findings show that HIV blocks multiple signaling points that would lead to the up-regulation of IFN-stimulated genes, allowing more effective replication in IFN-α-rich environments.


Autoimmunity ◽  
1991 ◽  
Vol 9 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Josep Font ◽  
Alfons Loapez-Soto ◽  
Ricard Cervera ◽  
Joan Balasch ◽  
Lucio Pallarés ◽  
...  

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2972-2972
Author(s):  
Thomas L. Ortel ◽  
Fatih Cagri Sarikaya ◽  
Ahmet Alptekin ◽  
Karen E. Hansen ◽  
Robert A.S. Roubey ◽  
...  

Abstract Abstract 2972 Poster Board II-950 Background: Antiphospholipid syndrome (APS) is characterized by venous and/or arterial thromboembolic events, recurrent fetal loss, and persistently elevated antiphospholipid antibody (aPL) levels. Familial clustering of individuals with elevated aPL levels occurs, and up to 37% of patients with APS have one or more relatives with at least one clinical feature of APS. Individuals with elevated aPL levels or APS are also frequently identified in families with other autoimmune (AI) disorders, such as lupus or rheumatoid arthritis. Individuals with different autoimmune disorders appear to share common susceptibility loci, suggesting that a common set of susceptibility genes may contribute to clinically distinct autoimmune disorders. To investigate the heritability of APS, we are enrolling patients with APS who have one or more family members affected by APS (multiplex APS) or by other, non-APS, autoimmune disorders (multiplex AI). This study summarizes clinical characteristics of probands and family members enrolled to date in these two groups. Methods: Probands meeting clinical and laboratory criteria for APS (Miyakis, et al. J.Thromb.Haemost, 2006;4: 295-306) who had at least one clinically affected relative positive for either APS or another autoimmune disorder (e.g., lupus, rheumatoid arthritis) were recruited and enrolled into the study. A detailed personal and family history was obtained and relevant family members were also approached to participate in the study. Blood specimens were collected for genetic, serologic, and coagulation testing. Results: Review of more than 200 potential participants identified 13 probands with multiplex APS families and 49 with multiplex AI families. Probands from both groups more frequently had primary rather than secondary APS, and thromboembolic events were the most common clinical manifestation. Catastrophic APS was reported in 1 multiplex APS proband and 4 multiplex AI probands. Proband characteristics are summarized in the Table. In the multiplex APS families, 1 to 3 family members had APS, and the most common clinical manifestation was thromboembolism. In addition, 8 multiplex APS families also had one or more family members who were affected with other autoimmune disorders, most commonly lupus and rheumatoid arthritis. In the multiplex AI families, 1 to 8 family members were affected by a variety of autoimmune disorders, including lupus, Hashimoto's disease, Sjögren's syndrome, rheumatoid arthritis, myasthenia gravis, type I diabetes mellitus, and other diseases. Affected family members most commonly included siblings and/or parents of the probands. Conclusions: In the participants enrolled to date, probands with APS who belonged to multiplex APS or multiplex AI families most commonly had primary APS, and thromboembolic complications were the most common clinical manifestation. Families that were multiplex AI were more common than families that included more than one family member affected with APS, and families that were multiplex APS frequently included members that had other autoimmune disorders. Disclosures: No relevant conflicts of interest to declare.


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