Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Elevated Cytokines and Chemokine Levels in Antiphospholipid Antibody (aPL)-Positive Patients.

L. Murthy,  Vijaya, Jatwani,  Shraddha, A. Aguilar-Valenzuela,  Renan, D. Doan,  Ellis, Papalardo,  Elizabeth, B. Gonzalez,  Emilio, S. Pierangeli,  Silvia


Based on in vitro and animal studies, certain cytokines and chemokines such as tissue factor (TF), vascular endothelial growth factor (VEGF), soluble (s) E-selectin (sE-sel), and tumor necrosis factor (TNF)-a have been shown to be associated with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). Here we examined the levels of cytokines/chemokines in aPL-positive patients with or without SLE, and compared them to controls.


Baseline sera/plasma of persistently aPL-positive patients [IgG/M Anticardiolipin antibody (aCL) > 40U, IgG/M anti-b2 glycoprotein-I antibody (ab2GPI) > 20U, and/or positive lupus anticoagulant test] were obtained from an ongoing pilot interventional clinical study (clinical trials. gov #: NCT00674297). The biomarker levels of these 22 aPL-positive patients (primary APS: 8, APS with SLE: 8, asymptomatic aPL without SLE: 4 and asymptomatic aPL with SLE: 2) were compared to 22 matched healthy controls with no evidence of autoimmune, infectious, or inflammatory diseases. Interleukin (IL)-1b, IL6, IL8, TNF-a, VEGF, interferon inducible protein (IP)-10 and sCD40L were measured in serum using a Multiplex Assay (Millipore Milliplex™); titers of sE-sel, and sTF were detected by ELISA. The Kruskal-Wallis test was used to compare the levels of biomarkers in aPL-positive subjects as compared to the controls. Spearman test was used to correlate the levels of the biomarkers in the different subgroups of patients.


As compared to controls, we found an increase in the levels of IL-1b, IL6, TNF- a, IP-10, sCD40L and sTF in patients with APS. In a subgroup analysis, patients with aPL/APS and SLE (n=10) had significantly higher levels of TNF-a, IP10 and sCD40L as compared to aPL/APS patients without SLE (n=12) (p= 0.05, 0.029 and 0.05, respectively).

Biomarker# Of aPL (+) samples elevated above cut-off points/(%)Means of aPL positive samplesMeans of controlsp
IL1b16/22 (73)7.650.35<0.0001
IL617/22 (77)42.150.71<0.0001
IL89/22 (41)27.4440.870.1763
TNF-a22/22 (100)14.710.46<0.0001
VEGF12/22 (54)208.78113.590.9778
IP-1022/22 (100)683.43106.7<0.0001
sCD40L21/22 (95)1070.1924.67<0.0001
s TF16/16 (100)449.5913.05<0.0001
sE-sel3/16 (19)20.7842.040.0006


Our results underscore the importance of biomarkers in aPL-positive patients. This may help better understand the pathogenic mechanisms involved, and the development of targeted treatments.

To cite this abstract, please use the following information:
L. Murthy, Vijaya, Jatwani, Shraddha, A. Aguilar-Valenzuela, Renan, D. Doan, Ellis, Papalardo, Elizabeth, B. Gonzalez, Emilio, et al; Elevated Cytokines and Chemokine Levels in Antiphospholipid Antibody (aPL)-Positive Patients. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2253
DOI: 10.1002/art.30016

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