Abstract
Background
Antiphospholipid antibody syndrome (APS) is an acquired autoimmune disorder characterized by recurrent venous or arterial thrombosis and/or pregnancy complications. Recently, thrombotic APS was linked to increased neutrophil extracellular traps (NET) formation, suggesting an association between NETs and the severity of APS-related thrombosis.
Methods
We performed a retrospective study on patients tested for presence of antiphospholipid antibodies (990 negative and 374 positive) to evaluate the association between the neutrophil activation state, estimated by the neutrophil reactive index (NEU-RI), a parameter routinely available from some haematology analysers, and antiphospholipid antibodies.
Results
We do not observe a difference in NEU-RI values between positive and negative patients globally. However, interestingly, we highlight an association between high titers of IgM and low NEU-RI values indicating a lower neutrophil activation.
Conclusion
Our data are in line with the recent questioning about the putative clinical consistency of positive solid-phase aPL IgM.
Bullet points
NEUT-RI is described as an accurate biomarker of neutrophil activation.
High-titers of anti-phospholipid IgM is associated with lower NEUT-RI values.
Lower NEUT-RI values suggest lower neutrophil activation in these patients.
High titers of anticardiolipin IgG are associated with higher NEUT-RI values.
IgM aPL positivity may constitute a distinct entity obeying a different mechanism.
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Acknowledgements
We wish to thank all the staff at the hematology department for performing the biological analyses. We also thank the research team at the “Direction de la Recherche Clinique et de l’Innovation” at Nîmes University Hospital. We also thank Teresa Sawyers, Medical Writer at the BESPIM, Nîmes University Hospital, France, for her expert editorial assistance.
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S.B. and M.F. analyzed the data and wrote the paper. É. N. supervised the laboratory activity. A.O. and M.C. performed the research. J.C.G. designed the research, performed the statistical analysis and wrote the paper.
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Bouvier, S., Fortier, M., Nouvellon, E. et al. NEUT-RI, a surrogate marker of NETosis is lower in patients with strong IgM antiphospholipid antibodies. J Thromb Thrombolysis (2024). https://doi.org/10.1007/s11239-024-03001-1
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DOI: https://doi.org/10.1007/s11239-024-03001-1