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High IgA antiphospholipid autoantibodies in healthy Sudanese explain the increased prevalence among Sudanese compared to Swedish systemic lupus erythematosus patients.


ABSTRACT: OBJECTIVES:IgA antiphospholipid antibodies (aPL) are prevalent in systemic lupus erythematosus (SLE) patients of African American, Afro-Caribbean and South African origin. Nevertheless, data from North Africa are lacking, and most studies use manufacturer-suggested cut-offs based on Caucasian controls. Therefore, we compared aPL isotypes in Sudanese and Swedish SLE patients using nation-based cut-offs. METHODS:Consecutive SLE patients and age- and sex-matched controls from Sudan (N?=?115/106) and Sweden (N?=?340/318) were included. All patients fulfilled the 1982 American College of Rheumatology SLE classification criteria. Antiphospholipid syndrome-related events were obtained from patients' records. IgA/G/M anticardiolipin and anti-?2 glycoprotein I (?2GPI) were analysed with two independent assays. IgA anti-?2GPI domain 1 (D1) was also investigated. Manufacturers' cut-offs and the 95th and 99th percentile cut-offs based on national controls were used. RESULTS:Sudanese patients and controls had higher levels and were more often positive for IgA aPL than Swedes when using manufacturers' cut-offs. In contrast, using national cut-offs, the increase in IgA aPL among Sudanese patients was lost. Occurrence of IgA anti-D1 did not differ between the countries. Venous thromboses were less common among Sudanese patients and did not associate with aPL. No clinical associations were observed with IgA anti-?2GPI in Sudanese patients. Thromboses in Swedes were associated with IgG/M aPL. Fetal loss was associated with aPL in both cohorts. CONCLUSIONS:IgA anti-?2GPI prevalence was higher among Sudanese compared to Swedish patients when manufacturers' cut-offs were used. This situation was reversed when applying national cut-offs. Anti-D1 was not increased in Sudanese patients. Previous studies on populations of African origin, which demonstrate a high prevalence of IgA aPL positivity, should be re-evaluated using a similar cut-off approach.

SUBMITTER: Elbagir S 

PROVIDER: S-EPMC7536526 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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High IgA antiphospholipid autoantibodies in healthy Sudanese explain the increased prevalence among Sudanese compared to Swedish systemic lupus erythematosus patients.

Elbagir Sahwa S   Elshafie Amir I AI   Elagib Elnour M EM   Mohammed NasrEldeen A NA   Aledrissy Mawahib Ie MI   Manivel Vivek Anand VA   Pertsinidou Eleftheria E   Nur Musa Am MA   Gunnarsson Iva I   Svenungsson Elisabet E   Rönnelid Johan J  

Lupus 20200802 11


<h4>Objectives</h4>IgA antiphospholipid antibodies (aPL) are prevalent in systemic lupus erythematosus (SLE) patients of African American, Afro-Caribbean and South African origin. Nevertheless, data from North Africa are lacking, and most studies use manufacturer-suggested cut-offs based on Caucasian controls. Therefore, we compared aPL isotypes in Sudanese and Swedish SLE patients using nation-based cut-offs.<h4>Methods</h4>Consecutive SLE patients and age- and sex-matched controls from Sudan (  ...[more]

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2016-03-07 | GSE69372 | GEO