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AB0083 Antiphospholipid Syndrome and Marcers of Inflamation
  1. N. Seredavkina1,
  2. T. Reshetnyak1,
  3. M. Satybaldyeva1,
  4. Z. Verizhnikova2,
  5. E. Alexandrova2,
  6. A. Novikov2,
  7. E. Nasonov1
  1. 1Department of Systemic Connective Tissue Diseases
  2. 2Department of Immunology and Molecular Biology of Rheumatic Diseases, Nasonova Research Institute of Rheumatology, Moscow, Russian Federation


Background Last years the reasons of earlier and more frequent atherosclerosis and cardiovascular/cerebrovascular disorders in rheumatic diseases and also the participation of antiphospholipid antibodies (aPL) in atherothrombosis are up for debate. Analysis of blood concentration of deferent autoantibodies, acute-phase reactants and lipid profile as well as investigation of traditional and nontraditional risk factors and intima-media thickness in patient (pts) with antiphospholipid syndrome (APS) is topical for the understanding of the role of atherosclerosis in APS.

Objectives To investigate levels of high sensitive CRP (hs-CRP), interleukin 6 (IL 6), tumor necrosis factor α (TNFα), soluble TNFα-receptor 1 (sTNFα-R1) and intercellular adhesion molecule 1 (ICAM-1) in APS pts.

Methods The total of 96 APS pts (52 with primary APS (PAPS) and 44 with SLE+APS) and 29 age– and sex–matched healthy controls (HC) were included. Thromboses in past history were registered in 83/96 (86%) pts: in 21 – arterial (AT), in 38 – venous (VT), in 24 – AT+VT. Serum markers of inflammation and endothelial cells activation were measured: IL 6 – in 89 pts and 20 HC, TNFα – in 73 pts and 20 HC, sTNFα-R1 – in 90 pts and 28 HC and ICAM-1 – in 66 pts and 20 HC, respectively. All the pts underwent electrocardiography, echocardiography, Holter monitoring, ultrasonography and laboratory testing including aPL, hs-CRP and lipid profile of plasma.

Results Serum levels of hs-CRP, IL 6, TNFα, sTNFα-R1 and ICAM-1 were significantly higher in pts compared to HC (p<0.05 in all cases). Levels of IL 6 and sTNFα-R1 in PAPS pts were lower than in SLE+APS pts (1.01 [0.27; 1.90] pg/ml; 2.43 [1.05; 4.13] ng/ml vs 2.30 [1.90; 3.30] pg/ml; 3.89 [2.20; 6.00] ng/ml respectively, p<0.05). Concentration of ICAM-1 was significantly higher in pts with VT than in pts with AT, with AT+VT and without T (445.2 [342.7; 426.4] vs 316.0 [282.3; 349.4] vs 356.7 [327.2; 383.4] vs 344.1 [314.2; 379.2] ng/ml, respectively; p=0.04). Coronary heart disease (CHD) positively associated with increased levels of sTNFα-R1: CHD was diagnosed in 17/45 pts with elevated sTNFα-R1 levels and in 3/45 pts with normal sTNFα-R1 levels (OR 2.13 [95%IC 1.51; 2.99], p<0.001). During the first year after thrombosis there was an inverse association between postthrombotic time duration (PTTD) and IL 6 and TNFα: increased levels of IL 6 and TNFα were detected in 4/4 (100%) and 8/15 (53%) pts with acute thrombosis (PTTD ≤1 week), in 15/16 (94%) and 5/5 (100%) pts with 1<6 months and in 12/12 (100%) and 19/21 (90%) pts with 6<12, respectively, p<0.05 in all cases. Levels of IL 6 (3.36 [2.33; 4.13] pg/ml) and TNFα (5.75 [3.19; 8.28] ng/ml) in pts with PTTD ≤1 week were higher than in pts with 1<6 months (IL 6 =1.88 [1.14; 4.08] ng/ml and TNFα =4.53 [3.55; 6.81] ng/ml) and 6<12 months (IL 6 =1.72 [1.01; 2.86] pg/ml and TNFα =2.9 [1.96; 3.49] ng/ml), p<0.05 in all cases.

Conclusions Serum levels of hsC-RP, IL 6, TNFα, sTNFα-R1 and ICAM-1 were significantly elevated in pts compared to HC. ICAM-1 level was higher in pts with VT than pts with AT, AT+VT and without T. Increased level of sTNFα-R1 was associated with CHD. During the first year after thrombosis there was an strong inverse association between postthrombotic time duration and IL 6 and TNFα. Increased levels of IL 6 and TNFα are reflective of subclinical inflammation.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5737

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