NEUT-RI, a surrogate marker of NETosis is lower in patients with strong IgM antiphospholipid antibodies

Journal of Thrombosis and Thrombolysis(2024)

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Abstract
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. 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. 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. Our data are in line with the recent questioning about the putative clinical consistency of positive solid-phase aPL IgM. 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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Key words
Antiphospholipid syndrome,Antiphospholipid antibodies,Fluorescence signal intensity,Immunoglobulin M,NETosis
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