Objectives To assess the prevalence and clinical significance of autoantibodies against lysobisphophatidic acid (aLBPA) in patients with antiphospholipid syndrome (APS). Methods We conducted a retrospective analysis involving 91 patients with persistent conventional antiphospholipid antibodies (aPL): 60 patients with at least one clinical event of APS (symptomatic group) and 31 without (asymptomatic group), as well as 33 aPL-negative controls. Detection of aLBPA in serum samples was performed using an enzyme-linked immunosorbent assay (ELISA) specifically designed for this study. Results The prevalence of aLBPA is significantly higher in patients with persistent aPL than that of the control group (p< 0.0001). Among patients with persistent aPL, our findings reveal a significantly higher prevalence of aLBPA in asymptomatic patients compared with their symptomatic counterparts (p= 0.027). Notably, patients positive for IgG aPL alone demonstrated a greater likelihood of presenting clinical events suggestive of APS. Conclusion The combined assay of aLBPA and conventional aPL could be used to stratify patients with persistent aPL. This combined approach could serve as a valuable tool in the management of this complex autoimmune disease, particularly in guiding decisions regarding the initiation of primary thromboprophylaxis in asymptomatic patients with persistent aPL.

中文翻译：

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抗磷脂综合征中针对溶血二磷酸的自身抗体的患病率和临床价值


目的 评估抗磷脂综合征 （APS） 患者溶血二磷酸酯酸 （aLBPA） 自身抗体的患病率和临床意义。方法 我们进行了回顾性分析，涉及 91 例持续性常规抗磷脂抗体 （aPL） 患者： 60 例至少有 1 例 APS 临床事件的患者 （症状组） 和 31 例无临床事件 （无症状组），以及 33 例 aPL 阴性对照。使用专为本研究设计的酶联免疫吸附测定 （ELISA） 检测血清样本中的 aLBPA。结果 持续性 aPL 患者 aLBPA 患病率显著高于对照组 （p< 0.0001）。在持续性 aPL 患者中，我们的研究结果显示，与有症状的患者相比，无症状患者的 aLBPA 患病率显着更高 （p= 0.027）。值得注意的是，单独 IgG aPL 阳性的患者表现出出现提示 APS 的临床事件的可能性更大。结论 aLBPA 与常规 aPL 联合检测可用于对持续性 aPL 患者进行分层。这种联合方法可以作为管理这种复杂自身免疫性疾病的宝贵工具，特别是在指导无症状持续性 aPL 患者开始一级血栓预防的决策时。