Patients with antiphospholipid syndrome display endothelial perturbation

Massimo Cugno, Maria Orietta Borghi, Laura Maria Lonati, Lorenzo Ghiadoni, Maria Gerosa, Claudia Grossi, Valentina De Angelis, Gaia Magnaghi, Angela Tincani, Daniela Mari, Piersandro Riboldi, Pier Luigi Meroni

Research output: Contribution to journalArticle


Background: There is strong evidence that antiphospholipid antibodies (aPL) perturb endothelium both in vitro and in experimental animal models. by inducing a vasculopathy and an endothelial pro-inflammatory/coagulant phenotype. However, few contrasting studies raised the issue about the possibility to detect a comparable endothelial perturbation in anti-phospholipid syndrome (APS) patients. The aim of this observational case-control study was to evaluate several parameters of endothelial perturbation in patients with APS and without any other atherosclerosis risk factor. Patients and Methods: We investigated plasma levels of soluble adhesion molecules (s-ICAM-1, s-VCAM-1, s-E-selectin), soluble thrombomodulin (sTM), von Willebrand factor (vWF) and tissue plasminogen activator (t-PA) by solid-phase assays in 40 selected APS patients and 40 age- and sex-matched healthy subjects. In addition, we evaluated circulating endothelial cells by flow cytometry and brachial artery flow-mediated vasodilation. Patients and controls were free of conditions known to affect both the biological and the functional endothelial parameters. Results: Plasma levels of sTM, s-E-selectin and s-VCAM-1 did not differ from controls, while a significant increase in s-ICAM-1 (P = 0.029), t-PA (P = 0.003) and vWF titres (P = 0.002) was found. Circulating mature endothelial cells were also significantly higher in patients than in controls (P = 0.05) and decreased during both vitamin K antagonists (P = 0.001) and antiplatelet (P = 0.032) treatments. Mean brachial artery flow-mediated vasodilation responses were significantly impaired compared to healthy subjects (P = 0.0001). Conclusions: As a whole these findings indicate that APS patients display an endothelial perturbation in the absence of other detectable traditional risk factors for atherosclerosis.

Original languageEnglish
Pages (from-to)105-110
Number of pages6
JournalJournal of Autoimmunity
Issue number2
Publication statusPublished - Mar 2010


  • Adhesion molecules
  • Anti-phospholipid syndrome
  • Endothelium
  • Risk factors

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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    Cugno, M., Borghi, M. O., Lonati, L. M., Ghiadoni, L., Gerosa, M., Grossi, C., De Angelis, V., Magnaghi, G., Tincani, A., Mari, D., Riboldi, P., & Meroni, P. L. (2010). Patients with antiphospholipid syndrome display endothelial perturbation. Journal of Autoimmunity, 34(2), 105-110.