Role of anti-annexin V antibodies in peripheral vascular ischemia of systemic sclerosis patients

ABSTRACT

To evaluate the role of a-AXVAbs IgG isotype in SSc and correlate it with peripheral microvascular and macrovascular affection. This study was conducted on 20 SSc female patients and 10 healthy controls. Clinical assessment was performed especially for peripheral vascular affection. ACL [IgG, IgM], Anti Scl-70 and a-AXV Abs were measured by ELISA and AC A by IIP. NFC and Doppler U/S were done. Diffuse SSc found in 11 patients and limited in 9 patients. A-AXV Abs were +ve in 19 patients, mean +/- SD 14.6 +/- 5.2, a highly significant increase compared to controls [t=5.3p<0.001]. There was no significant difference between diffuse and limited SSc [t-1.47 and p>0.05]. Patients were classified into 2 groups according to presence or absence of peripheral vascular affection Group I, included 12 and Group II 8 patients. There was a highly significant difference between them regarding duration of RP [p<0.001], a significant difference regarding a-AXV Abs [p<0.05], but no such regarding ACL [IgG and IgM], anti-Scl-70 or anti-ACA. Within group I, there was a significant positive correlation between a-AXV Abs and disease duration, RP and ACL [IgG and, IgM] [p<0.05]. NFC showed scleroderma pattern early 5%, active 75% and late 20%.Comparing a-AXV Abs in them, a highly significant difference in active and late [p<0.001]. Doppler US showed irregular thickening in carotid arteries, stenosis and calcification in ulnar and calcification and irregular thickening in femoral and popliteal arteries. A highly significant increase of a-AXV Abs in ulnar artery stenosis [p<0.001]. Measurement of a-AXV Abs in SSc can discriminate patients with vascular affection from those without it, with specificity 62.5%, and sensitivity 91.7%. Peripheral micro and macrovascular affection should be assessed