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Antiphospholipid Antibody Testing for Anti-cardiolipin and Anti-β2 Glycoprotein I Antibodies Using Chemiluminescence-Based Panels

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Hemostasis and Thrombosis

Part of the book series: Methods in Molecular Biology ((MIMB,volume 2663))

Abstract

Antiphospholipid (antibody) syndrome (APS) is a prothrombotic condition with increased risk for thrombosis and pregnancy-related morbidity. In addition to clinical criteria related to these risks, APS is characterized by the persistent presence of antiphospholipid antibodies (aPL), as detected in the laboratory using a potentially wide variety of assays. The three APS criteria-related assays are lupus anticoagulant (LA), as detected using clot-based assays, and the solid-phase assays of anti-cardiolipin antibodies (aCL) and anti-β2 glycoprotein I antibodies (aβ2GPI), with immunoglobulin subclasses of IgG and/or IgM. These tests may also be used for the diagnosis of systemic lupus erythematosus (SLE). In particular, APS diagnosis/exclusion remains challenging for clinicians and laboratories because of the heterogeneity of clinical presentations in those being evaluated and the technical application and variety of the associated tests used in laboratories. Although LA testing is affected by a wide variety of anticoagulants, which are often given to APS patients to prevent any associated clinical morbidity, detection of solid-phase aPL is not influenced by these anticoagulants, and this thus represents a potential advantage to their application. On the other hand, various technical issues challenge accurate laboratory detection or exclusion of aPL. This report describes protocols for the assessment of solid-phase aPL, specifically aCL and aβ2GPI of IgG and IgM class by means of a chemiluminescence-based assay panel. These protocols reflect tests able to be performed on the AcuStar instrument (Werfen/Instrumentation Laboratory). Certain regional approvals may also allow this testing to be performed on a BIO-FLASH instrument (Werfen/Instrumentation Laboratory).

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Abbreviations

aPL:

antiphospholipid antibodies

aCL:

anti-cardiolipin antibodies

aβ2GPI:

anti-β2 glycoprotein I antibodies

APS:

antiphospholipid syndrome

CLIA:

chemiluminescence immunoassay

LA:

lupus anticoagulant

SLE:

systemic lupus erythematosus

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Acknowledgments

The authors thank current laboratory and past staff for the regular performance of these aPL assays in the Westmead laboratory. We also thank Werfen/IL for past assistance with CLIA-based assay evaluations performed in our laboratory.

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Authors and Affiliations

  1. Haematology Department, Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital, Westmead, NSW, Australia

    Soma Mohammed, Ronny Vong & Leonardo Pasalic

  2. Sydney Centres for Thrombosis and Haemostasis, Westmead, NSW, Australia

    Leonardo Pasalic

  3. School of Medical Sciences, Faculty of Medicine and Health University of Sydney, Westmead Hospital, Westmead, NSW, Australia

    Emmanuel J. Favaloro

  4. Westmead Clinical School, Sydney University, Westmead, NSW, Australia

    Leonardo Pasalic

  5. School of Dentistry and Medical Sciences, Faculty of Science and Health, Charles Sturt University, Wagga, Wagga, NSW, Australia

    Emmanuel J. Favaloro

Authors
  1. Emmanuel J. Favaloro
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  2. Soma Mohammed
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  3. Ronny Vong
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  4. Leonardo Pasalic
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Corresponding author

Correspondence to Emmanuel J. Favaloro .

Editor information

Editors and Affiliations

  1. School of Medical Sciences, Faculty of Medicine and Health University of Sydney, Westmead Hospital, Westmead, NSW, Australia

    Emmanuel J. Favaloro

  2. Hemostasis & Thrombosis Center, University of California, Davis, Sacramento, CA, USA

    Robert C. Gosselin

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Favaloro, E.J., Mohammed, S., Vong, R., Pasalic, L. (2023). Antiphospholipid Antibody Testing for Anti-cardiolipin and Anti-β2 Glycoprotein I Antibodies Using Chemiluminescence-Based Panels. In: Favaloro, E.J., Gosselin, R.C. (eds) Hemostasis and Thrombosis. Methods in Molecular Biology, vol 2663. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-3175-1_19

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  • DOI: https://doi.org/10.1007/978-1-0716-3175-1_19

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  • Publisher Name: Humana, New York, NY

  • Print ISBN: 978-1-0716-3174-4

  • Online ISBN: 978-1-0716-3175-1

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