Journal Article Ahead of print
PubMed: 41233954 DOI: 10.1177/09612033251396268
A high level of sTREM-1 predicts occurrence of thrombosis, obstetrical event or death in a prospective cohort of patients with antiphospholipid antibodies and/or systemic lupus. Results of the APLART study.
Lupus
Authors: Virginie Dufrost, Thomas Foret, Thomas Moulinet, Jeremy Lagrange, Adrien Jacquot, Cédric Baumann, Isabelle Clerc-Urmès, Valérie Eschwège, Cécile Lakomy, Katrien M J Devreese, Patrick Lacolley, Veronique Regnault, Sébastien Gibot, Stéphane Zuily, Denis Wahl
Affiliations
- CHRU-Nancy, Vascular Medicine Division and National Referral Centre For Rare Vascular and Systemic Autoimmune Diseases, Nancy, France.
- Université de Lorraine, INSERM, DCAC, Nancy, France.
- Department of Internal Medicine and Clinical Immunology, Regional Competence Center For Rare Systemic Autoimmune Diseases, Nancy University Hospital, Nancy, France.
- CHRU-Nancy, F-54000 Nancy, France.
- Imaging Department, Nancy University Hospital, Nancy, France.
- Methodology, Data Management Ant Statistic Unit, MPI Department, Nancy University Hospital, Nancy, France.
- Hematology Laboratory, CHRU de Nancy-, Nancy, France.
- Coagulation Laboratory, Ghent University Hospital, Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.
- Medical Intensive Care Unit, Nancy University Hospital, Nancy, France.
Abstract
ObjectivesThe main challenge in the care of patients with primary antiphospholipid syndrome (APS) or associated to systemic lupus erythematosus (SLE) is to determine whether patients will experience new events that may impair their clinical outcome. Triggering receptor expressed on myeloid cells-1 (TREM-1) is an amplifier of the Toll like receptor (TLR4) pathway, which is involved in APS. Plasma soluble TREM-1 (sTREM-1) levels indicate increased receptor activation and were significantly greater in thrombotic primary APS patients compared to controls. This prospective cohort study investigated the predictive value of plasma sTREM-1 levels at inclusion for the occurrence of thrombotic events or death in patients with APS, antiphospholipid antibodies (aPLs) and/or SLE.MethodsSerum sTREM-1 levels were measured at inclusion in 108 patients with APS, isolated aPL or SLE followed during 46 months. The primary outcomes included thrombosis, death and obstetrical morbidity. The occurrence of the first event of interest and predictors were modeled in a multivariable Cox model.ResultsDuring follow-up, 15 of the 108 patients presented with thromboses (14%), 5 patients died (5%), and 3 women experienced obstetrical morbidities (3%). Elevated serum sTREM-1 levels were an independent predictor for the occurrence of the composite outcome (HR 7.54 [95% CI; 2.44-23.31] p < .001). In addition, sTREM-1 levels were greater in patients with APS than patients with isolated aPL (p < .01).ConclusionHigh levels of sTREM-1 at inclusion predicted the occurrence of a thrombotic and obstetric event or death in patients with aPL and/or SLE. Therefore, sTREM-1 represents a potential new prognostic biomarker in these patients.
MeSH
Antibodies, Antiphospholipid, Antibodies, Lupus Erythematosus, Systemic, Antiphospholipid Syndrome, Morbidity, Thrombosis