Scientific Letters
Vol. 12 No. 1 (2020): Mediterranean Journal of Hematology and Infectious Diseases, Volume 12, 2020

High Prevalence of Antiphospholipid Antibodies in Children with Non-Transfusion Dependent Thalassemia and Possible Correlations with Microparticles

Antiphospholipid Antibodies and Thalassemia in children

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Received: June 8, 2020
Accepted: September 15, 2020
Published: 2020-10-26 — Updated on 2020-10-27

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Antiphospholipid antibodies (APAs) are developed antibodies to the phospholipid surfaces or to the proteins binding to phospholipids. Increased PS-expressed red blood cells (RBC) may be a risk factor in APAs development. There were only a few studies reported on APAs in thalassemia, and their associations to PS-expressing microparticles (MPs), remain unknown. The presence of antiphospholipid antibodies (APAs) in pediatric thalassemia patients and their associations with phosphatidylserine (PS)- expressing microparticles (MPs), a previously unexplored relationship, were the aims of this report. We identified that positive APA rates were highest in non-transfusion-dependent thalassemia (NTDT) subjects, followed by transfusion-dependent thalassemia (TDT) subjects and controls (29.5%, 18.2% and 17.9%, respectively).  Subgroup analysis demonstrated that positive anti- ?2 glycoprotein I (a?2-GPI)- IgG rates in NTDT subjects were significantly greater than in controls and that the percentage of MPs was also significantly elevated in thalassemia subjects. More specifically, there were significant correlations found between a?2GPI-IgG and anticardiolipin (aCL)-IgM APAs, and MPs.

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Greenberg PL, Gordeuk V, Issaragrisil S, Siritanaratkul N, Fucharoen S, Ribeiro RC. Major hematologic diseases in the developing world- new aspects of diagnosis and management of thalassemia, malarial anemia, and acute leukemia. Hematology Am Soc Hematol Educ
Program. 2001;1:479-498. https://doi.org/10.1182/asheducation-2001.1.479 PMid: 11723000
Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med. 2005;353(11):1135-1146. https://doi.org/10.1056/NEJMra050436 PMid: 16162884
Bonifazi F, Conte R, Baiardi P, Bonifazi D, Felisi M, Giordano P, et al. Pattern of complications and burden of disease in patients affected by beta thalassemia major. Curr Med Res Opin. 2017;33(8):1525-1533. https://doi:10.1080/03007995.2017.1326890 PMid: 28471307
Logothetis J CM, Economidou J, Stefanis C, Hakas P, Augoustaki O, Sofroniadou K, et al. Thalassemia major (homozygous beta-thalassemia). A survey of 138 cases with emphasis on neurologic and muscular aspects. Neurology. 1972;22(3):294-304.
https://doi:10.1212/wnl.22.3.294 PMid: 5062264
Cappellini MD, Robbiolo L, Bottasso BM, Coppola R, Fiorelli G, Mannucci AP. Venous thromboembolism and hypercoagulability in splenectomized patients with thalassaemia intermedia. Br J Haematol. 2000;111(2):467-473. https://doi:10.1046/j.1365-2141.2000.02376.x.
PMid: 11122086
Eldor A, Rachmilewitz EA. The hypercoagulable state in thalassemia. Blood. 2002;99(1):36-43. https://doi:10.1182/blood.v99.1.36 PMid: 11756150
Kheansaard W, Phongpao K, Paiboonsukwong K, Pattanapanyasat K, Chaichompoo P, Svasti S. Microparticles from ?-thalassaemia/HbE patients induce endothelial cell dysfunction. Sci Rep. 2018;8(1):13033. https://doi:10.1038/s41598-018-31386-6
PMid: 30158562 PMCid: PMC6115342
Klaihmon P, Vimonpatranon S, Noulsri E, Lertthammakiat S, Anurathapan U, Sirachainan N et al. Normalized levels of red blood cells expressing phosphatidylserine, their microparticles, and activated platelets in young patients with ?-thalassemia following bone marrow
transplantation. Ann Hematol. 2017;96(10):1741-1747. https://doi:10.1007/s00277-017-3070-2 PMid: 28748286
Youssry I, Soliman N, Ghamrawy M, Samy RM, Nasr A, Abdel Mohsen M. Circulating microparticles and the risk of thromboembolic events in Egyptian beta thalassemia patients. Ann Hematol. 2017;96:597-603. https://doi:10.1007/s00277-017-2925-x PMid: 28168351
Rai R, Swetha T. Association of anti-phospholipid antibodies with connective tissue diseases. Indian Dermatol Online J. 2015;6(2):89-91. https://doi:10.4103/2229-5178.153009 PMid: 25821728
Islam MA, Alam SS, Kundu S, Prodhan AHMSU, Khandker SS, Reshetnyak T, et al. Prevalence of antiphospholipid antibodies in Behçet's disease: A systematic review and meta-analysis. PLoS One. 2020;15(1):e0227836. https://doi:10.1371/journal.pone.0227836 PMid: 31929597
PMCid: PMC6957187
Liu A, Zhang H. Detection of antiphospholipid antibody in children with Henoch-Schönlein purpura and central nervous system involvement. Pediatr Neurol. 2012;47(3):167-170. https://doi:10.1016/j.pediatrneurol.2012.05.024 PMid: 22883280
Urbanus RT, Derksen RH, de Groot PG. Current insight into diagnostics and pathophysiology of the antiphospholipid syndrome. Blood Rev. 2008;22(2):93-105. https://doi:10.1016/j.blre.2007.09.001 PMid: 17964017
Kashef S, Karimi M, Amirghofran Z, Ayatollahi M, Pasalar M, Ghaedian MM, et al. Antiphospholipid antibodies and hepatitis C virus infection in Iranian thalassemia major patients. Int J Lab Hematol. 2008;30(1):11-16. https://doi:10.1111/j.1751-553X.2007.00916.x. PMid: 18190462
Sharma S, Raina V, Chandra J, Narayan S. Lupus anticoagulant and anticardiolipin antibodies in polytransfused betathalassemia major. Hematology. 2006;11(4):287-290. https://doi:10.1080/10245330600954130. PMid: 17178669
Versteeg HH, Ruf W. Thiol pathways in the regulation of tissue factor pro-thrombotic activity. Curr Opin Hematol. 2019;119(6):860-870. https://doi:10.1055/s-0039-1681102. PMid: 30861549
de Laat B, Wu XX, van Lummel M, Derksen RH, de Groot PG, Rand JH. Correlation between antiphospholipid antibodies that recognize domain I of beta2-glycoprotein I and a reduction in the anticoagulant activity of annexin A5. Blood. 2007;109(4):1490-1494.
https://doi:10.1182/blood-2006-07-030148. PMid: 17053060
Urbanus RT, Pennings MT, Derksen RH, de Groot PG. Platelet activation by dimeric beta2-glycoprotein I requires signaling via both glycoprotein Ibalpha and apolipoprotein E receptor 2'. J Thromb Haemost. 2008;6(8):1405-1412. https://doi:10.1111/j.1538-7836.2008.03021.x.
PMid: 18485085
Shi T, Giannakopoulos B, Yan X, Yu P, Berndt MC, Andrews RK, et al. Anti-beta2-glycoprotein I antibodies in complex with beta2-glycoprotein I can activate platelets in a dysregulated manner via glycoprotein Ib-IX-V. Arthritis Rheum. 2006;54(8):2558-2567.
https://doi:10.1002/art.21968. PMid: 16868978
Gardiner C, Hills J, Machin S, Cohen H. Diagnosis of antiphospholipid syndrome in routine clinical practice. Lupus. 2013;22(1):18-25. https://doi:10.1177/0961203312460722. PMid: 22988029 PMCid: PMC4108293
Giordano P, Tesse R, Lassandro G, Fracchiolla D, Ranieri P, Lotito A, et al. Clinical and laboratory characteristics of children positive for antiphospholipid antibodies. Blood Transfus. 2012;10(3):296-301. https://doi:10.2450/2011.0069-11. PMid: 22244004 PMCid: PMC3417728
Biggioggero M, Meroni PL. The geoepidemiology of the antiphospholipid antibody syndrome. Autoimmun Rev. 2010;9(5):A299-304. https://doi:10.1016/j.autrev.2009.11.013. PMid: 19932199
Giordano P, Galli M, Del Vecchio GC, Altomare M, Norbis F, Ruggeri L. Lupus anticoagulant, anticardiolipin antibodies and hepatitis C virus infection in thalassaemia. Br J Haematol. 1998;102(4):903-906. https://doi:10.1046/j.1365-2141.1998.00853.x. PMid: 9734637
Atichartakarn V, Chuncharunee S, Chandanamattha P, Likittanasombat K, Aryrachai K. Correction of hypercoagulability and amelioration of pulmonary arterial hypertension by chronic blood transfusion in an asplenic hemoglobin E/?-thalassemia patient. Blood.
;103(7):2844-2846. https://doi:10.1182/blood-2003-09-3094 PMid: 14645000
Pittoni V, Isenberg D. Apoptosis and antiphospholipid antibodies. Semin Arthritis Rheum. 1998;28(3):163-178. https://doi:10.1016/s0049-0172(98)80033-4 PMid: 9872477
Del Vecchio GC, Schettini F, Piacente L, De Santis A, Giordano P, De Mattia D. Effects of deferiprone on immune status and cytokine pattern in thalassaemia major. Acta Haematol. 2002;108(3):144-149. https://doi:10.1159/000064705. PMid: 12373086
Khamashta M, Taraborelli M, Sciascia S, Tincani A. Antiphospholipid syndrome. Best Pract Res Clin Rheumatol. 2017;151 Suppl 1:S43-S47. https://doi:10.1016/S0049-3848(17)30066-X. PMid: 28262233

How to Cite



“High Prevalence of Antiphospholipid Antibodies in Children with Non-Transfusion Dependent Thalassemia and Possible Correlations with Microparticles: Antiphospholipid Antibodies and Thalassemia in children” (2020) Mediterranean Journal of Hematology and Infectious Diseases, 12(1), p. e2020071. doi:10.4084/mjhid.2020.071.