Abstract 2057: Changes operated in protein pattern of monocytes from patients with antiphospholipid syndrome treated with statins.
Authors:
MJ Cuadrado, C Lopez-Pedrera, A Aguirre, V Hernandex, P. Buendia, N Barbarroja, L Aristide, F Velasco, MA Khamashta.
Background:
Not all patients with antiphospholipid antibodies clot. Those with high titers, however, are at sufficient risk that prophylactic therapy is often given. In vitro studies have shown that fluvastatin blocks the binding of antiphospholipid antibodies to endothelial cells. This study addressed differences in protein expression in APS vs controls and in APS patients pre- and post-fluvastatin.
Methods:
25 APS patients and 30 controls had proteomic analysis. Ten APS patients received fluvastatin for one month.
Results:
The APS proteomic analyses identified multiple proteins. In particular three (annexin I and II, Rho A, ubiquitin-like nedd 8) were increased and two were decreased (PDI and HSP 60kd) that are known to contribute to hypercoagulability. After one month the statin-treated patients showed a reversal of these changes (but after stopping fluvastatin, reverted to the baseline abnormalities).
Conclusion:
Proteomic analysis was able to identify protein changes in the sera of APS patients with thrombosis and that fluvastatin could reverse these changes.
Editorial Comment:
The control group included 10 patients with aPL but no thrombosis. Did NONE of them have changes in the putative proteins? We really need to be able to identify a predictor of thrombosis so that we could identify the patients that need prophylactic therapy. This fascinating study points out the need for a randomized trial of statins to prevent thrombosis in aPL-positive patients. Unfortunately, statins cannot be used in APS pregnancy, because of fetal malformations.
