Enhanced type I interferon gene signature in primary antiphospholipid syndrome: Association with earlier disease onset and preeclampsia

Author(s)

Ugolini-Lopes, Michelle Remiao ^[1] ; Torrezan, Giovana Tardin ^[2] ; Rossi Gandara, Ana Paula ^[1] ; Ribeiro Olivieri, Eloisa Helena ^[2] ; Nascimento, Iana Souza ^[1] ; Okazaki, Erica ^[3] ; Bonfa, Eloisa ^[1] ; Carraro, Dirce Maria ^[2] ; Oliveira de Andrade, Danieli Castro ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Med, Rheumatol Div, Sao Paulo - Brazil

^[2] AC Camargo Canc Ctr, Lab Genom & Mol Biol, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Hematol Div, Sao Paulo - Brazil

• Document type: Review article
• Source: AUTOIMMUNITY REVIEWS; v. 18, n. 4, p. 393-398, APR 2019.
• Web of Science Citations: 3

Abstract

Objective: Recently, two studies demonstrated that a relevant percentage of primary antiphospholipid syndrome (PAPS) patients had an upregulation of interferon (IFN) genes. However, 20%-28% of these patients had anti-dsDNA, a highly specific systemic lupus erythematosus (SLE) autoantibody. This study aimed to determine the prevalence of the type I IFN signature in the peripheral blood mononuclear cells of PAPS patients without specific SLE autoantibodies and search for its clinical associations. Methods: Fifty-three PAPS patients (Sydney's criteria) were consecutively selected and age-matched with 50 healthy controls. A third group of nonimmune-mediated thrombophilia patients was also included. The expression of 41 IFN-induced genes was analyzed using real time quantitative PCR. A principal component analysis determined which genes composed the IFN signature, and the z-score was calculated. An ROC curve defined the signature cut-off. Results: Six genes remained in the IFN signature DNAJA1, IFIT5, IF127, MX1, IF16, and TYK2. The ROC cutoff was 3.9-fold (AUC = 0.706, S = 0.49, E = 0.86, PPV = 0.79, NPV = 0.61). The type I IFN signature was present in 49% of the patients with PAPS compared with 14.0% of the healthy controls and 17% of the nonimmunemediated thrombophilia patients (p < .0001). The IFN signature was associated with a younger age at the first antiphospholipid syndrome event (p = .023) and with preeclampsia (p = .032). Conclusion: Our results indicate that PAPS patients without lupus-specific antibodies have an enhanced type IFN gene signature that is not observed in nonimmune-mediated thrombophilia. Also, this overexpression of type I IFN-regulated genes associated with an earlier onset of antiphospholipid syndrome event and preeclampsia. (AU)

• FAPESP's process: 14/17965-1 - Type I Interferon Signature in Primary Antiphospholipid Syndrome
• Grantee: Danieli Castro Oliveira de Andrade
• Support Opportunities: Regular Research Grants