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Blood, 1 September 2004, Vol. 104, No. 5, pp. 1369-1374. Prepublished online as a Blood First Edition Paper on May 18, 2004; DOI 10.1182/blood-2004-03-0793. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-03-0793v1 104/5/1369    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Hurtado, V. Articles by Hermida, J. Search for Related Content PubMed PubMed Citation Articles by Hurtado, V. Articles by Hermida, J. Related Collections Clinical Trials and Observations Hemostasis, Thrombosis, and Vascular Biology Immunobiology Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY Autoantibodies against EPCR are found in antiphospholipid syndrome and are a risk factor for fetal death Verónica Hurtado, Ramón Montes, Jean-Christophe Gris, María L. Bertolaccini, Álvaro Alonso, Miguel A. Martínez-González, Munther A. Khamashta, Kenji Fukudome, David A. Lane, and José Hermida From the Haematology Department and the Division of Cardiovascular Pathophysiology, Laboratory of Thrombosis and Haemostasis, Clínica Universitaria/School of Medicine, Applied Medical Research Centre, University of Navarra, Pamplona, Spain; Haematology Laboratory, University Hospital, Nîmes, France; Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, London, United Kingdom; Department of Epidemiology and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Department of Immunology, Saga Medical School, Saga, Japan; and Department of Haematology–Division of Investigative Science, Hammersmith Campus, Imperial College, London, United Kingdom. The antiphospholipid syndrome (APS) is associated with thrombosis and fetal death but the pathologic mechanisms are poorly understood. Since endothelial protein C receptor (EPCR) plays a role in the anticoagulant system and in placental development, we hypothesized that anti-EPCR autoantibodies may be involved in clinical manifestations of APS and in fetal loss. The levels of immunoglobulin M (IgM) and IgG anti-EPCR autoantibodies were analyzed by enzyme-linked immunosorbent assay (ELISA) in 43 patients with APS and 43 controls. Anti-EPCR levels were higher in APS patients than in controls. Interestingly, one of the IgM anti-EPCR autoantibodies inhibited the generation of activated protein C on endothelium. Since markedly high anti-EPCR levels were found in women with fetal death, 87 patients with a first episode of unexplained fetal death were subsequently analyzed and their anti-EPCR levels were compared with 87 matched controls. We found that anti-EPCR autoantibodies constitute an independent risk factor for a first fetal death episode: the adjusted odds ratios (ORs) for anti-EPCR autoantibodies above the 95th percentile were 23.0 (95% confidence interval [CI], 2.0-266.3) for IgM and 6.8 (95% CI, 1.2-38.4) for IgG. Anti-EPCR autoantibodies can be detected in APS patients and are independent risk factors for fetal death. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Gandrille Endothelial cell protein C receptor and the risk of venous thrombosis Haematologica, June 1, 2008; 93(6): 812 - 816. [Full Text] [PDF] E. Molina, J. Hermida, J. Lopez-Sagaseta, C. Puy, and R. Montes The functional properties of a truncated form of endothelial cell protein C receptor generated by alternative splicing Haematologica, June 1, 2008; 93(6): 878 - 884. [Abstract] [Full Text] [PDF] X. Zheng, W. Li, J.-M. Gu, D. Qu, G. L. Ferrell, N. L. Esmon, and C. T. Esmon Effects of membrane and soluble EPCR on the hemostatic balance and endotoxemia in mice Blood, February 1, 2007; 109(3): 1003 - 1009. [Abstract] [Full Text] [PDF] S. M. Abo and V. A. DeBari Laboratory Evaluation of the Antiphospholipid Syndrome Ann. Clin. Lab. Sci., January 1, 2007; 37(1): 3 - 14. [Abstract] [Full Text] [PDF]

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