Gene-expression patterns predict phenotypes of immune-mediated thrombosis

• Published in: Blood Vol. 107; no. 4; pp. 1391 - 1396
• Main Authors: Potti, Anil, Bild, Andrea, Dressman, Holly K., Lewis, Deborah A., Nevins, Joseph R., Ortel, Thomas L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.02.2006; 2006 by The American Society of Hematology
• Subjects: Adult; Aged; Antibodies, Antiphospholipid - blood; Antiphospholipid Syndrome - genetics; Antiphospholipid Syndrome - immunology; Female; Gene Expression Regulation; Hemostasis, Thrombosis, and Vascular Biology; Humans; Male; Middle Aged; Oligonucleotide Array Sequence Analysis; Reference Values; Thromboembolism - epidemiology; Thromboembolism - genetics; Thromboembolism - immunology
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2005-07-2669

Antiphospholipid antibody syndrome (APS) is a complex autoimmune thrombotic disorder with defined clinical phenotypes. Although not all patients with elevated antiphospholipid antibody (aPLA) levels develop complications, the severity of these potential events mandates aggressive and extended lifelong anti-thrombotic therapy. One hundred twenty-nine patients (57 patients with APS and venous thromboembolism [VTE], 32 patients with VTE without aPLA, 32 patients with aPLA only, and 8 healthy patients) were enrolled. RNA from peripheral-blood collection was used for DNA microarray analysis. Patterns of gene expression that characterize APS as well as thrombosis in the presence of aPLA were identified by hierarchical clustering and binary regression methods. Gene-expression profiles identify and predict individuals with APS from patients with VTE without aPLA. Importantly, similar methods identified expression profiles that accurately predicted those patients with aPLA at high risk for thrombotic events. All profiles were validated in independent cohorts of patients. The ability to predict APS, but more importantly, those patients at risk for venous thrombosis, represents a paradigm for a genomic approach that can be applied to other populations of patients with venous thrombosis, providing for more effective clinical management of disease, while also reflecting the possible underlying biologic processes.