ArticleArthritis & rheumatology (Hoboken, N.J.)2023
Anti-Neutrophil Extracellular Trap Antibodies in Antiphospholipid Antibody-Positive Patients: Results From the Antiphospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Clinical Database and Repository.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 38 citations in OpenAlex.
- IgM antiphospholipid antibodies are associated with a microvascular phenotype in antiphospholipid syndrome.Advances in rheumatology (London, England) · 2026Article
- Inflammatory arthritis irAE may represent a unique autoimmune disease primarily driven by T cells but likely not autoantibodies.Science advances · 2026Article
- Histidine alleviates Hashimoto's thyroiditis via the neutrophil extracellular traps-NF-κB signaling pathway.Scientific reports · 2026Article
- Comprehensive Review of Antiphospholipid Syndrome: Over Four Decades of Advances and Challenges.Cells · 2026Review
- Autophagy, NET formation, and inflammation crosstalk in thrombotic autoimmune diseases.Frontiers in immunology · 2026Review
- Antiphospholipid Syndrome: An Antibody-Mediated Disease With Emerging Therapeutic Opportunities.Arthritis & rheumatology (Hoboken, N.J.) · 2025Review
- Inflammatory arthritis immune related adverse events represent a unique autoimmune disease entity primarily driven by T cells, but likely not autoantibodies.medRxiv : the preprint server for health sciences · 2025Article
- Activated Complement System's Impact in Antiphospholipid Syndrome Thrombosis: From Pathophysiology to Treatment.Journal of clinical medicine · 2025Review
- Anti-β2glycoprotein I-induced neutrophil extracellular traps cause endothelial activation.Rheumatology (Oxford, England) · 2025Article
- NETosis: A key player in autoimmunity, COVID-19, and long COVID.Journal of translational autoimmunity · 2025Review
- Characterization of anti-neutrophil extracellular traps (NET) antibodies according to systemic lupus erythematosus clinical phenotypes.Immunologic research · 2025Article
- Novel advances on pathophysiological mechanisms, clinical manifestations, and treatment of antiphospholipid syndrome.Frontiers in immunology · 2025Review
- Neutrophil Extracellular Traps (NETs) in Sterile Inflammatory Diseases.Journal of inflammation research · 2025Review
- Neutrophil extracellular traps in homeostasis and disease.Signal transduction and targeted therapy · 2024Review
- The role of DNA in the pathogenesis of SLE: DNA as a molecular chameleon.Annals of the rheumatic diseases · 2024Review
- Rethinking antiphospholipid syndrome to guide future management and research.Nature reviews. Rheumatology · 2024Review
- How We Interpret Thrombosis with Thrombocytopenia Syndrome?International journal of molecular sciences · 2024Review
- An Emerging Role for Anti-DNA Antibodies in Systemic Lupus Erythematosus.International journal of molecular sciences · 2023Review
- The Role of the Oxidative State and Innate Immunity Mediated by TLR7 and TLR9 in Lupus Nephritis.International journal of molecular sciences · 2023Review
- Interaction of the antiphospholipid syndrome autoantigen beta-2 glycoprotein I with DNA and neutrophil extracellular traps.Clinical immunology (Orlando, Fla.) · 2023Article
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Authors and funding
30 authors at 20 institutions in 8 countries.
Funding
Abstract
objectiveThis study aimed to elucidate the presence, antigen specificities, and potential clinical associations of anti-neutrophil extracellular trap (anti-NET) antibodies in a multinational cohort of antiphospholipid (aPL) antibody-positive patients who did not have lupus.
methodsAnti-NET IgG/IgM levels were measured in serum samples from 389 aPL-positive patients; 308 patients met the classification criteria for antiphospholipid syndrome. Multivariate logistic regression with best variable model selection was used to determine clinical associations. For a subset of the patients (n = 214), we profiled autoantibodies using an autoantigen microarray platform.
resultsWe found elevated levels of anti-NET IgG and/or IgM in 45% of the aPL-positive patients. High anti-NET antibody levels are associated with more circulating myeloperoxidase (MPO)-DNA complexes, which are a biomarker of NETs. When considering clinical manifestations, positive anti-NET IgG was associated with lesions affecting the white matter of the brain, even after adjusting for demographic variables and aPL profiles. Anti-NET IgM tracked with complement consumption after controlling for aPL profiles; furthermore, patient serum samples containing high levels of anti-NET IgM efficiently deposited complement C3d on NETs. As determined by autoantigen microarray, positive testing for anti-NET IgG was significantly associated with several autoantibodies, including those recognizing citrullinated histones, heparan sulfate proteoglycan, laminin, MPO-DNA complexes, and nucleosomes. Anti-NET IgM positivity was associated with autoantibodies targeting single-stranded DNA, double-stranded DNA, and proliferating cell nuclear antigen.
conclusionThese data reveal high levels of anti-NET antibodies in 45% of aPL-positive patients, where they potentially activate the complement cascade. While anti-NET IgM may especially recognize DNA in NETs, anti-NET IgG species appear to be more likely to target NET-associated protein antigens.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.