Anti-beta2-glycoprotein I IgG antibodies are associated with early-onset cryptogenic ischemic stroke

Nina Jaakonmäki; Tuukka Helin; Timea Szanto; Marialuisa Zedde; Tomi Sarkanen; Nicolas Martinez-Majander; Juha Sinisalo; Ulla Junttola; Petra Redfors; Bettina von Sarnowski; Ulrike Waje-Andreassen; Pauli Ylikotila; Nilufer Yesilot; Kristina Ryliškienė; Lauri Tulkki; Laura Amaya Pascasio; Radim Licenik; Phillip Ferdinand; Eva Gerdts; Dalius Jatužis; Alessandro Pezzini; Janika Kõrv; Juha Huhtakangas; Ana Catarina Fonseca; Lotta Joutsi-Korhonen; Hugoten Cate; Pekka Jäkälä; Jukka Putaala

doi:10.1177/23969873251351207

Title	Anti-beta2-glycoprotein I IgG antibodies are associated with early-onset cryptogenic ischemic stroke
Authors	Jaakonmäki, Nina ; Helin, Tuukka ; Szanto, Timea ; Zedde, Marialuisa ; Sarkanen, Tomi ; Martinez-Majander, Nicolas ; Sinisalo, Juha ; Junttola, Ulla ; Redfors, Petra ; von Sarnowski, Bettina ; Waje-Andreassen, Ulrike ; Ylikotila, Pauli ; Yesilot, Nilufer ; Ryliškienė, Kristina ; Tulkki, Lauri ; Amaya Pascasio, Laura ; Licenik, Radim ; Ferdinand, Phillip ; Gerdts, Eva ; Jatužis, Dalius ; Pezzini, Alessandro ; Kõrv, Janika ; Huhtakangas, Juha ; Fonseca, Ana Catarina ; Joutsi-Korhonen, Lotta ; Cate, Hugoten ; Jäkälä, Pekka ; Putaala, Jukka
DOI	10.1177/23969873251351207
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Is Part of	European stroke journal.. London : SAGE Publications Ltd.. 2025, Early Access, p. [1-8].. ISSN 2396-9873. eISSN 2396-9881
Keywords [eng]	antiphospholipid antibodies ; ischemic stroke ; young adult
Abstract [eng]	Background: Previously undetected antiphospholipid antibodies (aPLs) potentially provide explanations for early-onset cryptogenic ischemic stroke (CIS). Prior association studies conducted over a decade ago were inconclusive and not focused on patients with CIS. Methods: SECRETO is a multi-center case-control study enrolling patients aged 18–49 years with imaging-positive acute CIS and 1:1 matched stroke-free controls. Lupus anticoagulant (LA), anticardiolipin (aCL), and anti-beta2-glycoprotein I (aβ2GPI) IgG antibodies were assessed from blood samples taken at twotime points (baseline and 12-weeks) from patients and at a single time point from controls. Conditional logistic regression models assessed the association of aPLs, adjusted for age, level of education, and vascular risk factors. Results: A total of 503 patient-control pairs were analyzed. At either time-point, compared to healthy controls, patients had more frequently positive aβ2GPI (patients 11.9% vs controls 2.0%, p<0.001). There was no significant difference in the presence of positive LA between patients and controls. In the logistic regression model, at either time-point positive aB2GI and aCL were associated with CIS (odds ratio [OR] 11.22, 95% confidence interval [CI] 4.35–28.95 and OR 20.85, 95% CI 204–213.16, respectively). The frequency of patients with positive aβ2GPI or aCL increased from baseline to 12weeks (p<0.001), whereas frequency of positive LA results decreased (p<0.001). Conclusions: Positive aβ2GPI and aCL, but not LA, detected either shortly after stroke or after 12weeks were associated with early-onset CIS. Notably, after the acute phase, frequencies of positive aβ2GPI and aCL increased, whereas LA showed a reverse trend.
Published	London : SAGE Publications Ltd
Type	Journal article
Language	English
Publication date	2025
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„Anti-beta2-glycoprotein I IgG antibodies are associated with early-onset cryptogenic ischemic stroke“