Thromb Haemost 2023; 123(01): 076-084
DOI: 10.1055/a-1926-0453
Stroke, Systemic or Venous Thromboembolism

Circulating Endothelial Cells are Associated with Thromboembolic Events in Patients with Antiphospholipid Antibodies

1   INSERM, DCAC, Université de Lorraine, Nancy, France
2   Division of Vascular Medicine, CHRU-Nancy, Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy, France
1   INSERM, DCAC, Université de Lorraine, Nancy, France
2   Division of Vascular Medicine, CHRU-Nancy, Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy, France
Marie Heymonet
1   INSERM, DCAC, Université de Lorraine, Nancy, France
Jessie Risse
1   INSERM, DCAC, Université de Lorraine, Nancy, France
2   Division of Vascular Medicine, CHRU-Nancy, Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy, France
3   CH de Sarreguemines, Sarreguemines, France
Gilbert C. Faure
4   Laboratory of Immunology, CHRU-Nancy, Nancytomique, Pôle Laboratoire
5   CRAN UMR CNRS 7039, Nancy, France
Huguette Louis
1   INSERM, DCAC, Université de Lorraine, Nancy, France
Jeremy Lagrange
1   INSERM, DCAC, Université de Lorraine, Nancy, France
6   Délégation à la Recherche Clinique et à l'Innovation, CHRU-Nancy, Nancy, France
Patrick Lacolley
1   INSERM, DCAC, Université de Lorraine, Nancy, France
6   Délégation à la Recherche Clinique et à l'Innovation, CHRU-Nancy, Nancy, France
Katrien Devreese
7   Department of Diagnostic Sciences, Coagulation Laboratory, Ghent University Hospital, Ghent University, Ghent, Belgium
Sébastien Gibot
8   Intensive Care Unit, CHRU-Nancy, Nancy, France
Veronique Regnault
1   INSERM, DCAC, Université de Lorraine, Nancy, France
6   Délégation à la Recherche Clinique et à l'Innovation, CHRU-Nancy, Nancy, France
1   INSERM, DCAC, Université de Lorraine, Nancy, France
2   Division of Vascular Medicine, CHRU-Nancy, Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy, France
Denis Wahl
1   INSERM, DCAC, Université de Lorraine, Nancy, France
2   Division of Vascular Medicine, CHRU-Nancy, Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy, France
› Author Affiliations
Funding Nancytomique has been funded by French Ministry of Research, Ligue Contre le Cancer, CHRU Nancy, and the European Regional Development Fund (FEDER).


Background Endothelial damage has been described in antiphospholipid antibody (aPL)-positive patients. However, it is uncertain whether circulating endothelial cells (CECs)—which are released when endothelial injury occurs—can be a marker of patients at high risk for thrombosis.

Methods Ninety-seven patients with aPL and/or systemic lupus erythematosus (SLE) were included. CECs were determined by an automated CellSearch system. We also assayed plasma levels of tissue factor-bearing extracellular vesicles (TF+/EVs) and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) as markers of endothelial dysfunction/damage.

Results Patients' mean age was 46.1 ± 13.9 years, 77 were women. Thirty-seven had SLE and 75 patients were suffering from antiphospholipid syndrome. Thirty-seven percent of patients presented a medical history of arterial thrombosis and 46% a history of venous thromboembolism (VTE). Thirteen patients had increased levels of CECs (>20/mL), with a mean CEC level of 48.3 ± 21.3 per mL. In univariate analysis, patients with obesity or medical history of myocardial infarction (MI), VTE, or nephropathy had a significant increased CEC level. In multivariate analysis, obesity (odds ratio [OR] = 6.07, 95% confidence interval [CI]: 1.42–25.94), VTE (OR = 7.59 [95% CI: 1.38–41.66]), and MI (OR = 5.5 [95% CI: 1.1–26.6)] were independently and significantly associated with elevated CECs. We also identified significant correlations between CECs and other markers of endothelial dysfunction: sTREM-1 and TF+/EVs.

Conclusion This study demonstrated that endothelial injury assessed by the levels of CECs was associated with thromboembolic events in patients with aPL and/or autoimmune diseases.

Supplementary Material

Publication History

Received: 10 May 2022

Accepted: 11 August 2022

Accepted Manuscript online:
17 August 2022

Article published online:
28 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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