{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:20Z","timestamp":1792787720181,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ministry of Science, Technological Development, and Innovation of the Republic of Serbia through two grant agreements with the University of Belgrade \u2013 Faculty of Pharmacy","award":["451-03-33\/2026-03\/200161"],"award-info":[{"award-number":["451-03-33\/2026-03\/200161"]}],"id":[{"id":"https:\/\/ror.org\/01znas443","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Ministry of Science, Technological Development, and Innovation of the Republic of Serbia through two grant agreements with the University of Belgrade \u2013 Faculty of Pharmacy","award":["451-03-34\/2026-03"],"award-info":[{"award-number":["451-03-34\/2026-03"]}],"id":[{"id":"https:\/\/ror.org\/01znas443","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"abstract":"\n Background<\/jats:title>\n Antiphospholipid syndrome (APS) is an autoimmune condition marked by thrombosis and pregnancy complications caused by antiphospholipid antibodies (aPL). This study evaluates immunological, inflammatory, and endothelial biomarkers in primary and secondary APS and SLE to determine their association with clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Material and methods<\/jats:title>\n \n We conducted a cross-sectional study including patients with primary (PAPS) (\n n<\/jats:italic>\n = 79), secondary (SAPS) (\n n<\/jats:italic>\n = 47), SLE (\n n<\/jats:italic>\n = 36), and control group (\n n<\/jats:italic>\n = 56). Serum and plasma samples were analyzed for aPLs, inflammatory markers (hs-CRP, IL-6), endothelial markers (endoglin), platelet activation (CD41\/CD61), tissue factor, and iron metabolism markers (hepcidin, ferritin, UIBC) using ELISA and automated assays. Statistical analyses included group comparisons, correlations, multivariate logistic regression analysis and principal component analysis (PCA).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Non-criteria aPLs, were significantly elevated in all patient groups compared to controls (\n p<\/jats:italic>\n < 0.001). Patients with SAPS demonstrated significantly higher levels of aCL IgG, aCL IgA, a\u03b22GPI IgM, and aPS\/PT (IgG and IgM) compared to PAPS. Strong correlations were identified between aPS\/PT IgG and the lupus anticoagulant ratio (LAR) (r = 0.670,\n p<\/jats:italic>\n < 0.001), as well as between a\u03b22GPI IgG and LAR (r = 0.625,\n p<\/jats:italic>\n < 0.001). Multivariate logistic regression identified that endoglin and ferritin were independently associated with clinical manifestations. For fetal loss, the model was statistically significant (\u03c7\n 21<\/jats:sup>\n = 16.18,\n p<\/jats:italic>\n = 0.013); an increase in endoglin raised the probability by 45.1% (OR = 1.451,\n p<\/jats:italic>\n = 0.040), while lower ferritin levels were also independently associated (\n p<\/jats:italic>\n = 0.004). Ferritin showed the strongest independent association with thrombosis (\u03c7\n 21<\/jats:sup>\n = 19.87,\n p<\/jats:italic>\n = 0.011), with each unit increase raising the probability of a thrombotic event by 1.5% (OR = 1.015). PCA identified two main factors explaining 63% of the variance: an \u201cImmunological-related\u201d factor (42.96%) dominated by aCL IgG, a\u03b22GPI IgG, aPS\/PT IgG, and aCL IgA, and a \u201cProthrombotic and metabolic-related\u201d factor (20.06%) driven by a\u03b22GPI IgM, tissue factor, aCL IgA, and inversely by UIBC.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The study highlights the interplay of immune, inflammatory, and endothelial dysfunction biomarkers in APS and their association with clinical manifestations. Combined assessment of conventional and non-criteria biomarkers may improve understanding of disease mechanisms and support a more comprehensive evaluation of patients with APS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/09612033261495245","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:28:51Z","timestamp":1790796531000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimarker profiling of immune and vascular disregulation in antiphospholipid syndrome and systemic lupus erythematosus"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2641-9817","authenticated-orcid":false,"given":"Neda","family":"Milinkovi\u0107","sequence":"first","affiliation":[{"name":"University of Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusica","family":"Mrdakovic","sequence":"additional","affiliation":[{"name":"University of Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1496-9034","authenticated-orcid":false,"given":"Natasa","family":"Stanisavljevic","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Hospital Medical Center \u201cBezanijska Kosa\u201d"},{"name":"University of Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Kotur Stevuljevic","sequence":"additional","affiliation":[{"name":"University of Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ljudmila","family":"Stojanovich","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Hospital Medical Center \u201cBezanijska Kosa\u201d"},{"name":"Department of Reumathology, University Clinical Center of Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragomir","family":"Marisavljevic","sequence":"additional","affiliation":[{"name":"University of Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violeta","family":"Dopsaj","sequence":"additional","affiliation":[{"name":"University of Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"e069717","DOI":"10.1136\/bmj-2021-069717","article-title":"Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management","volume":"380","author":"Knight JS","year":"2023","unstructured":"Knight JS, Branch DW, Ortel TL. Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management. BMJ 2023; 380: e069717. https:\/\/doi.org\/10.1136\/bmj-2021-069717","journal-title":"BMJ"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19635"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2023-224609"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.972012"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14030733"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-024-01519-5"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-022-00694-4"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203312460115"},{"issue":"3","key":"e_1_3_3_10_2","first-page":"32","article-title":"Evaluation of endoglin (CD105) expression and IL-3 levels in pregnant women with antiphospholipid syndrome","volume":"5","author":"Salih M.","year":"2015","unstructured":"Salih M. Evaluation of endoglin (CD105) expression and IL-3 levels in pregnant women with antiphospholipid syndrome. J Thi-Qar Sci. 2015; 5(3): 32\u201338.","journal-title":"J Thi-Qar Sci"},{"issue":"6","key":"e_1_3_3_11_2","first-page":"1027","article-title":"Increased serum soluble endoglin level and its clinical significance in antiphospholipid syndrome","volume":"50","author":"Li J","year":"2018","unstructured":"Li J, Zheng L, Shi LJ, et al. Increased serum soluble endoglin level and its clinical significance in antiphospholipid syndrome. Beijing Da Xue Xue Bao Yi Xue Ban 2018; 50(6): 1027\u20131032.","journal-title":"Beijing Da Xue Xue Bao Yi Xue Ban"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/09612033251330099"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203308096662"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12291-017-0702-1"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000926"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2022.101015"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.imbio.2005.10.006"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199907)42:7<1309::AID-ANR1>3.0.CO;2-F"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01753.x"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780251101"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13976"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2026.102745"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead633"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2022.04.031"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.3390\/cells15040356"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033261495245","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09612033261495245","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033261495245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:04:07Z","timestamp":1791036247000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09612033261495245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":24,"alternative-id":["10.1177\/09612033261495245"],"URL":"https:\/\/doi.org\/10.1177\/09612033261495245","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"09612033261495245"}}