抗磷脂抗体综合征的临床表现及抗体研究进展
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摘要
抗磷脂抗体综合征临床表现复杂多样,主要有血管血栓事件和习惯性流产,但其他的相关临床表现在诊断中也越来越被重视。除了已有的3种实验诊断标志物,抗凝血酶原抗体、抗β_2糖蛋白I新的结构域抗体、抗磷脂酰乙醇胺抗体、抗负电荷磷脂抗体、抗波形蛋白抗体、抗膜联蛋白抗体都具有一定的敏感性和特异性。其中该抗β_2糖蛋白Ⅰ结构域Ⅰ抗体和抗凝血酶原抗体可能是将来临床诊断应用的新标志物。
The clinical manifestations of antiphospholipid syndrome( APS) are complex and diverse,mainly including a history of venous or arterial thrombosis and / or habitual abortion,but more and more attention is being paid to other related clinical manifestations for diagnosis. In addition to the existing three experimental diagnostic markers,anti-prothrombin antibodies,anti-β_2-GPI new domain antibodies,antibodies against phosphatidylethanolamine,anionic phospholipids other than cardiolipin and vimentin,annexins have certain sensitivity and specificity. The anti-β_2-GPI domain I antibody and anti-prothrombin antibody may be the new markers for the clinical diagnosis in future.
The clinical manifestations of antiphospholipid syndrome( APS) are complex and diverse,mainly including a history of venous or arterial thrombosis and / or habitual abortion,but more and more attention is being paid to other related clinical manifestations for diagnosis. In addition to the existing three experimental diagnostic markers,anti-prothrombin antibodies,anti-β_2-GPI new domain antibodies,antibodies against phosphatidylethanolamine,anionic phospholipids other than cardiolipin and vimentin,annexins have certain sensitivity and specificity. The anti-β_2-GPI domain I antibody and anti-prothrombin antibody may be the new markers for the clinical diagnosis in future.
引文
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[19]Andreoli L,Nalli C,Borghi MO,et al.Domain I is the main specificity of anti-beta2 GPI in systemic autoimmune diseases[J].Arthritis Rheum,2013,65:S4.
[20]Ioannou Y,Pericleous C,Giles I,et al.Binding of antiphospholipid antibodies to discontinuous epitopes on domain I of human beta(2)-glycoprotein I:mutation studies including residues R39 to R43[J].Arthritis Rheum,2007,56(1):280-290.
[21]Agostinis C,Durigutto P,Sblattero D,et al.A human monoclonal antibody against domain I ofβ2-glycoprotein I prevents clotting and fetal loss induced by polyclonal anti-phospholipid antibodies in animal models[J].Arthritis Rheum,2013,65:S245.
[22]de Laat B,de Groot PG.Autoantibodies directed against domain I of beta2-glycoprotein I[J].Curr Rheumatol Rep,2011,13(1):70-76.
[23]Staub HL,Bertolaccini ML,Khamashta MA.Anti-phosphatidylethanolamine antibody,thromboembolic events and the antiphospholipid syndrome[J].Autoimmun Rev,2012,12:230-234.
[24]Sugi T,Matsubayashi H,Inomo A,et al.Antiphosphatidylethanolamine antibodies in recurrent early pregnancy loss and mid-to-late pregnancy loss[J].J Obstet Gynaecol Res,2004,30(4):326-332.
[25]Bertolaccini ML,Amengual O,Atsumi T,et al.'Non-criteria'a PL tests:report of a task force and preconference workshop at the 13th International Congress on Antiphospholipid Antibodies,Galveston,TX,USA,April 2010[J].Lupus 2011,20:191-205.
[26]Grossi C,Borghi MO,Papaardo E,et al.A more specific immunoassay for the diagnosis of APS[J].Arthritis Rheum,2013,65:S5.
[27]Sciascia S,Sanna G,Murru V,et al.The clinical value of testing for Aphl,a new ELISA kit with a unique phospholipid mixture in patients with systemic lupus erythematosus(SLE)[J].Arthritis Rheum,2013,65:S1.
[28]Nayfe R,Uthman I,Aoun J,et al.Seronegative antiphospholipid syndrome[J].Rheumatology(Oxford),2013,52(8):1358-1367.
[29]Cesarman-Maus G,Ríos-Luna NP,Deora AB,et al.Autoantibodies against the fibrinolytic receptor,annexin 2,in antiphospholipid syndrome[J].Blood,2006,107(11):4375-4382.
[30]Lambrianides A,Carroll CJ,Pierangeli SS,et al.Effects of polyclonal Ig G derived from patients with different clinical types of the antiphospholipid syndrome on monocyte signaling pathways[J].J Immunol,2010,184(12):6622-6628.
[2]Cervera R,Espinosa G.Update on the catastrophic antiphospholipid syndrome and the"CAPS Registry"[J].Semin Thromb Hemost,2012,38(4):333-338.
[3]Shoenfeld Y,Meroni PL,Toubi E.Antiphospholipid syndrome and systemic lupus erythematosus:are they separate entities or just clinical presentations on the same scale?[J].Curr Opin Rheumatol,2009,21(5):495-500.
[4]Frances C.Dermatological manifestations of Hughes'antiphospholipid antibody syndrome[J].Lupus,2010,19(9):1071-1077.
[5]Zuily S,Huttin O,Mohamed S,et al.Valvular heart disease in antiphospholipid syndrome[J].Curr Rheumatol Rep,2013,15(4):320.
[6]Brey RL,Muscal E,Chapman J.Antiphospholipid antibodies and the brain:a consensus report[J].Lupus,2011,20(2):153-157.
[7]Gerosa M,Poletti B,Pregnolato F,et al.Antiphospholipid syndrome and systemic lupus erythematosus:what's new about cognitive impairment[J].J Neurol,2009,256:S190.
[8]Ruffatti A,Tonello M,Visentin MS,et al.Risk factors for pregnancy failure in patients with anti-phospholipid syndrome treated with conventional therapies:a multicentre,case-control study[J].Rheumatology(Oxford),2011,50(9):1684-1689.
[9]Meroni PL,Borghi MO,Raschi E,et al.Pathogenesis of antiphospholipid syndrome:understanding the antibodies[J].Nat Rev Rheumatol,2011,7(6):330-339.
[10]Pengo V,Banzato A,Denas G,et al.Correct laboratory approach to APS diagnosis and monitoring[J].Autoimmun Rev,2013,12(8):832-834.
[11]Otomo K,Atsumi T,Amengual O,et al.Efficacy of the antiphospholipid score for the diagnosis of antiphospholipid syndrome and its predictive value for thrombotic events[J].Arthritis Rheum,2012,64(2):504-512.
[12]Gardiner C,Hills J,Machin SJ,et al.Diagnosis of antiphospholipid syndrome in routine clinical practice[J].Lupus,2013,22(1):18-25.
[13]Pregnolato F,Chighizola CB,Encabo S,et al.Anti-phosphatidylserine/prothrombin antibodies:an additional diagnostic marker for APS?[J].Immunol Res,2013,56(2/3):432-438.
[14]Pregnolato F,Chighizola C.Phospholipid autoantibodies(non-anticardiolipin)-anti-prothrombin antibodies[M].Shoenfeld Y,Gershwin E,Meroni PL.The Autoantibodies.3rd.New York:Elsevier,2014:741-749.
[15]Sciascia S,Sanna G,Murru V,et al.Anti-prothrombin(a PT)and anti-phosphatidylserine/prothrombin(a PS/PT)antibodies and the risk of thrombosis in the antiphospholipid syndrome.A systematic review[J].Thromb Haemost,2014,111(2):354-364.
[16]Shoenfeld Y,Krause I,Kvapil F,et al.Prevalence and clinical correlations of antibodies against six beta2-glycoprotein-I-related peptides in the antiphospholipid syndrome[J].J Clin Immunol,2003,23(5):377-383.
[17]Mahler M,Norman GL,Meroni PL,et al.Autoantibodies to domain1 of beta 2 glycoprotein 1:a promising candidate biomarker for risk management in antiphospholipid syndrome[J].Autoimmun Rev,2012,12(2):313-317.
[18]Zuily S,De Laat B,Regnault V,et al.Autoantibodies against domain I of beta2-glycoprotein indicate an increased risk for thrombosis in antiphospholipid patients,A prospective cohort study[J].J Thromb Haemost,2013,11:S3.
[19]Andreoli L,Nalli C,Borghi MO,et al.Domain I is the main specificity of anti-beta2 GPI in systemic autoimmune diseases[J].Arthritis Rheum,2013,65:S4.
[20]Ioannou Y,Pericleous C,Giles I,et al.Binding of antiphospholipid antibodies to discontinuous epitopes on domain I of human beta(2)-glycoprotein I:mutation studies including residues R39 to R43[J].Arthritis Rheum,2007,56(1):280-290.
[21]Agostinis C,Durigutto P,Sblattero D,et al.A human monoclonal antibody against domain I ofβ2-glycoprotein I prevents clotting and fetal loss induced by polyclonal anti-phospholipid antibodies in animal models[J].Arthritis Rheum,2013,65:S245.
[22]de Laat B,de Groot PG.Autoantibodies directed against domain I of beta2-glycoprotein I[J].Curr Rheumatol Rep,2011,13(1):70-76.
[23]Staub HL,Bertolaccini ML,Khamashta MA.Anti-phosphatidylethanolamine antibody,thromboembolic events and the antiphospholipid syndrome[J].Autoimmun Rev,2012,12:230-234.
[24]Sugi T,Matsubayashi H,Inomo A,et al.Antiphosphatidylethanolamine antibodies in recurrent early pregnancy loss and mid-to-late pregnancy loss[J].J Obstet Gynaecol Res,2004,30(4):326-332.
[25]Bertolaccini ML,Amengual O,Atsumi T,et al.'Non-criteria'a PL tests:report of a task force and preconference workshop at the 13th International Congress on Antiphospholipid Antibodies,Galveston,TX,USA,April 2010[J].Lupus 2011,20:191-205.
[26]Grossi C,Borghi MO,Papaardo E,et al.A more specific immunoassay for the diagnosis of APS[J].Arthritis Rheum,2013,65:S5.
[27]Sciascia S,Sanna G,Murru V,et al.The clinical value of testing for Aphl,a new ELISA kit with a unique phospholipid mixture in patients with systemic lupus erythematosus(SLE)[J].Arthritis Rheum,2013,65:S1.
[28]Nayfe R,Uthman I,Aoun J,et al.Seronegative antiphospholipid syndrome[J].Rheumatology(Oxford),2013,52(8):1358-1367.
[29]Cesarman-Maus G,Ríos-Luna NP,Deora AB,et al.Autoantibodies against the fibrinolytic receptor,annexin 2,in antiphospholipid syndrome[J].Blood,2006,107(11):4375-4382.
[30]Lambrianides A,Carroll CJ,Pierangeli SS,et al.Effects of polyclonal Ig G derived from patients with different clinical types of the antiphospholipid syndrome on monocyte signaling pathways[J].J Immunol,2010,184(12):6622-6628.