Cuadrado M J, Tinahones F, Camps M T, de Ramon E, Gómez-Zumaquero J M, Mujic F, Khamashta M A, Hughes G R
Rheumatology Department, Hospital Universitario Reina Sofia, Córdoba, Spain.
QJM. 1998 Sep;91(9):619-26. doi: 10.1093/qjmed/91.9.619.
Antiphospholipid antibodies (aPL), anti-beta 2-glycoprotein I (anti-beta 2-GPI) and anti-oxidized-low-density lipoprotein (LDL) antibodies are all implicated in the pathogenesis of antiphospholipid syndrome. To investigate whether different autoantibodies or combinations thereof produced distinct effects related to their antigenic specificities, we examined the frequencies of antiphospholipid syndrome (APS)-related features in the presence of different antibodies [aPL, beta 2-GPI, anti-oxidized low density lipoprotein (LDL)] in 125 patients with APS. Median follow-up was 72 months: 58 patients were diagnosed as primary APS and 67 as APS plus systemic lupus erythematosus (SLE). Anticardiolipin antibodies (aCL), anti-beta 2-GPI and anti-oxidized LDL antibodies were determined by ELISA; lupus anticoagulant (LA) by standard coagulometric methods. Univariate analysis showed that patients positive for anti-beta 2-GPI had a higher risk of recurrent thrombotic events (OR = 3.64, 95% CI, p = 0.01) and pregnancy loss (OR = 2.99, 95% CI, p = 0.004). Patients positive for anti-oxidized LDL antibodies had a 2.24-fold increase in the risk of arterial thrombosis (2.24, 95% CI, p = 0.03) and lower risk of thrombocytopenia (OR = 0.41 95% CI, p = 0.04). Patients positive for aCL antibodies had a higher risk of pregnancy loss (OR = 4.62 95% CI, p = 0.001). When these data were tested by multivariate logistic regression, the association between anti-beta 2-GPI and pregnancy loss and the negative association between anti-oxidized LDL antibodies and thrombocytopenia disappeared.
抗磷脂抗体（aPL）、抗β2糖蛋白I（抗β2-GPI）和抗氧化型低密度脂蛋白（LDL）抗体均与抗磷脂综合征的发病机制有关。为了研究不同自身抗体或其组合是否因其抗原特异性而产生不同影响，我们在125例抗磷脂综合征（APS）患者中检测了不同抗体（aPL、β2-GPI、抗氧化型低密度脂蛋白（LDL））存在时抗磷脂综合征（APS）相关特征的发生频率。中位随访时间为72个月：58例患者被诊断为原发性APS，67例为APS合并系统性红斑狼疮（SLE）。采用酶联免疫吸附测定法（ELISA）检测抗心磷脂抗体（aCL）、抗β2-GPI和抗氧化型LDL抗体；采用标准凝血方法检测狼疮抗凝物（LA）。单因素分析显示，抗β2-GPI阳性患者复发性血栓事件风险较高（比值比（OR）=3.64，95%置信区间（CI），p = 0.01），流产风险较高（OR = 2.99，95%CI，p = 0.004）。抗氧化型LDL抗体阳性患者动脉血栓形成风险增加2.24倍（2.24，95%CI，p = 0.03），血小板减少风险较低（OR = 0.41，95%CI，p = 0.04）。aCL抗体阳性患者流产风险较高（OR = 4.62，95%CI，p = 0.001）。当通过多因素逻辑回归分析这些数据时，抗β2-GPI与流产之间的关联以及抗氧化型LDL抗体与血小板减少之间的负关联消失。
