Gladd Debbie A, Olech Ewa
University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
Curr Rheumatol Rep. 2009 Feb;11(1):43-51. doi: 10.1007/s11926-009-0007-3.
Antiphospholipid antibodies (aPL) occur in a variety of autoimmune, malignant, and infectious diseases, with or without the thrombotic or obstetric sequelae that characterize the antiphospholipid syndrome. Although many studies have focused on the clinical implications of aPL in systemic lupus erythematosus, few have specifically addressed the questions facing rheumatologists caring for rheumatoid arthritis patients who are concomitantly positive for aPL. Such a clinical scenario requires current knowledge of antiphospholipid syndrome diagnosis criteria, test reliability, conditions causing temporal positivity of aPL, and treatment risks and benefits. Recently researched factors possibly integral to rheumatoid arthritis's increased morbidity and mortality and related to aPL include oxidatively modified low-density lipoprotein antibodies, homocysteine, annexins, infectious agents, beta estradiol, and specific gene polymorphisms. This review presents current scientific research addressing the pathophysiologic mechanisms and clinical implications of aPL in rheumatoid arthritis.
抗磷脂抗体（aPL）存在于多种自身免疫性、恶性和感染性疾病中，无论有无抗磷脂综合征所特有的血栓形成或产科后遗症。尽管许多研究关注aPL在系统性红斑狼疮中的临床意义，但很少有研究专门探讨照顾同时aPL呈阳性的类风湿关节炎患者的风湿病学家所面临的问题。这种临床情况需要了解抗磷脂综合征的诊断标准、检测可靠性、导致aPL暂时阳性的情况以及治疗的风险和益处。最近研究的可能与类风湿关节炎发病率和死亡率增加相关且与aPL有关的因素包括氧化修饰的低密度脂蛋白抗体、同型半胱氨酸、膜联蛋白、感染因子、β-雌二醇和特定基因多态性。本综述介绍了当前关于aPL在类风湿关节炎中的病理生理机制和临床意义的科学研究。
