Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clinic, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
Autoimmun Rev. 2012 Aug;11(10):705-12. doi: 10.1016/j.autrev.2011.12.006. Epub 2012 Jan 8.
Previous studies have suggested that the possession of the Val/Val genotype of the Val247Leu polymorphism of the β(2)-glycoproteinI (β(2)-GPI) gene may be associated with antiphospholipid syndrome (APS), and, among patients with APS, with the production of anti-β(2)-GPI antibodies or the development of thrombosis. Given the controversial results reported, the aim of this work is to combine previous findings by means of a systematic review and a meta-analysis.
We retrieved studies analyzing the genotype of the above-mentioned polymorphism among patients with APS by means of electronic database search. A meta-analysis was conducted in a random effects model and calculations of odds ratio (OR) and confidence intervals (CI) were done. Sensitivity analysis and tests for heterogeneity of the results were performed.
Eight previous studies analyzed the association of APS, anti-β(2)-GPI antibodies and/or thrombosis with the Val247Leu polymorphism. After meta-analysis, patients with APS had a significantly higher prevalence of the Val/Val genotype of this genetic variant when compared with controls (OR=2.04; 95% CI: 1.12, 3.73; P=0.02). Among patients with APS, those with anti-β(2)-GPI antibodies had a higher prevalence of this genotype (OR=1.73; 95% CI: 1.04, 2.87; P=0.03). No significant results were found for the presence of arterial or venous thrombosis.
Val/Val genotype of β(2)-GPI gene is associated with a significant excess risk to suffer from APS and, among patients with APS, to have anti-β(2)-GPI antibodies. No definite conclusions can be made regarding the association of this polymorphism with thrombosis among APS patients.
先前的研究表明,β(2)-糖蛋白 I(β(2)-GPI)基因 Val247Leu 多态性的 Val/Val 基因型可能与抗磷脂综合征(APS)有关,并且在 APS 患者中,与抗-β(2)-GPI 抗体的产生或血栓形成有关。鉴于报道的结果存在争议,本研究的目的是通过系统评价和荟萃分析结合以前的发现。
我们通过电子数据库搜索检索了分析 APS 患者上述多态性基因型的研究。采用随机效应模型进行荟萃分析,并计算比值比(OR)和置信区间(CI)。进行了敏感性分析和结果异质性检验。
八项先前的研究分析了 APS、抗-β(2)-GPI 抗体和/或血栓形成与 Val247Leu 多态性的相关性。荟萃分析后,与对照组相比,APS 患者这种遗传变异的 Val/Val 基因型的患病率明显更高(OR=2.04;95%CI:1.12,3.73;P=0.02)。在 APS 患者中,那些具有抗-β(2)-GPI 抗体的患者这种基因型的患病率更高(OR=1.73;95%CI:1.04,2.87;P=0.03)。对于动脉或静脉血栓形成,没有发现显著的结果。
β(2)-GPI 基因的 Val/Val 基因型与患 APS 的显著超额风险相关,并且在 APS 患者中,与具有抗-β(2)-GPI 抗体相关。对于这种多态性与 APS 患者血栓形成的相关性,不能得出明确的结论。