抗β2 糖蛋白 I 结构域 I 抗体的流行率和血栓风险评估：系统评价。
Prevalence and Thrombotic Risk Assessment of Anti-β2 Glycoprotein I Domain I Antibodies: A Systematic Review.
机构信息
Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, University of Turin and S. Giovanni Bosco Hospital, Turin, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Laboratory of Immuno-Rheumatology Research, Istituto Auxologico Italiano, Milan, Italy.
出版信息
Semin Thromb Hemost. 2018 Jul;44(5):466-474. doi: 10.1055/s-0037-1603936. Epub 2017 Aug 4.
BACKGROUND
To date, the exact prevalence of anti-β glycoprotein I domain I (anti-βGPI-DI) antibodies in patients with antiphospholipid syndrome (APS) and their role when assessing thrombosis risk is uncertain.
OBJECTIVES
To estimate the prevalence of anti-βGPI-DI in patients with APS and to determine whether anti-βGPI-DI-positive individuals are at greater risk of thrombosis, as compared with individuals without anti-βGPI-DI, by systematically reviewing the literature.
METHODS
A detailed literature search was applied a priori to Ovid MEDLINE In-Process and Other Non-Indexed Citation 1986 to present and to abstracts from the European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR)/Association for Rheumatology Health Professionals (ARHP ) Annual Meetings (2011-2015).
RESULTS
A total of 11 studies, including 1,585 patients, were analyzed. Patients were distributed as follow: 1,218 patients APS (45.4% anti-βGPI-DI-positive; in more detail: 504 primary APS [55.4% anti-βGPI-DI-positive], 192 secondary APS [43.2% anti-βGPI-DI-positive], and 522 not specified), 318 with systemic lupus erythematosus (SLE; 26.7% anti-βGPI-DI-positive), 49 asymptomatic carriers of antiphospholipid antibodies (aPL) (30.6% anti-βGPI-DI-positive), and 1,859 healthy controls. When considering the five studies eligible for thrombotic risk assessment, four studies found a significant association of anti-βGPI-DI-positivity with thrombotic events, whereas one study found no predictive correlation with thrombosis (overall odds ratio [OR] for pooled data: 1.99; 95% confidence interval [CI]: 1.52-2.6; < 0.0001).
CONCLUSION
We report an overall estimated median prevalence of anti-βGPI-DI antibodies of 44.3% in patients with APS and/or SLE and a significantly higher prevalence among patients with APS compared with SLE alone. Anti-βGPI-DI antibodies might represent a promising tool when assessing thrombotic risk in patients with APS.
背景
迄今为止，抗β糖蛋白 I 结构域 I（抗-βGPI-DI）抗体在抗磷脂综合征（APS）患者中的确切患病率及其在评估血栓风险中的作用尚不确定。
目的
通过系统综述文献，评估 APS 患者中抗-βGPI-DI 的患病率，并确定与无抗-βGPI-DI 患者相比，抗-βGPI-DI 阳性个体是否具有更高的血栓形成风险。
方法
预先对 Ovid MEDLINE In-Process 和其他非索引引文 1986 年至目前以及欧洲抗风湿病联盟（EULAR）和美国风湿病学会（ACR）/风湿病健康专业人员协会（ARHP）年会摘要（2011-2015 年）进行了详细的文献检索。
结果
共分析了 11 项研究，包括 1585 名患者。患者分布如下：1218 名 APS 患者（45.4%抗-βGPI-DI 阳性；更详细地说：504 名原发性 APS [55.4%抗-βGPI-DI 阳性]，192 名继发性 APS [43.2%抗-βGPI-DI 阳性]和 522 名未指定），318 名系统性红斑狼疮（SLE）患者（26.7%抗-βGPI-DI 阳性），49 名抗磷脂抗体（aPL）无症状携带者（30.6%抗-βGPI-DI 阳性）和 1859 名健康对照者。在考虑五项适合评估血栓形成风险的研究中，四项研究发现抗-βGPI-DI 阳性与血栓形成事件存在显著关联，而一项研究发现与血栓形成无预测相关性（汇总数据的总体优势比[OR]：1.99；95%置信区间[CI]：1.52-2.6；<0.0001）。
结论
我们报告了 APS 和/或 SLE 患者中抗-βGPI-DI 抗体的总体估计中位数患病率为 44.3%，且 APS 患者的患病率明显高于单独的 SLE 患者。抗-βGPI-DI 抗体在评估 APS 患者的血栓形成风险时可能是一种很有前途的工具。
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