Division of Hematology, University of Washington, Seattle, WA.
Department of Medicine, and.
Blood Adv. 2021 Oct 26;5(20):3931-3936. doi: 10.1182/bloodadvances.2021005205.
Anti-β-2 glycoprotein I antibodies (anti-B2GPI) are often cited as the major pathogenically relevant antibody in antiphospholipid syndrome (APS), but it is unclear if there is clinical evidence to support this theory. We performed a systematic review to determine if immunoglobulin G anti-B2GPI positivity was independently associated with thrombotic and/or obstetric manifestations of APS. We searched MEDLINE, EMBASE, The Cochrane Library, and clinicaltrials.gov electronic databases through April 2020 for prospective studies that met prespecified design criteria. Of 4758 articles identified through computer-assisted search, 4 studies examining obstetric outcomes and 2 studies examining thrombotic outcomes were included for qualitative assessment. The presence of anti-B2GPI had only a weak independent association with thrombosis and was, at best, inconsistently associated with obstetric complications. A quantitative assessment could not be performed because of study heterogeneity. The overall quality of the evidence was very low. Although anti-B2GPI are commonly thought to mediate APS manifestations, clinical evidence is lacking with very low-quality data to support a weak association with thrombosis.
抗β-2 糖蛋白 I 抗体（抗 B2GPI）常被认为是抗磷脂综合征（APS）中主要的致病性相关抗体，但目前尚不清楚是否有临床证据支持这一理论。我们进行了一项系统评价，以确定 IgG 抗 B2GPI 阳性是否与 APS 的血栓形成和/或产科表现独立相关。我们通过计算机辅助搜索，检索了 MEDLINE、EMBASE、The Cochrane Library 和 clinicaltrials.gov 电子数据库，以获取符合预设设计标准的前瞻性研究。在通过计算机辅助搜索确定的 4758 篇文章中，纳入了 4 项研究产科结局和 2 项研究血栓形成结局的定性评估。抗 B2GPI 的存在与血栓形成仅有微弱的独立相关性，而且与产科并发症的相关性最多也是不一致的。由于研究异质性，无法进行定量评估。证据的总体质量非常低。尽管抗 B2GPI 通常被认为介导 APS 的表现，但缺乏临床证据，且数据质量非常低，无法支持与血栓形成的弱相关性。
