Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Arthritis Res Ther. 2023 Oct 6;25(1):195. doi: 10.1186/s13075-023-03175-8.
β2-glycoprotein I (β2GPI) complexed with human leukocyte antigen DR (β2GPI/HLA-DR) was found to be a major autoantibody target in antiphospholipid syndrome (APS). This study aimed to reveal the association between anti-β2GPI/HLA-DR antibodies and vascular thromboses in women with systemic rheumatic diseases.
We conducted a retrospective longitudinal study. We measured anti-β2GPI/HLA-DR antibodies and compared them with anti-phospholipid antibody (aPL) profiles and the adjusted global antiphospholipid syndrome score (aGAPSS). Using receiver operating characteristic (ROC) analysis, we determined the best cut-off value for arterial thrombosis. We also evaluated the validity of anti-β2GPI/HLA-DR antibodies by adding to conventional cardiovascular risk factors in multivariate logistic analysis.
We evaluated 704 patients, including 66 (obstetric or thrombotic) APS, 13 primary APS, and 78 asymptomatic aPL carriers. Seventy-seven patients had a history of arterial thrombosis, and 14 patients had both arterial and venous thrombosis. These 14 patients, as well as patients with aGAPSS > 10 or triple-positive aPL profiles, displayed high anti-β2GPI/HLA-DR antibody titers. The ROC curve showed a sensitivity, specificity, and area under the curve (AUC) for arterial thrombosis of 33.8%, 91.4%, and 0.6009, respectively, with a cut-off value of 172.359 U/mL. The anti-β2GPI/HLA-DR antibody positivity using this cut-off value yielded an odds ratio of 5.13 (95%CI: 2.85-9.24), significantly improving the AUC from 0.677 to 0.730.
Anti-β2GPI/HLA-DR antibodies are associated with arterial thrombosis in female patients with systemic rheumatic diseases.
β2-糖蛋白 I（β2GPI）与人类白细胞抗原 DR（β2GPI/HLA-DR）形成复合物，被认为是抗磷脂综合征（APS）中的主要自身抗体靶标。本研究旨在揭示系统性风湿病女性患者中抗β2GPI/HLA-DR 抗体与血管血栓形成之间的关联。
我们进行了一项回顾性纵向研究。我们测量了抗β2GPI/HLA-DR 抗体，并将其与抗磷脂抗体（aPL）谱和调整后的全球抗磷脂综合征评分（aGAPSS）进行比较。使用受试者工作特征（ROC）分析，我们确定了动脉血栓形成的最佳截断值。我们还通过在多变量逻辑回归分析中加入传统心血管危险因素来评估抗β2GPI/HLA-DR 抗体的有效性。
我们评估了 704 名患者，包括 66 名（产科或血栓形成性）APS、13 名原发性 APS 和 78 名无症状 aPL 携带者。77 名患者有动脉血栓形成史，14 名患者有动静脉血栓形成。这些 14 名患者以及 aGAPSS>10 或三阳性 aPL 谱的患者显示出高抗β2GPI/HLA-DR 抗体滴度。ROC 曲线显示动脉血栓形成的敏感性、特异性和曲线下面积（AUC）分别为 33.8%、91.4%和 0.6009，截断值为 172.359 U/mL。使用该截断值的抗β2GPI/HLA-DR 抗体阳性率产生的优势比为 5.13（95%CI：2.85-9.24），显著提高了 AUC 从 0.677 到 0.730。
抗β2GPI/HLA-DR 抗体与系统性风湿病女性患者的动脉血栓形成有关。
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