Molinari Angelo Claudio, Martini Tiziano, Banov Laura, Ierardi Antonella, Leotta Marzia, Strangio Alessandra, Santoro Rita Carlotta
Thrombosis and Hemostasis Unit, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy.
Immuno-Haematology and Transfusion Medicine, Center for Congenital Bleeding Disorders, Cesena General Hospital, 47521 Cesena, Italy.
J Clin Med. 2023 Oct 20;12(20):6654. doi: 10.3390/jcm12206654.
Diagnosis of antiphospholipid syndrome (APS) requires the presence of a clinical criterion (thrombosis and/or pregnancy morbidity), combined with persistently circulating antiphospholipid antibodies (aPL). Lupus anticoagulant (LA) is one of the three laboratory parameters (the others being antibodies to either cardiolipin or β2-glycoprotein I) that defines this rare but potentially devastating condition. For the search for aCL and aβ2-GP-I, traditionally measured with immunological solid-phase assays (ELISA), several different assays and detection techniques are currently available, thus making these tests relatively reliable and widespread. On the other hand, LA detection is based on functional coagulation procedures that are characterized by poor standardization, difficulties in interpreting the results, and interference by several drugs commonly used in the clinical settings in which LA search is appropriate. This article aims to review the current state of the art and the challenges that clinicians and laboratories incur in the detection of LA.
抗磷脂综合征（APS）的诊断需要具备临床标准（血栓形成和/或妊娠并发症），并伴有持续循环的抗磷脂抗体（aPL）。狼疮抗凝物（LA）是定义这种罕见但可能具有毁灭性疾病的三个实验室参数之一（另外两个是抗心磷脂抗体或抗β2糖蛋白I抗体）。传统上，aCL和aβ2-GP-I是通过免疫固相测定法（ELISA）进行检测的，目前有几种不同的检测方法和技术，因此这些检测相对可靠且应用广泛。另一方面，LA检测基于功能凝血程序，其特点是标准化程度差、结果解释困难，并且在适合检测LA的临床环境中常用的几种药物会产生干扰。本文旨在综述LA检测的当前技术水平以及临床医生和实验室在检测LA时面临的挑战。
