Vascular Medicine Unit, Vascular and Endovascular Surgery Department, CHU-Besancon, 3 BD Alexandre Fleming, F-25000, Besancon, France.
Université de Franche-Comté, SINERGIES, F-25000, Besancon, France.
Curr Rheumatol Rep. 2024 May;26(5):178-187. doi: 10.1007/s11926-024-01140-1. Epub 2024 Feb 19.
Thrombotic risk assessment in antiphospholipid positive (aPL +) subjects is a major challenge, and the study of in vitro thrombin generation (thrombin generation assays (TGA)) could provide useful information. Activated protein C (APC) sensitivity is involved in thrombotic events in antiphospholipid syndrome patients. We summarized methods used to assess APC sensitivity with TGA and evaluated the prognostic role of APC resistance through literature search.
APC resistance induced by aPL is a complex pathway. Several cross-sectional studies assessed APC sensitivity to understand thrombotic event mechanisms in aPL + subjects. Only one prospective cohort had investigated the prognostic impact of APC resistance in aPL + subjects, with a positive and significant correlation between APC sensitivity and the risk of thrombosis during the follow up (hazard ratio, 6.07 [95% CI, 1.69-21.87]). APC resistance assessed with TGA could be associated with thrombotic events in aPL + subjects.
抗磷脂抗体阳性（aPL+）患者的血栓风险评估是一个主要挑战，体外凝血酶生成（凝血酶生成试验（TGA））的研究可能提供有用的信息。活化蛋白 C（APC）敏感性与抗磷脂综合征患者的血栓事件有关。我们总结了使用 TGA 评估 APC 敏感性的方法，并通过文献检索评估了 APC 抵抗的预后作用。
aPL 诱导的 APC 抵抗是一个复杂的途径。一些横断面研究评估了 APC 敏感性，以了解 aPL+患者的血栓事件机制。只有一项前瞻性队列研究调查了 APC 抵抗在 aPL+患者中的预后影响，在随访期间 APC 敏感性与血栓形成风险之间存在阳性和显著相关性（危险比，6.07 [95%CI，1.69-21.87]）。TGA 评估的 APC 抵抗可能与 aPL+患者的血栓事件有关。
