Service d'Immunologie, Biogénopôle, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
Service d'Immunologie, Biogénopôle, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix Marseille University, INSERM, C2VN Marseille, France.
Autoimmun Rev. 2024 Jun;23(6):103585. doi: 10.1016/j.autrev.2024.103585. Epub 2024 Jul 31.
This review aims to identify biological markers associated with the risk of recurrence of thrombotic and/or obstetric events in patients with antiphospholipid syndrome (APS).
A comprehensive review of literature was conducted to evaluate established and potential novel biological markers associated with thrombosis in APS. To this end, a PubMed literature search was conducted for the last twenty years using the following keywords or their combinations: thrombotic risk, recurrence of thrombosis, risk stratification, severity, predictive value.
Previous studies showed that multiple aPL positivity correlates with an increased risk of thrombosis in APS. Moreover, the analysis of N-glycosylation of antiphospholipid antibodies (aPL) revealed that low levels of IgG sialylation, fucosylation or galactosylation increases the pro-inflammatory activity of aPL, predisposing to thrombosis. In addition, quantification of neutrophil extracellular traps (NETs) and antibodies directed against NETs (anti-NETs) in serum demonstrates promising prognostic utility in assessing APS severity. Oxidative stress plays a role in the pathogenicity of APS and paraoxonase 1 (PON1) activity emerges as a promising biomarker of thrombotic risk in APS. Furthermore, identification of novel antigenic targets involved in the pathophysiology of APS, such as lysobisphosphatidic acid (LBPA), had led to the discovery of unconventional aPL, antibodies directed against the LBPA (aLBPA), whose clinical value could make it possible to identify APS patients at high risk of thrombotic recurrence.
The immunological profile of aPL, N-glycosylation of aPL, quantification of NETs and anti-NETs, analysis of biomarkers of oxidative stress and the discovery of aLBPA offer potential prognostic tools for risk stratification in APS patients.
本综述旨在确定与抗磷脂综合征（APS）患者血栓形成和/或产科事件复发风险相关的生物标志物。
对文献进行了全面综述，以评估与 APS 血栓形成相关的已确立和潜在的新型生物标志物。为此，使用以下关键词或其组合在过去 20 年内在 PubMed 上进行了文献检索：血栓形成风险、血栓形成复发、风险分层、严重程度、预测价值。
先前的研究表明，多种 aPL 阳性与 APS 中血栓形成风险增加相关。此外，对磷脂抗体（aPL）的 N-糖基化分析表明，IgG 唾液酸化、岩藻糖化或半乳糖化水平降低会增加 aPL 的促炎活性，导致血栓形成。此外，血清中中性粒细胞胞外陷阱（NETs）和针对 NETs 的抗体（抗-NETs）的定量表明，在评估 APS 严重程度方面具有有前景的预后实用价值。氧化应激在 APS 的发病机制中起作用，而过氧化物酶 1（PON1）活性是 APS 血栓形成风险的有前途的生物标志物。此外，鉴定参与 APS 病理生理学的新型抗原性靶标，如溶血磷脂酸（LBPA），导致发现了针对 LBPA 的非常规 aPL，即针对 LBPA 的抗体（aLBPA），其临床价值可用于识别具有高血栓复发风险的 APS 患者。
aPL 的免疫特征、aPL 的 N-糖基化、NETs 和抗-NETs 的定量、氧化应激生物标志物的分析以及 aLBPA 的发现为 APS 患者的风险分层提供了潜在的预后工具。
