抗磷脂综合征患者血栓复发高风险的生物标志物:文献综述。

IF 9.2 1区 医学 Q1 IMMUNOLOGY Autoimmunity reviews Pub Date : 2024-06-01 DOI:10.1016/j.autrev.2024.103585
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引用次数: 0

摘要

目的:本综述旨在确定抗磷脂综合征(APS)患者血栓和/或产科事件复发风险的生物标志物:本综述旨在确定抗磷脂综合征(APS)患者血栓和/或产科事件复发风险的生物标志物:方法:对文献进行全面综述,评估与 APS 血栓形成相关的已确定和潜在的新型生物标记物。为此,我们使用以下关键词或关键词组合对过去 20 年的 PubMed 文献进行了检索:血栓风险、血栓复发、风险分层、严重程度、预测价值:抗磷脂抗体(aPL)的 N-糖基化分析表明,低水平的 IgG sialylation、fucosylation 或 galactosylation 会增加 aPL 的促炎活性,从而导致血栓形成。此外,对血清中的中性粒细胞胞外捕获物(NETs)和针对NETs的抗体(抗NETs)进行定量分析,可用于评估APS的严重程度。氧化应激在 APS 的致病过程中起着重要作用,而副氧合酶 1 (PON1) 的活性则是 APS 中血栓风险的一种有希望的生物标志物。此外,溶血双磷脂酸(LBPA)等参与APS病理生理学的新型抗原靶点的鉴定导致了非常规aPL的发现,即针对LBPA的抗体(aLBPA),其临床价值可使识别血栓复发高风险的APS患者成为可能:aPL的免疫学特征、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。
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Biological markers of high risk of thrombotic recurrence in patients with antiphospholipid syndrome: A literature review

Objectives

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).

Methods

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.

Results

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.

Conclusion

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.

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来源期刊
Autoimmunity reviews
Autoimmunity reviews 医学-免疫学
CiteScore
24.70
自引率
4.40%
发文量
164
审稿时长
21 days
期刊介绍: Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.
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