Abstract:
The diagnosis of antiphospholipid syndrome (APS) relies on the detection of antiphospholipid antibodies (aPL). Currently, lupus anticoagulant (LA), anticardiolipin (aCL), and antibeta2-glycoprotein I antibodies (aβ2GPI) IgG or IgM are included as laboratory criteria, if persistently present. LAC measurement remains a complicated procedure with many pitfalls and interfered by anticoagulant therapy. Solid-phase assays for aCL and aβ2GPI show interassay differences. These methodological issues make the laboratory diagnosis of APS challenging. In the interpretation of aPL. results, antibody profiles help in identifying patients at risk. Other aPL, such as antibodies against the domain I of beta2-glycoprotein (aDI) and antiphosphatidylserine-prothrombin (aPS/PT) antibodies have been studied in the last years and may be useful in risk stratification of APS patients. Because of the methodological shortcomings of immunological and clotting assays, these non-criteria aPL may be useful in patients with incomplete antibody profiles to confirm or exclude the increased risk profile. This manuscript will focus on the laboratory aspects, the clinical relevance of assays and interpretation of aPL results in the diagnosis of APS.
摘要:
抗磷脂综合征(APS)的诊断依赖于抗磷脂抗体(aPL)的检测。目前,狼疮抗凝药(LA),抗心磷脂(aCL),和抗β2-糖蛋白I抗体(αβ2GPI)IgG或IgM作为实验室标准,如果持续存在。LAC测量仍然是一个复杂的过程,有许多陷阱,并受到抗凝治疗的干扰。aCL和aβ2GPI的固相测定显示测定间差异。这些方法学问题使得APS的实验室诊断具有挑战性。在对aPL的解释中。结果,抗体谱有助于识别有风险的患者.其他aPL,例如针对β2-糖蛋白(aDI)结构域I的抗体和抗磷脂酰丝氨酸-凝血酶原(aPS/PT)抗体在过去几年中已经被研究,这些抗体可能有助于APS患者的风险分层.由于免疫学和凝血试验的方法学缺陷,这些非标准aPL可能有助于抗体谱不完全的患者确认或排除增加的风险.这份手稿将集中在实验室方面,分析和aPL解释结果在APS诊断中的临床相关性。