风湿

改善APS的实验室诊断

作者:作者:Roberta Misasi,et al. 翻译:北医三院刘畅(liuchang_jane@yeah.net) 发布:柴静 审核:赵金霞 来源:中国风湿病公众论坛 日期:2017-08-12
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         前沿进展 | 改善APS的实验室诊断:新的抗原及新检测方法

关键字:  APS的实验室诊断 

        抗磷脂抗体(aPLs)是一组诊断磷脂及磷脂/蛋白复合物的异质性抗体。现行的检测方法,包括“固相”序列检测抗心磷脂抗体和抗β2GP1抗体,以及“液相”序列检测狼疮抗凝物。在过去的几年中,新的靶抗原以及检测方法被发现,由此改善了APS的实验室诊断。在这篇综述中将讨论β2-GPI结构域 ,凝血酶原/磷脂酰丝氨酸,波形蛋白/心磷脂,蛋白S,蛋白C,膜联蛋白A2,膜联蛋白A5以及磷脂抗原等。此外,化学发光法,多线点测定法以及薄层色谱法等新的检测技术被开发出来应用于aPL的检测。此外,本文特别的关注了“血清阴性”APS的诊断(临床表现提示APS,而常规检测aPL持续阴性)。近期的研究发现,在血清阴性APS患者血清中,应用新的靶抗原(主要是波形蛋白/心磷脂)以及新的检测方法(TLC)可检测到传统靶抗原及传统检测方法不能检测到的抗体。因此,APS表现多种多样,持续发展的新型检测方法将有助于检测不一而足的抗体。

        附原文:Antiphospholipidantibodies(aPLs) are a heterogeneous group of antibodies directed against phospholipidsor protein/phospholipid complexes. Currently, aPLs are assessed using either"solid-phase" assays that identify anticardiolipin antibodies andanti-β2-glycoprotein I antibodies or "liquid-phase" assay thatidentifies lupus anticoagulant. However, in the last few years,"new"antigenictargetsandmethodologicalapproacheshavebeen employed forrefininglaboratorydiagnosisofantiphospholipidsyndrome(APS).In this review the potential diagnostic value of antibodies to domains ofβ2-GPI, prothrombin/phosphatidylserine, vimentin/cardiolipin, protein S,protein C, annexin A2, annexin A5, and phospholipid antigens is discussed.Moreover, new technicalapproaches, including chemiluminescence, multilinedot assay, and thin layer chromatography (TLC) immunostaining, which utilizedifferent supports for detection of aPL, have been developed. A special focushas been dedicated on "seronegative" APS, that is, those patientswith a clinical profile suggestive of APS (thromboses, recurrent miscarriages,or foetal loss), who are persistently negative for the routinely used aPL.Recent findings suggest that, in sera from patients with SN-APS, antibodies maybe detected using "new"antigenictargets(mainlyvimentin/cardiolipin) ormethodologicalapproachesdifferent fromtraditional techniques (TLC immunostaining). Thus, APS represents a mosaic,in which antibodies against differentantigenictargetsmay bedetected thanks to the continuously evolving new technologies.

        引自:Misasi Ret al."New"antigenictargetsandmethodologicalapproachesforrefininglaboratorydiagnosisofantiphospholipidsyndrome.J Immunol Res.2015;2015:858542. doi:10.1155/2015/858542. Epub 2015 Mar 19.

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