Prevalence and Clinical Associations of Antiphospholipid Antibodies in Systemic Sclerosis: New Data From a French Cross-Sectional Study, Systematic Review, and Meta-Analysis

被引:17
作者
Sobanski, Vincent [1 ,2 ,3 ,4 ]
Lemaire-Olivier, Angelique [3 ,4 ]
Giovannelli, Jonathan [1 ,2 ,3 ,4 ]
Dauchet, Luc [5 ]
Simon, Myriam [3 ,4 ]
Lopez, Benjamin [1 ,2 ,6 ]
Yelnik, Cecile [1 ,2 ,3 ,4 ]
Lambert, Marc [1 ,2 ,3 ,4 ]
Hatron, Pierre-Yves [3 ,4 ]
Hachulla, Eric [1 ,2 ,3 ,4 ]
Dubucquoi, Sylvain [1 ,2 ,6 ]
Launay, David [1 ,2 ,3 ,4 ]
机构
[1] Univ Lille, U995, Lille Inflammat Res Int Ctr, Lille, France
[2] INSERM, Lille, France
[3] CHU Lille, Dept Med Interne & Immunol Clin, Lille, France
[4] Ctr Natl Reference Malad Syst & Autoimmunes Rares, Lille, France
[5] Univ Lille, CHU Lille, Inst Pasteur Lille, Inserm,UMR1167,RID AGE,Risk Factors & Mol Determi, Lille, France
[6] CHU Lille, Inst Immunol, Lille, France
来源
FRONTIERS IN IMMUNOLOGY | 2018年 / 9卷
关键词
systemic sclerosis; antiphospholipid antibodies; pulmonary hypertension; venous thrombosis; miscarriage; ANTI-BETA(2) GLYCOPROTEIN-I; ANTICARDIOLIPIN ANTIBODIES; CRITERIA; CLASSIFICATION; PLATELET; DISEASE; AUTOANTIBODIES; ACTIVATION; DIAGNOSIS; COHORT;
D O I
10.3389/fimmu.2018.02457
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objectives: Antiphospholipid antibodies (aPL) can be present in the sera of systemic sclerosis (SSc) patients. This study aimed to determine the prevalence of aPL in a cross-sectional study of SSc patients, to assess their clinical associations, to perform a systematic review of published reports and a meta-analysis to estimate the worldwide prevalence of aPL in SSc. Methods: Two-hundred and forty-nine SSc patients were consecutively tested once for lupus anticoagulant (LA), anticardiolipin (aCL), and anti-beta 2glycoprotein I (anti-beta 2GpI) antibodies. Clinical associations with aPL positivity were studied using a logistic regression model. A systematic review of the literature was carried out in PubMed and Embase. Meta-analysis was performed using number of aPL positive (at least one of the three antibodies positive) and negative patients. Meta-regression was used to study potential factors explaining the heterogeneity between studies. Results: In our cross-sectional study, aPL positivity was found in 16 patients (prevalence 6.4%; 95% CI [3.8-10.4]). In multivariate analysis, there was a significant association between aPL positivity and venous thrombosis (VT) (OR 6.25 [1.18-33.00]; p = 0.028) and miscarriage (OR 5.43; 95% CI [1.31-22.13]; p = 0.017). Twenty-four studies were included in the meta-analysis, representing a total population of 3036 SSc patients. The overall pooled prevalence of aPL in SSc was 16% (10-22) with a high degree of heterogeneity among studies. Conclusion: This study found a prevalence of aPL positivity in our SSc population of 6.4% (3.8-10.4) and an overall worldwide pooled prevalence of 14% (9-20). In our SSc population, aPL positivity was associated with VT and miscarriage. These data provide additional insights into the role of aPL in the vasculopathy observed in SSc.
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页数:11
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