Wise Young
06-22-2003, 06:27 AM
• Galli M, Luciani D, Bertolini G and Barbui T (2003). Anti{beta}2-glycoprotein I, antiprothrombin antibodies and the risk of thrombosis in the antiphospholipid syndrome. Blood Summary: The association of antiphospholipid antibodies with thrombosis and obstetric events defines the antiphospholipid syndrome. A recent systematic review of the literature showed that lupus anticoagulants are risk factors of thrombosis, independent of the type and site of the event, the presence of systemic lupus erythematosus, and the laboratory methods used to detect them. Anticardiolipin antibodies are not as strong risk factors, unless arterial thrombosis, the G isotype and medium or high titers were considered. Here, we extended the systematic review to antibeta2-glycoprotein I and antiprothrombin antibodies. Thirty-two, mainly retrospective, studies provided or enabled us to calculate the odds ratio with 95% confidence interval of antibeta2-glycoprotein I and antiprothrombin antibodies for thrombosis in 5,102 patients and 1,973 controls. Twenty-eight studies analysed 60 associations between antibeta2-glycoprotein I antibodies and thrombosis: 5 of 17 associations with arterial thrombosis, 12 of 21 with venous events, and 17 of 22 with any type of thrombosis were significant. Seventeen studies assessed 46 associations between antiprothrombin antibodies and thrombosis: only 17 were significant. As most studies involved patients with systemic lupus erythematosus, lupus anticoagulants, or anticardiolipin antibodies, it is difficult to establish the value of antibeta2-glycoprotein I and antiprothrombin antibodies as independent risk factors. In conclusion, the clinical significance of these antibodies still requires to be further investigated. However, before other clinical studies are done, standardization or at least harmonization of the methods used to detect antibeta2-glycoprotein I and antiprothrombin antibodies is mandatory. Division of Hematology, Ospedali Riuniti, Bergamo, Italy.