摘要
产科抗磷脂综合征(obstetric antiphospholipid syndrome,OAPS)是一种以病理妊娠为主要临床表现伴抗磷脂抗体(antiphospholipid antibodies,APLs)持续阳性为特征的自身免疫性疾病,其病理妊娠包括反复早期流产、子痫或子痫前期、胎盘功能不全相关并发症及孕中晚期胎儿死亡等。APLs介导的补体活化是OAPS重要的发病机制之一。多项研究显示APLs免疫复合物主要通过补体活化经典途径启动,通过旁路途径进一步扩增,主要通过C5a与C5a受体结合介导炎症反应,导致不良妊娠结局。以补体通路为靶向的药物未来可能成为OAPS重要的治疗手段之一,特别是对应用阿司匹林和肝素治疗后仍然出现病理妊娠结局的难治性OAPS患者。
Obstetric antiphospholipid syndrome(OAPS)is an autoimmune disease mainly clinically characterized by pregnancy complications,which include recurrent early abortion,eclampsia or pre-eclampsia,complications related to placental insufficiency,and fetal death of middle or late gestation period,and persistent positive antiphospholipid antibodies(APLs).APLs-mediated complement activation is one of the important pathogenic mechanisms in OAPS,and several studies show complement initiation is mainly through the complement activation classical pathway,further amplified by the alternative pathway,and finally C5 a binding to the C5 a receptor mediate the inflammatory response,leading to adverse pregnancy outcomes.Drugs targeting complement pathway may be one of the important treatment options for OAPS in the future,especially in patients with refractory OAPS who still have adverse pregnancy outcomes after aspirin and heparin treatment.
作者
陈思运
蒋慧
王楚涵
黄璨
赵久良
赵岩
曾小峰
CHEN Si-yun;JIANG Hui;WANG Chu-han;HUANG Can;ZHAO Jiu-liang;ZHAO Yan;ZENG Xiao-feng(Department of Rheumatology and Clinical Immunology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Key Laboratory of Rheumatology,Ministry of Education,State Key Laboratory of Difficult Severe And Rare Diseases,National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID),Beijing 100730,China)
出处
《中华临床免疫和变态反应杂志》
CAS
2022年第5期511-516,共6页
Chinese Journal of Allergy & Clinical Immunology
基金
十四·五国家重点研发计划常见多发病防治专项(2021YFC2501300)
中央高水平医院临床科研专项(2022-PUMCH-A-008,2022-PUMCH-A-038)。
关键词
产科抗磷脂综合征
抗磷脂抗体
补体
补体抑制治疗
Obstetric antiphospholipid syndrome
antiphospholipid antibody
complement
complement inhibition therapy
