Mira Merashli1, Jose Delgado Alves2, Fabrizio Gentile3, Paul R J Ames4. 1. Department of Rheumatology, American University of Beirut, Beirut, Lebanon. 2. Immune Response & Vascular Disease Unit, Nova University, Lisbon, Portugal. 3. Department of Medicine & Health Sciences, Universita' del Molise, Campobasso, Italy. 4. Immune Response & Vascular Disease Unit, Nova University, Lisbon, Portugal. Electronic address: paxmes@aol.com.
Abstract
BACKGROUND: The relationship between antiphospholipid antibodies (aPL) and multiple sclerosis (MS) is unclear. OBJECTIVES: To evaluate a link between aPL and MS. METHODS: EMBASE and PubMed search to August 2016; Peto's odds ratio (OR) meta-analysis. RESULTS: The pooled prevalence of participants positive for IgG and IgM anticardiolipin (aCL) from 12 case-control studies was superior in MS than controls (6.8% vs 1.8%, p = 0.01 and 8.58% vs 2.18%, p = 0.001) with medium and high heterogeneities respectively (I2 = 48.55% and 68.13%). The pooled prevalence of participants positive for IgG anti-beta2glycoprotein-I (aβ2GPI) from seven case-control studies was lower in MS than controls (0.93% vs 4.02%) with high heterogeneity (I2 = 53.92%) though the pooled prevalence of participants positive for IgM aβ2GPI was similar (7.24% vs 6.13%) with high heterogeneity (I2 = 52.85%). Five cohorts compared IgG/IgM aCL and IgM aβ2GPI in stable/remission vs active/relapsing MS: the pooled prevalence of IgG aCL was similar in active/relapsing and stable/remission MS (19% vs 18.9%) but the pooled prevalence of IgM aCL was higher in active than in stable MS (36.9% vs 21%, p < 0.0001) as well as that of IgM β2GPI (40.5% vs 3.2%, p < 0.0001) with no heterogeneity. CONCLUSION: Data from case-control studies do not support a link between IgG/IgM aPL and MS. Data from cohort studies comparing active vs stable MS indicate a strong link between aPL of IgM isotype and active/relapsing MS but in the absence of aPL titres to comment upon this may either represent an epiphenomenon of active neuro-inflammation or natural autoantibodies devoid of pathogenic potential. Data expressed as frequency of aPL positive participants rather than average titres preclude further assumptions.
BACKGROUND: The relationship between antiphospholipid antibodies (aPL) and multiple sclerosis (MS) is unclear. OBJECTIVES: To evaluate a link between aPL and MS. METHODS: EMBASE and PubMed search to August 2016; Peto's odds ratio (OR) meta-analysis. RESULTS: The pooled prevalence of participants positive for IgG and IgM anticardiolipin (aCL) from 12 case-control studies was superior in MS than controls (6.8% vs 1.8%, p = 0.01 and 8.58% vs 2.18%, p = 0.001) with medium and high heterogeneities respectively (I2 = 48.55% and 68.13%). The pooled prevalence of participants positive for IgG anti-beta2glycoprotein-I (aβ2GPI) from seven case-control studies was lower in MS than controls (0.93% vs 4.02%) with high heterogeneity (I2 = 53.92%) though the pooled prevalence of participants positive for IgM aβ2GPI was similar (7.24% vs 6.13%) with high heterogeneity (I2 = 52.85%). Five cohorts compared IgG/IgM aCL and IgM aβ2GPI in stable/remission vs active/relapsing MS: the pooled prevalence of IgG aCL was similar in active/relapsing and stable/remission MS (19% vs 18.9%) but the pooled prevalence of IgM aCL was higher in active than in stable MS (36.9% vs 21%, p < 0.0001) as well as that of IgM β2GPI (40.5% vs 3.2%, p < 0.0001) with no heterogeneity. CONCLUSION: Data from case-control studies do not support a link between IgG/IgM aPL and MS. Data from cohort studies comparing active vs stable MS indicate a strong link between aPL of IgM isotype and active/relapsing MS but in the absence of aPL titres to comment upon this may either represent an epiphenomenon of active neuro-inflammation or natural autoantibodies devoid of pathogenic potential. Data expressed as frequency of aPL positive participants rather than average titres preclude further assumptions.
Authors: Eva K Kempers; Virgil A S H Dalm; Marie Josee E van Rijn; Annemarie G M G J Mulders; Frank W G Leebeek; Moniek P M de Maat; A J Gerard Jansen Journal: Rheumatol Adv Pract Date: 2021-11-27