脳血管障害:研究と診療の進歩(10) : 抗リン脂質抗体症候群と脳血管障害

概要

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Antiphospholipid syndrome (APL) is important as a cause of ischemic stroke in young adults. In our study, stroke patients with APL were significantly younger and were more likely to be women than stroke patients without APL. Valvular heart disease, neurological complications, and hematological disorders were more frequent in the APL-positive group. The mean value of thrombin-antithrombin III complex was significantly lower in the APL-positive group. Cerebral infarctions in the carotid system were less and large artery lesions were more frequent in the APL-positive patients. β2-glycoprotein I (β2-GPI) is the antigen most responsible for antiphospholipid antibodies. At the DNA level, 4 different types of allelic polymorphism have been detected in β2-GPI. Position 247 allele is composed of either valine (V) or leucine (L), resulting in genotype expression of VV, VL, or LL. In our study, the V and VL genotypes were more frequent in patients with cerebral infarction than in normal controls. The VL genotype was more frequent among patients aged ≦60 years than those aged >60 years. The mean values of (3-thromboglobulin and platelet factor 4 in patients with the VL genotype were significantly higher than in those with the LL genotype. The results suggested that V247 β2-GPI allele is a genetic risk factors for the development of cerebral infarction.
東京女子医科大学の論文