{"id":240,"date":"2025-06-11T13:36:08","date_gmt":"2025-06-11T13:36:08","guid":{"rendered":"https:\/\/analizesanocare.ro\/?post_type=product&#038;p=240"},"modified":"2025-08-08T13:57:11","modified_gmt":"2025-08-08T13:57:11","slug":"markeri-pentru-sindromul-antifosfolipidic","status":"publish","type":"product","link":"https:\/\/analizesanocare.ro\/en\/analiz\u0103\/markeri-pentru-sindromul-antifosfolipidic\/","title":{"rendered":"Markeri pentru sindromul antifosfolipidic"},"content":{"rendered":"<h2><strong>Informa\u021bii generale Anticorpi anti-anexina V<\/strong><\/h2>\n<p>Anticorpii anti-anexina V sunt markeri de linia a doua \u00een diagnosticul serologic al sindromului antifosfolipidic<sup>1<\/sup>.<\/p>\n<p>Sindromul antifosfolipidic (APS) este o boal\u0103 autoimun\u0103 caracterizat\u0103 clinic prin episoade de tromboz\u0103 (venoas\u0103, arterial\u0103 sau ambele) \u0219i\/ sau complica\u021bii obstetricale \u0219i prin prezen\u021ba persistent\u0103 de anticorpi antifosfolipidici circulan\u021bi. APS poate \u00eenso\u021bi o afec\u021biune reumatismal\u0103, cum ar fi <a href=\"https:\/\/www.synevo.ro\/lupus-eritematos-sistemic-o-boala-autoimuna\/\" data-wpel-link=\"internal\">lupusul eritematos sistemic (LES)<\/a>, sau poate fi primar, f\u0103r\u0103 o afec\u021biune reumatismal\u0103 asociat\u0103.<\/p>\n<p>Anticorpii antifosfolipidici sunt imunoglobuline direc\u021bionate fie \u00eempotriva fosfolipidelor, fie \u00eempotriva proteinelor plasmatice legate de fosfolipidele exprimate pe suprafa\u021ba celulelor endoteliale sau a trombocitelor<sup>1;2<\/sup>.<\/p>\n<p>Conform criteriilor de clasificare revizuite \u0219i publicate \u00een 2006 (Sapporo-Sydney), diagnosticul APS necesit\u0103 asocierea cel pu\u021bin a unui criteriu clinic \u0219i a unui criteriu de laborator. Criteriile de laborator se refer\u0103 la detectarea urm\u0103torilor anticorpi antifosfolipidici:<\/p>\n<ul>\n<li>lupus anticoagulant (LA), prezent la cel pu\u021bin 2 determin\u0103ri la interval de 12 s\u0103pt\u0103m\u00e2ni;<\/li>\n<li>anticorpi cardiolipinici (aCL) IgG \u0219i IgM cu titruri &gt;40 GPL\/MPL, prezen\u021bi la cel pu\u021bin 2 determin\u0103ri la interval de 12 s\u0103pt\u0103m\u00e2ni;<\/li>\n<li>anticorpi anti- \u03b22-glicoproteina 1 (\u03b22-GPI) IgG \u0219i IgM, cu titruri crescute (&gt;percentila 99 a limitei superioare de referin\u021b\u0103) prezen\u021bi la cel pu\u021bin 2 determin\u0103ri la interval de 12 s\u0103pt\u0103m\u00e2ni<sup>2<\/sup>.<\/li>\n<\/ul>\n<p>Detectarea acestor trei tipuri de anticorpi trebuie efectuat\u0103 \u00een paralel: \u00een general, dac\u0103 nu este detectat nici unul dintre ace\u0219ti anticorpi diagnosticul de APS este improbabil, \u00een timp ce detectarea mai multor tipuri de anticorpi se asociaz\u0103 cu forme mai severe de APS<sup>3<\/sup>.<\/p>\n<p>Cu toate acestea, \u00een practic\u0103 pot fi \u00eent\u00e2lni\u021bi pacien\u021bi care prezint\u0103 semne clinice sugestive pentru APS, dar la care se ob\u021bin \u00een mod repetat rezultate negative la cele trei teste men\u021bionate mai sus. Pentru definirea acestor cazuri a fost propus termenul de APS \u201eseronegativ\u201d<sup>4<\/sup>.<\/p>\n<p>\u00cen situa\u021bia unui APS \u201eseronegativ\u201d se poate recurge la efectuarea unor markeri serologici de linia a doua, cum ar fi: aCL IgA, \u03b22-GPI IgA, anticorpi antifosfatidilserin\u0103, anti-fosfoetanolamin\u0103, anti-fosfatidilinozitol, anti-fosfatidilcolin\u0103, anti-fosfatidilglicerol, anti-acid fosfatidic, anti-anexin\u0103, anti-protrombin\u0103. Ace\u0219ti autoanticorpi \u201enon-clasici\u201d au fost asocia\u021bi cu simptome sugestive de APS \u00een studii limitate \u0219i nu au fost inclu\u0219i \u00een criteriile de clasificare pentru a p\u0103stra specificitatea diagnosticului<sup>3;4<\/sup>.<\/p>\n<p>Anexinele reprezint\u0103 o familie de 12 proteine \u00eenalt conservate capabile s\u0103 lege fosfolipidele anionice \u00eentr-un mod dependent de calciu. Dintre acestea, anexina V se remarc\u0103 ca un anticoagulant natural ce se g\u0103se\u0219te \u00een principal la nivelul trofoblastului \u0219i celulelor endoteliale. Activitatea anticoagulant\u0103 marcat\u0103 a acestei proteine se datoreaz\u0103 cristaliz\u0103rii sale deasupra bistratului de fosfolipide membranare, form\u00e2nd un \u201escut\u201d ce blocheaz\u0103 accesul enzimelor coagul\u0103rii la fosfatidilserin\u0103, inhib\u00e2nd astfel activarea cascadei coagul\u0103rii. Anticorpii antifosfolipidici interfer\u0103 cu legarea anexinei V la fosfolipide \u0219i cu fenomenul de cristalizare, acceler\u00e2nd reac\u021biile coagul\u0103rii \u0219i favoriz\u00e2nd apari\u021bia trombozelor<sup>5;6;7<\/sup>.<\/p>\n<p>A\u0219a cum s-a ar\u0103tat pe modele murine, anexina 5 este exprimat\u0103 intens la nivelul placentei \u0219i se consider\u0103 c\u0103, datorit\u0103 afinit\u0103\u021bii sale crescute pentru fosfolipidele \u00eenc\u0103rcate negativ, este necesar\u0103 pentru men\u021binerea integrit\u0103\u021bii acesteia<sup>8<\/sup>.<\/p>\n<p>Niveluri crescute de autoanticorpi anti-anexin\u0103 V au fost descrise la 20-30% dintre pacien\u021bii cu LES. De asemenea, s-a sugerat c\u0103 ace\u0219ti anticorpi ar fi asocia\u021bi cu manifest\u0103rile clinice de APS (tromboze \u0219i pierderi recurente de sarcin\u0103)<sup>5;7<\/sup>.<\/p>\n<h2><strong>Recomand\u0103ri pentru determinarea anticorpilor anti-anexina V<\/strong><\/h2>\n<p><u>Cazurile cu simptomatologie APS <\/u><u>\u0219i<\/u> <u>markeri <\/u><u>serologici de prim\u0103 linie negativi<\/u>.<strong>\u00a0<\/strong><\/p>\n<ul>\n<li>Suspiciunile clinice de APS sunt: episoade de tromboz\u0103 venoas\u0103 sau arterial\u0103, survenite \u00een special la pacien\u021bi tineri, \u00een absen\u021ba oric\u0103rui diagnostic alternativ sau a altei etiologii trombotice;<\/li>\n<li>Complica\u021bii ale sarcinii (una sau mai multe pierderi de sarcin\u0103 dup\u0103 s\u0103pt\u0103m\u00e2na 10 cu f\u0103t morfologic normal, una sau mai multe na\u0219teri premature \u00eenainte de s\u0103pt\u0103m\u00e2na 34 cauzate de preeclampsie sever\u0103 sau insuficien\u021b\u0103 placentar\u0103, sau 3 sau mai multe avorturi spontane \u00eenainte de s\u0103pt\u0103m\u00e2na 10 de sarcin\u0103 la care s-au exclus etiologiile cromozomiale, hormonale sau anatomice);<\/li>\n<li>Evaluarea riscului trombotic la pacien\u021bii diagnostica\u021bi cu boli de \u021besut conjunctiv (\u00een special LES);<\/li>\n<li>Evaluarea unei trombocitopenii neexplicabile<sup>8;9<\/sup>.<\/li>\n<\/ul>\n<h2><strong>Preg\u0103tire pacient <\/strong><\/h2>\n<p>jeun (pe nem\u00e2ncate) sau postprandial (dup\u0103 mese)<sup>9<\/sup>.<\/p>\n<p><strong>Specimen recoltat <\/strong>\u2013 s\u00e2nge venos<sup>9<\/sup>.<\/p>\n<p><strong>Recipient de recoltare <\/strong>\u2013 vacutainer f\u0103r\u0103 anticoagulant cu\/f\u0103r\u0103 gel separator<sup>9<\/sup>.<\/p>\n<p><strong>Prelucrare necesar\u0103 dup\u0103 recoltare <\/strong>\u2013 se separ\u0103 serul prin centrifugare<sup>9<\/sup>.<\/p>\n<p><strong>Volum prob\u0103<\/strong> \u2013 minim 0.5 mL ser<sup>9<\/sup>.<\/p>\n<p><strong>Cauze de respingere<\/strong> <strong>a probei <\/strong>\u2013 ser intens hemolizat, lipemic sau puternic contaminat bacterian<sup>9<\/sup>.<\/p>\n<p><strong>Stabilitate prob\u0103 <\/strong>\u2013 serul separat este stabil 7 zile la 4\u00b0C; timp \u00eendelungat la -20 \u00b0C<sup>9<\/sup>.<\/p>\n<p><strong>Metod\u0103<\/strong> \u2013 <u>Imunodot<\/u><sup>9<\/sup>.<\/p>\n<h2><strong>Valori de <\/strong><strong>referin\u021b\u0103 Anticorpi anti-anexina V<\/strong><\/h2>\n<p>Anticorpi anti-anexin\u0103 V: Negativ<sup>9<\/sup>.<\/p>\n<p><strong>Interpretarea rezultatelor<\/strong><\/p>\n<div>Ob\u021binerea unui rezultat pozitiv la testarea anticorpilor anti-anexin\u0103 impune repetarea la cel pu\u021bin 12 s\u0103pt\u0103m\u00e2ni a \u00eenc\u0103 unui test pentru a confirma persisten\u021ba acestor anticorpi.<\/div>\n<div>Interpretarea rezultatelor se va face numai prin corelarea cu celelalte criterii de APS (clinice si de laborator)<sup>3;4;9<\/sup>.<\/div>\n<p>&nbsp;<\/p>\n<h2><strong>Bibliografie<\/strong><\/h2>\n<ol>\n<li>ARUP Laboratories. Test Directory: Antiphospholipid Syndrome \u2013 APS. www.aruplab.com 2017. Ref Type: Internet\u00a0Communication.<\/li>\n<li>Miyakis S, Lockshin MD, Atsumi T, et al: International consensus statement on an update of the classification criteria for\u00a0definite antiphospholipid syndrome (APS). In J Thromb Haemost 2006;4:295-306.<\/li>\n<li>Quest Diagnostics. Laboratory Testing in the Identification of Antiphospholipid Syndrome. <a href=\"https:\/\/www.questdiagnostics.com\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">www.questdiagnostics.com<\/a>.\u00a0Ref type:Internet communication.<\/li>\n<li>Conti F, Capozzi A, Truglia S, Lococo E, Longo A, Misasi R, Alessandri C, Valesini G, Sorice M. The Mosaic of \u201cSeronegative\u201d\u00a0Antiphospholipid Syndrome. J Immunol Res. 2014;2014:389601.<\/li>\n<li>Misasi R, Capozzi A, Longo A, Recalchi S, Lococo E, Alessandri C, Conti F, Valesini G, Sorice M. \u201cNew\u201d antigenic targets and\u00a0methodological approaches for refining laboratory diagnosis of antiphospholipid syndrome. J Immunol Res. 2015;2015:858542<\/li>\n<li>Rand JH, Wu XX, Quinn AS, Ashton AW, Chen PP, Hathcock JJ, Andree HA, Taatjes DJ. Hydroxychloroquine protects the\u00a0annexin A5 anticoagulant shield from disruption by antiphospholipid antibodies: evidence for a novel effect for an old\u00a0antimalarial drug. Blood. 2010 Mar 18;115(11):2292-9.<\/li>\n<li>Scholz P, Auler M, Brachvogel B, Benzing T, Mallman P, Streichert T, Klatt AR. Detection of multiple annexin autoantibodies\u00a0in a patient with recurrent miscarriages, fulminant stroke and seronegative antiphospholipid syndrome. Biochem Med (Zagreb). 2016;26(2):272-8.<\/li>\n<li>Bizzaro N, Tonutti E, Villalta D, Tampoia M, Tozzoli R. Prevalence and clinical correlation of anti-phospholipid-binding protein\u00a0antibodies in anticardiolipin-negative patients with systemic lupus erythematosus and women with unexplained recurrent\u00a0miscarriages. Arch Pathol Lab Med. 2005 Jan;129(1):61-8.<\/li>\n<li>Laborator Synevo. Referin\u021bele specifice tehnologiei de lucru utilizate 2017. Ref Type: Catalog<\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"<p>Informa\u021bii generale Anticorpi anti-anexina V Anticorpii anti-anexina V sunt markeri de linia a doua \u00een diagnosticul serologic al sindromului antifosfolipidic1. Sindromul antifosfolipidic (APS) este o boal\u0103 autoimun\u0103 caracterizat\u0103 clinic prin episoade de tromboz\u0103 (venoas\u0103, arterial\u0103 sau ambele) \u0219i\/ sau complica\u021bii obstetricale \u0219i prin prezen\u021ba persistent\u0103 de anticorpi antifosfolipidici circulan\u021bi. APS poate \u00eenso\u021bi o afec\u021biune reumatismal\u0103, [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false},"product_brand":[],"product_cat":[42,87],"product_tag":[],"class_list":["post-240","product","type-product","status-publish","product_cat-markeri-boli-autoimune","product_cat-markeri-pentru-sindromul-antifosfolipidic","first","instock","shipping-taxable","purchasable","product-type-simple"],"acf":[],"_links":{"self":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product\/240","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/media?parent=240"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_brand?post=240"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_cat?post=240"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_tag?post=240"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}