Классификационные критерии антифосфолипидного синдрома ACR/EULAR 2023
https://doi.org/10.47360/1995-4484-2025-12-23
Аннотация
Многие ревматические заболевания являются моделями патологии человека. Это воспалительные ревматические заболевания, аутовоспалительные и аутоиммунные болезни. Моделью антитело-индуцированного тромбоза или приобретенной тромбофилии является антифосфолипидный синдром (АФС). В 2023 г. опубликованы классификационные критерии АФС, которые разрабатывались совместно Американской коллегией ревматологов (ACR, American College of Rheumatology) и Европейским альянсом ревматологических ассоциаций (EULAR, European Alliance of Associations for Rheumatology) и отражают полиораганность и мультидисциплинарность этого симптомокомплекса. В данном обзоре обсуждаются существовавшие до 2023 г. классификационные критерии АФС и критерии 2023 г.
Об авторе
Т. М. РешетнякРоссия
Решетняк Татьяна Магомедалиевна.
115522, Москва, Каширское шоссе, 34а; 125993, Москва, ул. Баррикадная, 2/1, стр. 1
Конфликт интересов:
Нет
Список литературы
1. Насонов ЕЛ (ред.). Антифосфолипидный синдром. М.: Литтера;2004.
2. Решетняк Т.М. Антифосфолипидный синдром: диагностика и клинические проявления (лекция). Научно-практическая ревматология. 2014;52(1):56-71. doi: 10.14412/1995-4484-2014-56-71
3. Hughes G. Hughes syndrome: The antiphospholipid syndrome – A clinical overview. Clin Rev Allergy Immunol. 2007;32(1):3-12.
4. Hughes GR. Hughes syndrome (the antiphospholipid syndrome): A disease of our time. Inflammopharmacol. 2011;19(2):69-73. doi: 10.1007/s10787-010-0071-3
5. Sontheimer RD. The anticardiolipin syndrome. A new way to slice an old pie, or a new pie to slice? Arch Dermatol. 1987;123(5):590-595. doi: 10.1001/archderm.123.5.590
6. Misasi R, Longo A, Recalchi S, Caissutti D, Riitano G, Manganelli V, et al. Molecular mechanisms of “antiphospholipid antibodies” and their paradoxical role in the pathogenesis of “sero-negative APS”. Int J Mol Sci. 2020;21(21):8411. doi: 10.3390/ijms21218411
7. Harris EN. Syndrome of the black swan. Br J Rheumatol. 1987;26(5):324-326. doi: 10.1093/rheumatology/26.5.324
8. Alarcón-Segovia D, Delezé M, Oria CV, Sánchez-Guerrero J, Gómez-Pacheco L, Cabiedes J, et al. Antiphospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosus. A prospective analysis of 500 consecutive patients. Medicine (Baltimore). 1989;68(6):353-365. doi: 10.1097/00005792-198911000-00003
9. Wilson WA, Gharavi AE, Koike T, Lockshin MD, Branch DW, Piette JC, et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: Report of an international workshop. Arthritis Rheum. 1999;42(7):1309-1311. doi: 10.1002/1529-0131(199907)42:7<1309::AID-ANR1>3.0.CO;2-F
10. Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295-306. doi: 10.1111/j.1538-7836.2006.01753.x
11. Amigo MC, Garcia-Torres R, Robles M, Bochicchio T, Reyes PA. Renal involvement in primary antiphospholipid syndrome. J Rheumatol. 1992;19(8):1181-1185.
12. Hojnik M, George J, Ziporen L, Shoenfeld Y. Heart valve involvement (Libman – Sacks endocarditis) in the antiphospholipid syndrome. Circulation. 1996;93(8):1579-1587. doi: 10.1161/01.cir.93.8.1579
13. Asherson RA. New subsets of the antiphospholipid syndrome in 2006: “PRE-APS” (probable APS) and microangiopathic antiphospholipid syndromes (“MAPS”). Autoimmun Rev. 2006;6(2):76-80. doi: 10.1016/j.autrev.2006.06.008
14. Amigo MC, Garcia-Torres R, Robles M, Bochicchio T, Reyes PA. Renal involvement in primary antiphospholipid syndrome. J Rheumatol. 1992;19(8):1181-1185.
15. Barbhaiya M, Zuily S, Naden R, Hendry A, Manneville F, Amigo MC, et al.; ACR/EULAR APS Classification Criteria Collaborators. The 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Arthritis Rheumatol. 2023;75(10):1687-1702. doi: 10.1002/art.42624
16. Knight JS, Erkan D. Rethinking antiphospholipid syndrome to guide future management and research. Nat Rev Rheumatol. 2024;20(6):377-388. doi: 10.1038/s41584-024-01110-y
17. Foddai SG, Radin M, Cecchi I, Rubini E, Barinotti A, Alba P, et al. 2023 ACR/EULAR classification criteria in existing research cohorts: An international study. Rheumatology (Oxford). 2024 Jan 30:keae058. doi: 10.1093/rheumatology/keae058
18. Erkan D. Antiphospholipid syndrome: To classify or not to classify? Turk J Haematol. 2024;41(1):37-40. doi: 10.4274/tjh.galenos.2024
19. Devreese KMJ, Bertolaccini ML, Branch DW, de Laat B, Erkan D, Favaloro EJ, et al. An update on laboratory detection and interpretation of antiphospholipid antibodies for diagnosis of antiphospholipid syndrome: Guidance from the ISTH-SSC Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibodies. J Thromb Haemost. 2025;23(2):731-744. doi: 10.1016/j.jtha.2024.10.022
20. Yang Y, Jiang H, Tang Z, Pan H, Liu H, Cheng X, et al. Assessment of the 2023 ACR/EULAR antiphospholipid syndrome classification criteria in a Chinese cohort: Impact on clinical practice. J Autoimmun. 2024;146:103237. doi: 10.1016/j.jaut.2024.103237
21. Zhao Y, Huang C, Zhou Y, Qi W, Cai B, Hu C, et al. Performance validation of the 2023 American College of Rheumatology/ European League Against Rheumatism antiphospholipid syndrome classification criteria in an antiphospholipid syndrome cohort. J Thromb Haemost. 2024;22(6):1660-1674. doi: 10.1016/j.jtha.2024.02.019
22. Lu Q, Gan Y, Yao Z, Li C. A diagnostic performance study of the 2023 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for patients with antiphospholipid syndrome from the Antiphospholipid Syndrome Chinese Collaborative cohort presenting with suspected antiphospholipid syndrome. Arthritis Rheumatol. 2024 Feb 25. doi: 10.1002/art.42835
23. Foddai SG, Radin M, Cecchi I, Rubini E, Barinotti A, et al. 2023 ACR/EULAR classification criteria in existing research cohorts: An international study. Rheumatology (Oxford). 2024;63(10):2770-2775. doi: 10.1093/rheumatology/keae058
24. Castillo-Martínez D, Mora-Ramírez M, Molina-Sánchez R, Amezcua-Guerra LM. The 2023 ACR/EULAR antiphospholipid syndrome classification criteria identify patients at high risk of complications. Clin Rheumatol. 2024 Sep 18. doi: 10.1007/s10067-024-07144-7
25. Ortel TL, Neumann I, Ageno W, Beyth R, Clark NP, Cuker A, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: Treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020;4(19):4693-4738. doi: 10.1182/bloodadvances.2020001830
26. Taylor A, Kumar S, Pozzi N. Forecasting the future of antiphospholipid syndrome: Prospects and challenges. Mo Med. 2023; 120(5):359-366.
27. Puntmann VO, Valbuena S, Hinojar R, Petersen SE, Greenwood JP, Kramer CM, et al.; SCMR Clinical Trial Writing Group. Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus for CMR imaging endpoints in clinical research: Part I – Analytical validation and clinical qualification. J Cardiovasc Magn Reson. 2018;20(1):67. doi: 10.1186/s12968-018-0484-5
28. Farzaneh-Far A, Roman MJ, Lockshin MD, Devereux RB, Paget SA, Crow MK, et al. Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus. Arthritis Rheum. 2006;54(12):3918-3925. doi: 10.1002/art.22265
29. Corrigendum to: 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(45):4317. doi: 10.1093/eurheartj/ehz828
30. Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT, et al.; Euro-Phospholipid Project Group. Antiphospholipid syndrome: Clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum. 2002;46(4):1019-1027. doi: 10.1002/art.10187
31. Erkan D, Derksen R, Levy R, Machin S, Ortel T, Pierangeli S, et al. Antiphospholipid syndrome clinical research task force report. Lupus. 2011;20(2):219-224. doi: 10.1177/0961203310395053
32. Girón-González JA, García del Río E, Rodríguez C, Rodríguez-Martorell J, Serrano A. Antiphospholipid syndrome and symptomatic carriers of antiphospholipid antibody: Prospective analysis of 404 individuals. J Rheumatol. 2004;31(8):1560-1567.
33. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):35-41. doi: 10.1161/01.str.24.1.35
34. Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA, Wolf ME, Hennerici MG. The ASCOD phenotyping of ischemic stroke (Updated ASCO Phenotyping). Cerebrovasc Dis. 2013;36(1):1-5. doi: 10.1159/000352050
35. Tektonidou MG, Sotsiou F, Nakopoulou L, Vlachoyiannopoulos PG, Moutsopoulos HM. Antiphospholipid syndrome nephropathy in patients with systemic lupus erythematosus and antiphospholipid antibodies: Prevalence, clinical associations, and long-term outcome. Arthritis Rheum. 2004;50(8):2569-2579. doi: 10.1002/art.20433
36. Barbhaiya M, Taghavi M, Zuily S, Domingues V, Chock EY, Tektonidou MG, et al.; New APS Classification Criteria Steering Committee and APS ACTION Collaborators. Efforts to better characterize “Antiphospholipid antibody nephropathy” for the 2023 ACR/EULAR antiphospholipid syndrome classification criteria: Renal pathology subcommittee report. J Rheumatol. 2024;51(2):150-159. doi: 10.3899/jrheum.2022-1200
37. Suzumori N, Sugiura-Ogasawara M. Genetic factors as a cause of miscarriage. Curr Med Chem. 2010;17(29):3431-3437. doi: 10.2174/092986710793176302
38. Brigham SA, Conlon C, Farquharson RG. A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage. Hum Reprod. 1999;14(11):2868-2671. doi: 10.1093/humrep/14.11.2868
39. Mayer-Pickel K, Nanda M, Gajic M, Cervar-Zivkovic M. Preeclampsia and the antiphospholipid syndrome. Biomedicines. 2023;11(8):2298. doi: 10.3390/biomedicines11082298
40. Long Y, Huang C, Cui Y, Xie Z, Zhou Y, Shi X, et al. Cluster analysis of antiphospholipid antibodies-associated adverse pregnancy outcome patients: Based on a 13-years cohort study. Clin Exp Med. 2023;23(8):5377-5388. doi: 10.1007/s10238-023-01195-x
41. Zhou Z, Teng J, Sun Y, Liu H, Cheng X, Su Y, et al. Characteristics of pregnancy complications and treatment in obstetric antiphospholipid syndrome in China. Clin Rheumatol. 2019;38(11):3161-3168. doi: 10.1007/s10067-019-04670-7
42. Abou-Nassar K, Carrier M, Ramsay T, Rodger MA. The association between antiphospholipid antibodies and placenta mediated complications: A systematic review and meta-analysis. Thromb Res. 2011;128(1):77-85. doi: 10.1016/j.thromres.2011.02.006
43. Gestational hypertension and preeclampsia: ACOG practice bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237-e260. doi: 10.1097/AOG.0000000000003891
44. Martínez-Taboada VM, Gómez AM, Del Barrio-Longarela S, Merino A, Comins-Boo A, López-Hoyos M, et al. Impact of the 2023 ACR/EULAR classification criteria in women with primary antiphospholipid syndrome during pregnancy. Diagnostics (Basel). 2024;14(19):2162. doi: 10.3390/diagnostics14192162
45. Reményi B, Wilson N, Steer A, Ferreira B, Kado J, Kumar K, et al. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease – An evidence-based guideline. Nat Rev Cardiol. 2012;9(5):297-309. doi: 10.1038/nrcardio.2012.7
46. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC, et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019;32(1):1-64. doi: 10.1016/j.echo.2018.06.004
47. Zuily S, Huttin O, Mohamed S, Marie PY, Selton-Suty C, Wahl D. Valvular heart disease in antiphospholipid syndrome. Curr Rheumatol Rep. 2013;15(4):320. doi: 10.1007/s11926-013-0320-8
48. Zuily S, Cervera R, Foret T, Bertocchi S, Tincani A. Thrombocytopenia in antiphospholipid syndrome: Is anticoagulation and/or antiaggregation always required? Autoimmun Rev. 2024;23(1):103417. doi: 10.1016/j.autrev.2023.103417
49. Vreede AP, Bockenstedt PL, McCune WJ, Knight JS. Cryptic conspirators: A conversation about thrombocytopenia and antiphospholipid syndrome. Curr Opin Rheumatol. 2019;31(3):231-240. doi: 10.1097/BOR.0000000000000595
50. Devreese KMJ, de Groot PG, de Laat B, Erkan D, Favaloro EJ, Mackie I, et al. Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis: Update of the guidelines for lupus anticoagulant detection and interpretation. J Thromb Haemost. 2020;18(11):2828-2839. doi: 10.1111/jth.15047
51. Чельдиева ФА, Решетняк ТМ, Черкасова МВ, Лила АМ. Исследование антифосфолипидных антител иммуноферментным и хемилюминесцентным методами у пациентов с антифосфолипидным синдромом и системной красной волчанкой (предварительные данные). Клиническая лабораторная диагностика. 2021;66(9):546-551. doi: 10.51620/0869-2084-2021-66-9-546-551
52. Tebo AE, Willis R, Nwosu A, Bashleben C, Fox DA, Linden MA, et al. Reporting and establishment of reference intervals for antiphospholipid antibody immunoassays: A survey of participants in the College of American Pathologists proficiency testing program. Arch Pathol Lab Med. 2024;148(6):686-693. doi: 10.5858/arpa.2023-0095-CP
53. Carbone T, Infantino M, Antico A, Porcelli B, Villalta D, Pafundi V, et al. An Italian nationwide survey on the evolution of autoantibody diagnostics in autoimmune rheumatic diseases. Clin Exp Rheumatol. 2023;41(11):2277-2285. doi: 10.55563/clinex-prheumatol/bhnk4l
54. Zhang XS, Bizzaro N, Tebo AE, Nandakumar V, Infantino M, Carbone T, et al. Discouraging non-ELISA antiphospholipid antibody assays in antiphospholipid syndrome classification may hinder clinical research. Immunol Res. 2024;72(3):361-363. doi: 10.1007/s12026-023-09443-8
55. Lakos G, Favaloro EJ, Harris EN, Meroni PL, Tincani A, Wong RC, et al. International consensus guidelines on anticardiolipin and anti-β2-glycoprotein I testing: Report from the 13th International Congress on Antiphospholipid Antibodies. Arthritis Rheum. 2012;64(1):1-10. doi: 10.1002/art.33349
56. Pires da Rosa G, Ferreira E, Sousa-Pinto B, Rodríguez-Pintó I, Brito I, Mota A, et al. Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review. Front Immunol. 2022;13:967178. doi: 10.3389/fimmu.2022.967178
Рецензия
Для цитирования:
Решетняк Т.М. Классификационные критерии антифосфолипидного синдрома ACR/EULAR 2023. Научно-практическая ревматология. 2025;63(1):12-23. https://doi.org/10.47360/1995-4484-2025-12-23
For citation:
Reshetnyak T.M. Classification criteria of antiphospholipid syndrome ACR/EULAR 2023 and comments on them. Rheumatology Science and Practice. 2025;63(1):12-23. (In Russ.) https://doi.org/10.47360/1995-4484-2025-12-23