Comorbid association of antiphospholipid antibodies and migraine: A systematic review and meta-analysis

Publication date: Available online 7 March 2017
Source:Autoimmunity Reviews
Author(s): Md. Asiful Islam, Fahmida Alam, Kah Keng Wong
BackgroundAntiphospholipid antibodies (aPLs) namely anticardiolipin (aCL) antibody, anti-β2-glycoprotein I (β2GPI) antibody and lupus anticoagulant (LA) are autoantibodies produced against anionic phospholipids and proteins on plasma membranes. Migraine is a primary headache disorder which has growing evidences of autoimmune-mediated pathogenesis and previous studies suggested the presence of aPLs in migraine patients.AimsTo evaluate the comorbid association between aPLs (aCL, anti-β2GPI and LA) and migraine compared to healthy controls.MethodsStudies were searched through PubMed, ISI Web of Science and Google Scholar databases without restricting the languages and year (up to October 2016) and were selected based on the inclusion criteria. Two authors independently extracted data from the included studies. All analyses were conducted by using random effects model to calculate the odds ratio (OR) and 95% confidence interval (CI). Quality assessment was carried out by using the modified Newcastle-Ottawa Scale (NOS). Publication bias was evaluated via visualization of funnel plots, Begg's and Egger's tests.ResultsThe database searches produced 1995 articles, 13 of which were selected (912 migraineurs and 822 healthy controls). 8.59%, 15.21% and 4.11% of the migraineurs exhibited aCL, anti-β2GPI and LA which was 4.83, 1.63 and 3.03 times higher, respectively, than healthy controls. A significant presence of aCL (OR: 3.55, 95% CI: 1.59–7.95; p=0.002) or anti-β2GPI antibodies (OR: 2.02, 95% CI: 1.20–3.42; p=0.008) were observed in migraine patients, however, LA was not significantly associated (OR: 2.02, 95% CI: 0.50–8.37; p=0.320). Majority of the studies (n=10 of 13) demonstrated NOS score of 7 or above and no significant publication bias was observed.ConclusionMigraine might be an autoimmune-associated neurologic disorder. The presence of aCL or anti-β2GPI antibodies were significant in migraine patients compared to healthy controls, suggesting an involvement of these antibodies in migraine attack.



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