Antiphospholipid antibodies and the antiphospholipid syndrome: pathogenic mechanisms.

Abstract

Antiphospholipid antibodies (Abs) are associated with thrombosis and are a risk factor for recurrent pregnancy loss and obstetric complications in patients with the antiphospholipid syndrome. It is generally accepted that the major autoantigen for aPL Abs is beta (2) glycoprotein I, which mediates the binding of aPL Abs to target cells (i.e., endothelial cells, monocytes, platelets, trophoblasts, etc.) leading to thrombosis and fetal loss. This article addresses molecular events triggered by aPL Abs on endothelial cells, platelets, and monocytes and complement activation, as well as a review of the current knowledge with regard to the putative receptor(s) recognized by aPL Abs on target cells as well as novel mechanisms that involve fibrinolytic processes. A section is devoted to the description of thrombotic and inflammatory processes that lead to obstetric complications mediated by aPL Abs. Based on experimental evidence using in vitro and in vivo models, new targeted therapies for treatment and/or prevention of thrombosis and pregnancy loss in antiphospholipid syndrome are proposed.

• Authors: Silvia S Pierangeli, Pojen P Chen, Elena Raschi, Silvia Scurati, Claudia Grossi, Maria Orietta Borghi, Ivan Palomo, E Nigel Harris, Pier Luigi Meroni
• Journal: Seminars in thrombosis and hemostasis (Semin Thromb Hemost) Vol. 34 Issue 3 Pg. 236-50 (Apr 2008) ISSN: 0094-6176 [Print] United States
• PMID: 18720303 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antibodies, Antiphospholipid
• Autoantigens
• Inflammation Mediators
• beta 2-Glycoprotein I
• Thromboplastin
• Thrombin

Topics

• Abortion, Habitual (etiology, physiopathology)
• Antibodies, Antiphospholipid (immunology)
• Antiphospholipid Syndrome (blood, etiology, immunology, physiopathology)
• Autoantigens (immunology)
• Blood Platelets (immunology, physiology)
• Complement Activation
• Endothelial Cells (immunology, physiology)
• Female
• Fibrinolysis
• Humans
• Inflammation Mediators (physiology)
• Monocytes (immunology, physiology)
• Placenta (pathology)
• Pregnancy
• Pregnancy Complications, Hematologic (blood, etiology, physiopathology)
• Thrombin (physiology)
• Thrombophilia (blood, etiology, physiopathology)
• Thromboplastin (physiology)
• Trophoblasts (immunology, pathology)
• Venous Thrombosis (blood, etiology, physiopathology)
• beta 2-Glycoprotein I (immunology)