Antiphospholipid antibodies and the antiphospholipid syndrome: Pathogenic mechanisms

Silvia S. Pierangeli, Pojen P. Chen, Elena Raschi, Silvia Scurati, Chaudia Grossi, Maria Orietta Borghi, Ivan Palomo, E. Nigel Harris, Pier Luigi Meroni

Research output: Contribution to journalArticlepeer-review

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 β2 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.

Original languageEnglish
Pages (from-to)236-250
Number of pages15
JournalSeminars in Thrombosis and Hemostasis
Volume34
Issue number3
DOIs
Publication statusPublished - Apr 2008

Keywords

  • Anti-β glycoprotein I antibodies
  • Antiphospholipid antibodies
  • Decidual cells
  • Endothelial cell activation
  • Lupus anticoagulant
  • Platelet activation
  • Pregnancy loss
  • Thrombosis
  • Trophoblast

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

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