title: What have we learned about antiphospholipid syndrome from patients and antiphospholipid carrier cohorts?
abstract: Venous or arterial thrombosis or pregnancy morbidity in the presence of circulating antiphospholipid antibodies (aPL) define the antiphospholipid syndrome (APS). In terms of accepted APS criteria, aPL are detected by one coagulation test (lupus anticoagulant; LAC) and two immunoassays (anticardiolipin antibodies and anti-β2-glycoptrotein I antibodies). In patients with APS, a single positive test carries a much lower risk of thrombosis recurrence or new pregnancy loss than does multiple (or triple) positivity. The same holds true for aPL carriers, namely subjects with laboratory tests but without clinical criteria for APS. Thus, very different risk categories exist among patients with APS as well as in carriers of aPL. Triple positivity apparently identifies the pathogenic autoantibody (antidomain I-II of β2-glycoptrotein I); it is in this category of patients that trials on new therapeutic strategies should focus.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Clinical Cardiology, Thrombosis Centre, University of Padova Medical School, Padua, Italy. vittorio.pengo@unipd.it
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Banzato
authors.forename: Elisa
authors.initials: E
authors.lastname: Bison
authors.forename: Alessia
authors.initials: A
authors.lastname: Bracco
authors.forename: Gentian
authors.initials: G
authors.lastname: Denas
authors.forename: Amelia
authors.initials: A
authors.lastname: Ruffatti
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid