title: Infections and vaccines in the etiology of antiphospholipid syndrome.
abstract: OBJECTIVE
  To present scientific evidence supporting the infectious origin for the antiphospholipid syndrome (APS) by molecular mimicry between pathogens, infection and vaccination with β2-glycoprotein I (β2-GPI) molecule.
  
  
  RESULTS
  APS is characterized by the presence of pathogenic autoantibodies against β2-GPI. The infection etiology of APS was well established. Likewise, a link between vaccination such as tetanus toxoid may trigger antibodies targeting tetanus toxoid and β2-GPI, due to molecular mimicry between the two molecules. During the years, the pathogenic potential of anti-tetanus toxoid antibodies cross reactive with β2-GPI were found to be pathogenic in animal models, inducing experimental APS.
  
  
  CONCLUSIONS
  Accumulated evidence supports that the presence of anti-β2-GPI antibodies is associated with a history of infections and the main mechanism to explain this correlation is molecular mimicry. The relationship between tetanus toxoid vaccination and APS reveals a novel view on the autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA).
authors.affiliation: Zabludowitz Center for Autoimmune Diseases, Sheba Medical Center affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Paola
authors.initials: P
authors.lastname: Cruz-Tapias
authors.forename: Miri
authors.initials: M
authors.lastname: Blank
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Anaya
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects; D016736:Antiphospholipid Syndrome / Q000209:etiology* / Q000276:immunology; D001323:Autoantibodies / Q000096:biosynthesis; D003429:Cross Reactions / Q000276:immunology; D006801:Humans; D007239:Infections / Q000150:complications*; D018716:Molecular Mimicry; D013745:Tetanus Toxoid / Q000009:adverse effects*; D053482:beta 2-Glycoprotein I / Q000276:immunology
chemical_list: D000276:Adjuvants, Immunologic; D001323:Autoantibodies; D013745:Tetanus Toxoid; D053482:beta 2-Glycoprotein I