title: Novel insights into pathogenesis, diagnosis and treatment of antiphospholipid syndrome.
abstract: OBJECTIVE
  To provide an update of recent insights into the pathogenesis, diagnosis and treatment of antiphospholipid syndrome (APS) from current literature.
  
  
  RESULTS
  β2GPI was recently implicated in the pathogenesis of thrombosis. High titres of anti-β2GPI antibodies are present in patients with triple positivity which highlight its importance. Consensus guidelines have been published to standardise diagnostic assays and once implemented may yield more accurate diagnoses of APS. An 'aPL score' has been formulated to improve the detection and outcomes of patients. New oral anticoagulants, statins and concomitant therapy with warfarin and aspirin have been identified as potential novel therapeutic interventions for thrombotic APS. Advances in the pathogenesis of obstetric APS have occurred, such as the concept of redefining the syndrome as inflammatory and clearer identification of the roles of complement, β2GPI and annexin 5. Independent risk factors for pregnancy failure have been recognised and when combined with clinical and laboratory features may improve patient outcomes. Interventions involving adjusted doses of low molecular weight heparin in combination with aspirin have shown promising results from initial studies.
  
  
  CONCLUSIONS
  Recent insights into the pathogenesis of APS have unveiled novel areas for treatment intervention. Diagnostic criteria and recommendations have been revised and formulated to provide consensus and standardisation for diagnosis.
authors.affiliation: Lupus Research Unit, The Rayne Institute, King's College London School of Medicine, London, UK.
authors.forename: Sonali
authors.initials: S
authors.lastname: Wijetilleka
authors.forename: Tina
authors.initials: T
authors.lastname: Scoble
authors.forename: Munther
authors.initials: M
authors.lastname: Khamashta
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood; D000925:Anticoagulants / Q000008:administration & dosage; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001241:Aspirin / Q000008:administration & dosage; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011256:Pregnancy Outcome; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D053482:beta 2-Glycoprotein I / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D016756:Immunoglobulins, Intravenous; D053482:beta 2-Glycoprotein I; D001241:Aspirin