title: Pathophysiological insights into the antiphospholipid syndrome.
abstract: The antiphospholipid syndrome (APS) is characterized by venous and/or arterial thrombosis and severe pregnancy morbidity in presence of antiphospholipid antibodies (aPL). While there is compelling evidence that aPL cause the clinical manifestations of APS, the underlying mechanisms are still a matter of scientific debate. This is mainly related to the broad heterogeneity of aPL. There are three major types of aPL: The first one binds to (anionic) phospholipids, e.g. cardiolipin, in absence of other factors (cofactor independent aPL). The second type binds to phospholipids only in presence of protein cofactors, e.g. ß2-glycoprotein I (ß2GPI) (cofactor dependent aPL). The third type binds to cofactor proteins directly without need for phospholipids. It is widely believed that cofactor independent aPL (type 1) are associated with infections and, more importantly, non-pathogenic, while pathogenic aPL belong to the second and in particular to the third type. This view, in particular with regard to type 1 aPL, has not been undisputed and novel research data have shown that it is in fact untenable. We summarize the available data on the pathogenetic role of aPL and the implications for diagnosis of APS and future research.
authors: Karl J. Lackner, MD Institute of Clinical Chemistry and Laboratory Medicine University Medical Centre Mainz 55131 Mainz Germany, Tel: +49 6131 177190 Fax: +49 6131 176627 E-Mail: karl.lackner@unimedizin-mainz.de.
authors: Karl J
authors: KJ
authors: Lackner
authors: Davit
authors: D
authors: Manukyan
authors: Nadine
authors: N
authors: Müller-Calleja
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis*; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis*; D053482:beta 2-Glycoprotein I / Q000097:blood
chemical_list: D017152:Antibodies, Antiphospholipid; D053482:beta 2-Glycoprotein I
keywords: antiphospholipid antibodies; antiphospholipid syndrome; thrombosis; ß2-glycoprotein I