title: The role of platelets in antiphospholipid syndrome.
abstract: Despite extensive research, the pathogenesis of antiphospholipid syndrome (APS) remains obscure in many aspects. However, it is widely accepted that thrombosis is the result of a hypercoagulable state caused by antibodies directed against β2-glycoprotein I (β2-GPI), a protein whose physiological role is unknown. Although underestimated, platelets may be involved in APS and its thrombotic manifestations, especially arterial, in several ways. Thrombocytopenia is the most relevant non-criteria manifestation of APS, possibly caused by direct binding of anti-β2-GPI antibodies or anti-β2-GPI-β2-GPI complexes. On the other hand, platelets may have a key role in APS-related thrombosis due to the presence of multiple receptors that can interact with anti-β2-GPI antibodies (especially apolipoprotein E receptor 2' (apoER2') and glycoprotein Ibα (GPIbα)) with consequent release of different procoagulant mediators such as thromboxane B2, platelet factor 4 (PF4), and platelet factor 4 variant (CXCL4L1). The aim of this review is to put together evidence on the possible role of platelets in APS and to stimulate further research on the issue.
authors.affiliation: a Cardiology Clinic, Department of Cardiac , Thoracic, and Vascular Sciences, Padua University Hospital , Padua , Italy.
authors.forename: G
authors.initials: G
authors.lastname: Baroni
authors.affiliation: a Cardiology Clinic, Department of Cardiac , Thoracic, and Vascular Sciences, Padua University Hospital , Padua , Italy.
authors.forename: A
authors.initials: A
authors.lastname: Banzato
authors.affiliation: a Cardiology Clinic, Department of Cardiac , Thoracic, and Vascular Sciences, Padua University Hospital , Padua , Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bison
authors.affiliation: a Cardiology Clinic, Department of Cardiac , Thoracic, and Vascular Sciences, Padua University Hospital , Padua , Italy.
authors.forename: G
authors.initials: G
authors.lastname: Denas
authors.affiliation: a Cardiology Clinic, Department of Cardiac , Thoracic, and Vascular Sciences, Padua University Hospital , Padua , Italy.
authors.forename: G
authors.initials: G
authors.lastname: Zoppellaro
authors.affiliation: a Cardiology Clinic, Department of Cardiac , Thoracic, and Vascular Sciences, Padua University Hospital , Padua , Italy.
authors.forename: V
authors.initials: V
authors.lastname: Pengo
mesh_terms: D016736:Antiphospholipid Syndrome / Q000097:blood*; D001792:Blood Platelets / Q000378:metabolism*; D006801:Humans; D013927:Thrombosis / Q000097:blood*
keywords: Antibodies; pathophysiology; phospholipids; platelets; thrombosis