Pathogenic mechanisms of the anti-phospholipid antibodies

The antiphospolipid syndrome (APS) is an autoimmune disease characterized by recurrent fetal loss, thrombotic events (arterial or venous) and hemocytopenic disorders associated to high titers of circulating aPL. Two variants of the APS have been described. Primary APS is a clinical entity without evidence of any other autoimmune disease and secondary APS is a clinical disorder mainly associated with Systemic Lupus Erithematosus (SLE). aPL are a widely group of immunoglobulins directed against different components or proteins factors. In 1990 three groups of researchers identified that beta(2)GP-I is the mainly antigenic target of aPL in APS patients. There are evidences that show that more than one pathogenic mechanism is involved in the development of the APS. The best documented clinical manifestations associated with the APS are recurrent fetal loss and thrombotic disorders. The latter is based on observations in vivo in animal models and in vitro on the effects caused by a beta(2)GP-I antibodies from patients with APS or from animals which cause experimental APS. The objective of the present paper is to show the pathogenic mechanisms that participate in the development of the APS. We also presented evidence that shows that a beta(2)GP-I induces pro-inflammatory, pro-adhesive and pro-coagulant disorder. (C) 2009 Elsevier Espana, S.L. All rights reserved.