Antiphospholipid syndrome: an update

被引:25
作者
Merashli, Mira [1 ]
Noureldine, Mohammad Hassan A. [2 ]
Uthman, Imad [3 ]
Khamashta, Munther [4 ]
机构
[1] Royal London Hosp, Fac Med, Div Rheumatol, London E1 2DR, England
[2] Lebanese Amer Univ, Med Ctr, Rizk Hosp, Fac Med, Beirut, Lebanon
[3] Amer Univ Beirut, Fac Med, Div Rheumatol, Beirut, Hamra, Lebanon
[4] Kings Coll London, Rayne Inst, St Thomas Hosp, Div Womens Hlth,Graham Hughes Lupus Res Lab, London SE1 7EH, England
关键词
Antiphospholipid antibodies; antiphospholipid syndrome; management; pathogenesis; risk stratification; MOLECULAR-WEIGHT HEPARIN; INTERNATIONAL CONSENSUS STATEMENT; SYSTEMIC-LUPUS-ERYTHEMATOSUS; THROMBOTIC RISK-ASSESSMENT; 1ST TRIMESTER TROPHOBLAST; RECURRENT PREGNANCY LOSS; TASK-FORCE REPORT; ANTIBODY SYNDROME; CONTROLLED-TRIAL; RENAL-TRANSPLANTATION;
D O I
10.1111/eci.12449
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundAntiphospholipid syndrome (APS) or Hughes syndrome' is a prothrombotic disease characterized by thrombosis and pregnancy morbidity in the presence of antiphospholipid antibodies (aPL). More than three decades have passed, and experts are still uncovering new pieces of this disease complex pathogenesis and management. Materials and methodsWe searched in literature using MEDLINE and PubMed databases focusing on the latest development on disease pathogenesis, risk assessment of thrombosis and treatment of APS. ResultsThe phosphatidylinositol 3-kinase (PI3K)-AKT-mTORC pathway was most recently identified to have a crucial role in activating inflammation among endothelial vessel wall causing vascular lesions in APS. Additionally, new variables are being implemented to assess the risk of thrombosis in patients with APS. Global APS Score (GAPSS) utilizes cardiovascular risk factors and new autoimmune antibodies as part of the score assessment and is the most valid so far. It can be a promising tool in the future for prediction of thrombosis. Anticoagulation remains the cornerstone in APS; however, many new potential therapeutic agents are developing and are currently under investigation. ConclusionsThe most recent advances in pathogenesis, risk stratification and treatment provide a platform for high yield studies with the ultimate goal of providing the optimal management to patients with APS.
引用
收藏
页码:653 / 662
页数:10
相关论文
共 110 条
  • [1] Oral Apixaban for the Treatment of Acute Venous Thromboembolism
    Agnelli, Giancarlo
    Buller, Harry R.
    Cohen, Alexander
    Curto, Madelyn
    Gallus, Alexander S.
    Johnson, Margot
    Masiukiewicz, Urszula
    Pak, Raphael
    Thompson, John
    Raskob, Gary E.
    Weitz, Jeffrey I.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (09) : 799 - 808
  • [2] Aisina R. B., 2014, Biomeditsinskaya Khimiya, V60, P72
  • [3] Effect of Hydroxychloroquine on Antiphospholipid Antibody-Induced Changes in First Trimester Trophoblast Function
    Albert, Caroline R.
    Schlesinger, William J.
    Viall, Chez A.
    Mulla, Melissa J.
    Brosens, Jan J.
    Chamley, Lawrence W.
    Abrahams, Vikki M.
    [J]. AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, 2014, 71 (02) : 154 - 164
  • [4] Treatment of refractory obstetric antiphospholipid syndrome: the state of the art and new trends in the therapeutic management
    Alijotas-Reig, J.
    [J]. LUPUS, 2013, 22 (01) : 6 - 17
  • [5] Limited effect of rituximab on thrombocytopaenia and anticardiolipin antibodies in a patient with primary antiphospholipid syndrome
    Ames, P. R. J.
    Tommasino, C.
    Fossati, G.
    Scenna, G.
    Brancaccio, V.
    Ferrara, F.
    [J]. ANNALS OF HEMATOLOGY, 2007, 86 (03) : 227 - 228
  • [6] Antiphospholipid Antibodies and Atherosclerosis: Insights from Systemic Lupus Erythematosus and Primary Antiphospholipid Syndrome
    Ames, Paul R. J.
    Margarita, Annamaria
    Alves, Jose Delgado
    [J]. CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY, 2009, 37 (01) : 29 - 35
  • [7] Kidney disease in antiphospholipid syndrome
    Amigo, Mary-Carmen
    [J]. RHEUMATIC DISEASE CLINICS OF NORTH AMERICA, 2006, 32 (03) : 509 - +
  • [8] Estimated Frequency of Antiphospholipid Antibodies in Patients With Pregnancy Morbidity, Stroke, Myocardial Infarction, and Deep Vein Thrombosis: A Critical Review of the Literature
    Andreoli, Laura
    Chighizola, Cecilia B.
    Banzato, Alessandra
    Pons-Estel, Guillermo J.
    de Jesus, Guilherme Ramire
    Erkan, Doruk
    [J]. ARTHRITIS CARE & RESEARCH, 2013, 65 (11) : 1869 - 1873
  • [9] Efficacy and safety of long-term low molecular weight heparin in patients with antiphospholipid syndrome
    Antonio Vargas-Hitos, Jose
    Ateka-Barrutia, Oier
    Sangle, Shirish
    Khamashta, Munther A.
    [J]. ANNALS OF THE RHEUMATIC DISEASES, 2011, 70 (09) : 1652 - 1654
  • [10] Patient-level analysis of five international cohorts further confirms the efficacy of aspirin for the primary prevention of thrombosis in patients with antiphospholipid antibodies
    Arnaud, Laurent
    Mathian, Alexis
    Devilliers, Herve
    Ruffatti, Amelia
    Tektonidou, Maria
    Forastiero, Ricardo
    Pengo, Vittorio
    Lambert, Marc
    Lefevre, Guillaume
    Martinez-Zamora, Maria Angeles
    Balasch, Juan
    Wahl, Denis
    Amoura, Zahir
    [J]. AUTOIMMUNITY REVIEWS, 2015, 14 (03) : 192 - 200