Peripheral vascular disease in antiphospholipid syndrome

Area of Science:

• Immunology
• Cardiovascular Medicine
• Rheumatology

Background:

• Atherosclerosis is increasingly viewed as an inflammatory condition.
• Activated T lymphocytes, oxidized low-density lipoproteins (oxLDL), and heat shock proteins (HSP) are found in atherosclerotic lesions.
• Autoantigens like beta2GPI, targeted by antiphospholipid antibodies (aPL) in antiphospholipid syndrome (APS), are also present.

Purpose of the Study:

• To investigate the association between antiphospholipid antibodies (aPL) and atherosclerosis.
• To explore the link between antiphospholipid syndrome (APS) and accelerated atherosclerosis.
• To clarify the role of aPL in the development of atherosclerotic plaques.

Main Methods:

• Review of existing literature and patient data.
• Analysis of prevalence rates of APS and aPL in vascular disease.
• Comparison of atherosclerosis prevalence in APS, SLE patients, and controls using ultrasonography.

Main Results:

• Cross-reactivity exists between aPL and antibodies to oxLDL.
• Animal studies suggest aPL are associated with atheroma.
• Prevalence of asymptomatic atherosclerosis is higher in APS and SLE patients, especially those with aPL, compared to controls.

Conclusions:

• The association between APS/aPL and atherosclerosis is debated due to small study sizes and confounding risk factors.
• While some APS patients show premature atherosclerosis without other risk factors, predicting which patients will develop it remains challenging.
• Further research is needed to fully elucidate the complex relationship between autoimmune conditions, aPL, and cardiovascular disease.