Autoantibody explosion in antiphospholipid syndrome.

Area of Science:

• Immunology
• Rheumatology
• Hematology

Background:

• Antiphospholipid syndrome (APS) is defined by thrombosis and pregnancy morbidity.
• It is primarily associated with antiphospholipid antibodies (aPL) like anticardiolipin, anti-beta2-glycoprotein I, and lupus anticoagulant.
• APS shares immunological features with systemic lupus erythematosus, including a broader spectrum of autoantibodies.

Purpose of the Study:

• To comprehensively describe the autoantigen properties, prevalence, and clinical significance of 30 distinct antibodies in APS.
• To investigate the role of 'non-classical' aPL and other autoantibodies in APS pathogenesis.
• To explore the potential of this expanded autoantibody profile for early APS identification and manifestation prediction.

Main Methods:

• Review and analysis of existing literature on autoantibodies in APS.
• Characterization of autoantigen properties for 30 different antibodies.
• Assessment of antibody prevalence and correlation with clinical manifestations.

Main Results:

• Identified 30 different autoantibodies associated with APS beyond the classical aPL.
• These include autoantibodies targeting platelets, glycoproteins, coagulation factors, lamins, mitochondrial antigens, and cell surface markers.
• Few autoantibodies were correlated with others, suggesting unique contributions to the syndrome's pro-thrombotic tendency.

Conclusions:

• APS is characterized by a wide array of autoantibodies, including 'non-classical' aPL and others targeting diverse antigens.
• This extensive autoantibody profile may play a role in the pro-thrombotic nature of APS.
• The broad spectrum of autoantibodies could be crucial for the early diagnosis and understanding of APS manifestations.