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Routine Screening Method for Microparticles in Platelet Transfusions
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Circulating microparticles, lupus anticoagulant and recurrent miscarriages.

Jaume Alijotas-Reig1, Carles Palacio-Garcia, Miquel Vilardell-Tarres

  • 1Department of Internal Medicine I, Vall d'Hebron University Hospital, Paseo Vall d'hebron 125-135, Faculty of Medicine, Universitat Autonoma, Barcelona, Spain. 16297jar@comb.es

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|May 5, 2009
PubMed
Summary

Recurrent miscarriage (RM) involves placental injury and inflammation, particularly in antiphospholipid antibody (aPL) cases. Circulating microparticles, linked to aPL and endothelial dysfunction, contribute to thrombotic events in RM.

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Immunology

Background:

  • Pregnancy is a pro-inflammatory and hypercoagulable state.
  • Recurrent miscarriage (RM) pathogenesis involves impaired trophoblastic invasion and placental microthrombi.
  • Antiphospholipid antibodies (aPL) are associated with RM, with both thrombotic and non-thrombotic mechanisms implicated.

Purpose of the Study:

  • This review focuses on the thrombotic mechanisms of RM related to aPL.
  • To explore the role of endothelial cell activation and circulating microparticles in aPL-associated RM.

Main Methods:

  • Review of literature on thrombotic mechanisms in RM associated with aPL.
  • Analysis of endothelial cell activation markers (ICAM-1, VCAM-1, E-selectin).
  • Investigation of microparticle generation, characteristics, and procoagulant activity.

Main Results:

  • aPL-related RM involves placental injury, endothelial cell activation, and dysfunction.
  • Thrombotic pathways include protein C inhibition, annexin-5 displacement, beta(2)GP1 inhibition, and tissue factor upregulation.
  • Circulating microparticles are increased in women with RM and contribute to coagulation, especially in the presence of lupus anticoagulant (LA).

Conclusions:

  • Endothelial cell activation and circulating microparticles are key players in the thrombotic pathogenesis of aPL-related RM.
  • Microparticles, particularly those with tissue factor, exacerbate coagulation in RM patients with LA.
  • Understanding these thrombotic mechanisms is crucial for managing RM in aPL-positive individuals.