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The interplay between the antiphospholipid syndrome and systemic lupus erythematosus
Angela Tincani1, Laura Andreoli, Cecilia Chighizola
1Division of Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy. tincani@bresciareumatologia.it
Abstract:
Antiphospholipid syndrome (APS) was firstly described in systemic lupus erythematosus (SLE), but it was recognized also as a primary APS (PAPS) form. These forms are not always distinguishable, since they show some common clinical/serological manifestations. We actually may deal with: (1) patients initially classified as PAPS gradually developing SLE; (2) patients with SLE and associated APS, whose complications generally affect morbidity and mortality; (3) patients with SLE and positive antiphospholipid antibodies without APS manifestations; the relevant issue in such patients is to provide effective prophylaxis. The close relationship between PAPS and SLE is also supported by: (i) nuclear autoimmunity and (ii) complement activation at least in animal models of APS. Future studies on the genetic background and/or on regulatory suppressive mechanisms may clarify how and why PAPS can evolve into SLE.
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