[Antiphospholipid antibodies: specificity and mechanism of action]

Circulating lupus-type anticoagulant is associated with an increased risk of arterial or venous thrombosis. The laboratory identification of lupus coagulant requires at least 2 different in vitro phospholipid-dependent coagulation techniques: immunological assessment based upon Elisa-type tests using pure phospholipids complements the coagulation procedure, but does not replace it. Circulating lupus anticoagulant is correlated with anti-phospholipid antibodies specific to phosphatidyl serine. Relationships between circulating lupus anticoagulant and anti-cardiolipin seem complex and are discussed. In fact, an entire family of anti-phospholipid antibodies exists, whose relationship with clinical manifestations remains to be determined. The effects of anti-phospholipid antibodies on human endothelial cells are described.