The pathogenesis of obstetric APS: a 2023 update

Area of Science:

• Immunology
• Obstetrics
• Pathology

Background:

• Antiphospholipid syndrome (APS) is an autoimmune disorder linked to thrombosis and pregnancy morbidity.
• Antiphospholipid antibodies (aPL) are identified as causative agents, leading to placental issues like inflammation and poor placentation.
• Histological analyses show reduced trophoblast invasion and limited uterine spiral artery remodeling in APS pregnancies.

Purpose of the Study:

• To review recent advancements in basic and translational research for obstetric Antiphospholipid syndrome (APS).
• To explore novel mechanisms underlying the pathogenesis of obstetric APS.
• To identify potential therapeutic targets based on molecular pathways.

Main Methods:

• Review of preclinical investigations and histological analyses of placental tissues.
• Identification of molecular targets of antiphospholipid antibodies (aPL).
• Analysis of downstream intracellular pathways in placental cells.

Main Results:

• Abnormalities in the maternal-fetal interface, including inflammation and poor placentation.
• Reduced trophoblast invasion and limited uterine spiral artery remodeling observed in APS placentas.
• Identification of molecular targets and intracellular pathways involved in aPL-mediated placental dysfunction.

Conclusions:

• Understanding the molecular mechanisms of APS is crucial for developing effective treatments.
• Further research into novel pathways may lead to targeted therapies for obstetric complications in APS.
• Definitive clinical trials are needed to validate potential therapeutics for Antiphospholipid syndrome.