The impact of antiphospholipid antibodies/antiphospholipid syndrome on systemic lupus erythematosus

Area of Science:

• Rheumatology
• Immunology
• Cardiology

Background:

• Antiphospholipid antibodies (aPLs) are key drivers of cardiovascular risk in Systemic Lupus Erythematosus (SLE).
• aPLs negatively influence disease manifestations, organ damage, and patient prognosis.
• Current classification criteria for Antiphospholipid Syndrome (APS) may not capture all high-risk individuals.

Purpose of the Study:

• To explore the role of non-classical aPLs in identifying SLE patients at heightened risk for thrombotic events.
• To review the impact of aPLs on major organ systems and pregnancy outcomes in SLE.
• To outline strategies for managing cardiovascular risk in aPL-positive SLE patients.

Main Methods:

• Review of existing literature on aPLs, SLE, and thrombosis.
• Analysis of studies investigating non-classical aPLs, including IgA anti-β2-glycoprotein I, anti-domain I β2-glycoprotein I, and aPS-PT.
• Examination of clinical data regarding organ involvement and pregnancy outcomes.

Main Results:

• Non-classical aPLs like IgA anti-β2-glycoprotein I, anti-domain I β2-glycoprotein I, and aPS-PT show potential in risk stratification.
• Kidney and neuropsychiatric systems are frequently involved in aPL-related organ damage.
• aPLs significantly increase the risk of adverse pregnancy outcomes.

Conclusions:

• Identifying specific non-classical aPLs can improve risk assessment for thrombotic events in SLE.
• Aggressive management of cardiovascular risk factors is crucial for these patients.
• Low-dose aspirin is recommended for primary prophylaxis, while warfarin is the standard for secondary prophylaxis.