The lupus anticoagulant/antiphospholipid syndrome

Area of Science:

• Immunology
• Hematology
• Obstetrics

Background:

• Antiphospholipid syndrome (APS) is linked to thrombosis, recurrent fetal loss, and thrombocytopenia.
• Pathogenesis of APS remains poorly understood despite strong clinical associations.

Purpose of the Study:

• To review diagnostic methods for APS.
• To discuss current understanding of APS pathogenesis.
• To outline anticoagulation strategies for managing thrombotic risk in APS.

Main Methods:

• Review of current literature on antiphospholipid antibodies and APS.
• Analysis of diagnostic assays for lupus anticoagulants (LACs) and anticardiolipin antibodies (ACAs).
• Discussion of emerging pathogenetic mechanisms and therapeutic approaches.

Main Results:

• Lupus anticoagulants and anticardiolipin antibodies are likely directed against protein-phospholipid complexes, not phospholipids alone.
• Other unrecognized protein-phospholipid complexes may contribute to APS.
• Long-term anticoagulation is the primary treatment for thrombotic risk.

Conclusions:

• Understanding APS pathogenesis is evolving, shifting focus to protein-phospholipid interactions.
• Accurate diagnosis and risk stratification are crucial for managing APS.
• Anticoagulation remains the cornerstone of thrombotic risk management in APS.