Antiphospholipid antibodies and their clinical importance

Overview

Antiphospholipid antibodies (APLA) represent a heterogenous group of antibodieswhichmayaffectdifferent coagulation cascade pathways by analogy with involvement of phospholipid surfaces invarious steps of blood coagulation. The result of this process leads usually to some degree ofthrombophilia. The most frequently detected APLA are represented by lupus anticoagulant (LA)and anticardiolipin antibodies (aCL). Protein cofactors of antigen determinantswhich are involvedinAPLAgeneration are β2-GPI, prothrombin, proteinC, protein S, annexinV, high andlow molecularmass kininogen, factor XII, thrombomodulin and tissue plasminogen activator. A majority of thesefactors participate in the initial phase of coagulation cascade or in additional mechanisms ofchecking on the cascade. It is possible that antibodies against these proteins can affect coagulationbalance. The syndrome represented by positive LA and aCL antibodies has been called antiphospholipidsyndrome. The basic concept of this syndrome is characterized by thrombophilic syndrome.The main spectrum of clinical manifestations of APS includes arterial and venous thromboses,spontaneous fetal losses and thrombocytopenia.

Key words:
lupus anticoagulant, antiphospholipid syndrome