Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management.
Review published in BMJ (Clinical research ed.) (2023)
Abstract
Antiphospholipid syndrome (APS) is a thrombo-inflammatory disease propelled by circulating autoantibodies that recognize cell surface phospholipids and phospholipid binding proteins. The result is an increased risk of thrombotic events, pregnancy morbidity, and various other autoimmune and inflammatory complications. Although antiphospholipid syndrome was first recognized in patients with lupus, the stand alone presentation of antiphospholipid syndrome is at least equally common. Overall, the diagnosis appears to affect at least one in 2000 people. Studies of antiphospholipid syndrome pathogenesis have long focused on logical candidates such as coagulation factors, endothelial cells, and platelets. Recent work has shed light on additional potential therapeutic targets within the innate immune system, including the complement system and neutrophil extracellular traps. Vitamin K antagonists remain the mainstay of treatment for most patients with thrombotic antiphospholipid syndrome and, based on current data, appear superior to the more targeted direct oral anticoagulants. The potential role of immunomodulatory treatments in antiphospholipid syndrome management is receiving increased attention. As for many systemic autoimmune diseases, the most important future direction is to more precisely identify mechanistic drivers of disease heterogeneity in pursuit of unlocking personalized and proactive treatments for patients.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Antiphospholipid syndrome (APS) is a thrombo-inflammatory disease propelled by circulating autoantibodies that recognize cell surface phospholipids and phospholipid binding proteins. The result is an increased risk of thrombotic events, pregnancy morbidity, and various other autoimmune and inflammatory complications.
Por qué esto importa para la hirudoterapia
Este artículo de revisión abarca los avances en el diagnóstico, la patogenia y el manejo del síndrome antifosfolípido (SAF), una enfermedad tromboinflamatoria impulsada por autoanticuerpos dirigidos contra proteínas de unión a fosfolípidos, con discusión de las vías de coagulación, células endoteliales, plaquetas, complemento y trampas extracelulares de neutrófilos. Señala que los antagonistas de la vitamina K siguen siendo la piedra angular del tratamiento del SAF trombótico. La relevancia del artículo para la hirudoterapia es, en el mejor de los casos, indirecta: si bien el SAF implica trombosis patológica que los anticoagulantes derivados de la sanguijuela, como la hirudina, podrían teóricamente abordar, la revisión no menciona sanguijuelas ni terapias derivadas de sanguijuela, y no se presentan datos que conecten el manejo del SAF con el secretoma de la sanguijuela.
Citación
Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management.
Knight et al. · BMJ (Clinical research ed.), 2023
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026