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.
Резюме
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.
Почему это важно для гирудотерапии
This review article covers advances in diagnosis, pathogenesis, and management of antiphospholipid syndrome (APS), a thrombo-inflammatory disease driven by autoantibodies targeting phospholipid-binding proteins, with discussion of coagulation pathways, endothelial cells, platelets, complement, and neutrophil extracellular traps. It notes that vitamin K antagonists remain the mainstay of treatment for thrombotic APS. The article's relevance to hirudotherapy is indirect at best: while APS involves pathological thrombosis that leech-derived anticoagulants like hirudin could theoretically target, the review does not mention leeches or leech-derived therapies, and no data are presented connecting APS management to the leech secretome.
Цитирование
Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management.
Knight et al. · BMJ (Clinical research ed.), 2023
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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