Tags

Type your tag names separated by a space and hit enter

Revisiting antiphospholipid antibodies: from targeting phospholipids to phospholipid binding proteins.
Clin Lab. 2004; 50(11-12):653-65.CL

Abstract

The antiphospholipid syndrome (APS) is a multi-system prothrombotic disorder associated with circulating auto-antibodies directed against various phospholipid-binding proteins. The major clinical manifestations are recurrent arterial or venous thrombosis, but due to its heterogeneity, atypical presentations can obscure the diagnosis. Decisions regarding when to attribute complications to aPL are difficult. The most established tests are lupus anticoagulant (LA) detected by clotting assays and anticardiolipin (aCL) detected by ELISA. Although LA and aCL assays are clinically useful, these tests do not clearly differentiate antibodies with different specificities. Antibodies to beta2GPI are associated with thrombosis in the APS. Although these antibodies are detected by aCL assay (e.g. beta2GPI-dependent aCL), some aCL are not associated with the syndrome (e.g. beta2GPI-independent aCL). Regarding LAs, more studies are needed to determine if it is clinically important to differentiate specificities against beta2GPI or prothrombin. The role of aPLs in the pathogenesis of thrombosis requires further and intensive investigation. If autoantibodies to particular phospholipid binding proteins are shown to be associated with different clinical presentations or to confer different risks, the availability of more accurate diagnostic techniques will be required for the recognition of pathogenic aPLs. By now, clinical judgement, careful exclusion of other etiologies and serial aPL levels are helpful in this regard.

Authors+Show Affiliations

The Rayne Institute, St Thomas' Hospital, London, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15575307

Citation

Bertolaccini, Maria Laura, et al. "Revisiting Antiphospholipid Antibodies: From Targeting Phospholipids to Phospholipid Binding Proteins." Clinical Laboratory, vol. 50, no. 11-12, 2004, pp. 653-65.
Bertolaccini ML, Hughes GR, Khamashta MA. Revisiting antiphospholipid antibodies: from targeting phospholipids to phospholipid binding proteins. Clin Lab. 2004;50(11-12):653-65.
Bertolaccini, M. L., Hughes, G. R., & Khamashta, M. A. (2004). Revisiting antiphospholipid antibodies: from targeting phospholipids to phospholipid binding proteins. Clinical Laboratory, 50(11-12), 653-65.
Bertolaccini ML, Hughes GR, Khamashta MA. Revisiting Antiphospholipid Antibodies: From Targeting Phospholipids to Phospholipid Binding Proteins. Clin Lab. 2004;50(11-12):653-65. PubMed PMID: 15575307.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Revisiting antiphospholipid antibodies: from targeting phospholipids to phospholipid binding proteins. AU - Bertolaccini,Maria Laura, AU - Hughes,Graham Rv, AU - Khamashta,Munther A, PY - 2004/12/4/pubmed PY - 2005/4/27/medline PY - 2004/12/4/entrez SP - 653 EP - 65 JF - Clinical laboratory JO - Clin Lab VL - 50 IS - 11-12 N2 - The antiphospholipid syndrome (APS) is a multi-system prothrombotic disorder associated with circulating auto-antibodies directed against various phospholipid-binding proteins. The major clinical manifestations are recurrent arterial or venous thrombosis, but due to its heterogeneity, atypical presentations can obscure the diagnosis. Decisions regarding when to attribute complications to aPL are difficult. The most established tests are lupus anticoagulant (LA) detected by clotting assays and anticardiolipin (aCL) detected by ELISA. Although LA and aCL assays are clinically useful, these tests do not clearly differentiate antibodies with different specificities. Antibodies to beta2GPI are associated with thrombosis in the APS. Although these antibodies are detected by aCL assay (e.g. beta2GPI-dependent aCL), some aCL are not associated with the syndrome (e.g. beta2GPI-independent aCL). Regarding LAs, more studies are needed to determine if it is clinically important to differentiate specificities against beta2GPI or prothrombin. The role of aPLs in the pathogenesis of thrombosis requires further and intensive investigation. If autoantibodies to particular phospholipid binding proteins are shown to be associated with different clinical presentations or to confer different risks, the availability of more accurate diagnostic techniques will be required for the recognition of pathogenic aPLs. By now, clinical judgement, careful exclusion of other etiologies and serial aPL levels are helpful in this regard. SN - 1433-6510 UR - https://www.unboundmedicine.com/medline/citation/15575307/Revisiting_antiphospholipid_antibodies:_from_targeting_phospholipids_to_phospholipid_binding_proteins_ DB - PRIME DP - Unbound Medicine ER -