Update on antiphospholipid antibodies: clinical significance

Abstract

Antiphospholipid antibodies (aPL) are autoantibodies directed to phospholipid-binding proteins and classically related to thrombosis and pregnancy loss in the so-called antiphospholipid syndrome (APS). A wide spectrum of clinical manifestations have been observed in individuals with aPL. These may be asymptomatic, or they may exhibit clinical features suggesting APS, but not fulfilling the International Classification Criteria; typical APS manifestation in the absence of detectable aPL is defined as seronegative APS; microangiopathic APS may involve either one tissue only or may present with widespread thrombosis episodes accompanied by acute multi-organ failure in the catastrophic syndrome. The detection of different aPL profiles seems to increase the diagnostic specificity of the tests. The future research should focus on the development of assays that selectively identify aPL associated with increased risk of thrombosis or pregnancy complications, in order to lead to therapeutic strategies able to prev...