Utilidad de biomarcadores no incluidos en los criterios de clasificación para la identificación y seguimiento de pacientes con Síndrome Antifosfolipídico
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2023
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20/12/2022
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Universidad Complutense de Madrid
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Abstract
El Síndrome Antifosfolipídico (SAF) es un desorden autoinmune multisistémico caracterizado por la aparición de fenómenos trombóticos (arteriales, venosos o de pequeño vaso) y/o morbilidad gestacional en pacientes con anticuerpos antifosfolipídicos (aPL). Para la identificación de los pacientes disponemos de unos criterios de clasificación, actualizados por última vez en 2004 y aún vigentes, debiendo estar presentes simultáneamente un criterio clínico y otro de laboratorio (anticoagulante lúpico, anticuerpos anti-cardiolipina o anti-beta-2-glicoproteína-I (aB2GP1) de isotipo IgG y/o IgM). La beta-2-glicoproteína-I (B2GP1) es una glicoproteína plasmática cuya función exacta no se conoce, pero ha sido involucrada en el desarrollo de aterosclerosis, en la coagulación (principalmente con funciones anticoagulantes), actuando como proteína scavenger, y participando en el aclaramiento de cuerpos apoptóticos. Los anticuerpos aB2GP1 son patogénicos, induciendo un fenotipo protrombótico, sugiriéndose una inhibición de la actividad anticoagulante de la B2GP1 y la activación de células endoteliales, plaquetas y monocitos. Otros factores no trombóticos han sido implicados, como el complemento. Su activación parece ser necesaria en modelos in vivo de trombosis vascular y pérdida fetal...
Antiphospholipid Syndrome (APS) is a systemic autoimmune disorder characterized by the occurrence of venous or arterial thrombotic events and/or gestational morbidity in patients with antiphospholipid antibodies (aPL). Classification criteria are available to identify APS patients, updated in 2004. They require the combination of one clinical and one laboratory criterion (lupus anticoagulant, anti-cardiolipin and anti-b2-glycoprotein-I antibodies (aB2GPI), both of IgG or IgM isotypes).Beta-2-glycoprotein-I (B2GP1) is a plasma glycoprotein whose exact function is not known but has been implicated in the development of atherosclerosis, in coagulation (mainly with anticoagulant functions), acting as a scavenger protein and participating in the clearance of apoptotic bodies. Antibodies against B2GP1 are pathogenic, inducing a prothrombotic phenotype. Inhibition of the anticoagulant activity of B2GP1 and the activation of endothelial cells, platelets and monocytes have been suggested as possible mechanisms. Other non-thrombotic factors have been implicated such as complement. Its activation seems to be necessary in vivo models of vascular thrombosis and fetal loss...
Antiphospholipid Syndrome (APS) is a systemic autoimmune disorder characterized by the occurrence of venous or arterial thrombotic events and/or gestational morbidity in patients with antiphospholipid antibodies (aPL). Classification criteria are available to identify APS patients, updated in 2004. They require the combination of one clinical and one laboratory criterion (lupus anticoagulant, anti-cardiolipin and anti-b2-glycoprotein-I antibodies (aB2GPI), both of IgG or IgM isotypes).Beta-2-glycoprotein-I (B2GP1) is a plasma glycoprotein whose exact function is not known but has been implicated in the development of atherosclerosis, in coagulation (mainly with anticoagulant functions), acting as a scavenger protein and participating in the clearance of apoptotic bodies. Antibodies against B2GP1 are pathogenic, inducing a prothrombotic phenotype. Inhibition of the anticoagulant activity of B2GP1 and the activation of endothelial cells, platelets and monocytes have been suggested as possible mechanisms. Other non-thrombotic factors have been implicated such as complement. Its activation seems to be necessary in vivo models of vascular thrombosis and fetal loss...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 20-12-2022