Long Term Follow up of Patients With Primary Obstetric Antiphospholipid Syndrome

Niznik, Stanley; Rapoport, Micha J.; Avnery, Orly; Lubetsky, Aharon; Shavit, Ronen; Ellis, Martin; Agmon‐Levin, Nancy

doi:10.3389/fphar.2022.824775

Cited by 4 publications

(1 citation statement)

References 31 publications

(41 reference statements)

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“…Vascular APS is mainly characterized by venous, arterial and small vessel thrombotic events in different organs [12]. Obstetrical APS (OAPS) is manifested with pregnancy morbidities and lower frequency of thrombotic events [12][13][14][15]. Distinct molecular signatures in these two APS subtypes were also found [16].…”

Section: Introductionmentioning

confidence: 99%

Trophoblast Cell Function in the Antiphospholipid Syndrome

Vrzić Petronijević,

Vilotić,

Bojić-Trbojević

et al. 2023

Biomedicines

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Antiphospholipid syndrome (APS) is a complex thrombo-inflammatory autoimmune disease characterized by the presence of antiphospholipid antibodies (aPL). Women with APS are at high risk of recurrent early pregnancy loss as well as late obstetrical complications—premature birth due to placental insufficiency or severe preeclampsia. Accumulating evidence implies that vascular thrombosis is not the only pathogenic mechanism in obstetric APS, and that the direct negative effect of aPL on the placental cells, trophoblast, plays a major role. In this review, we summarize the current findings regarding the potential mechanisms involved in aPL-induced trophoblast dysfunction. Introduction on the APS and aPL is followed by an overview of the effects of aPL on trophoblast—survival, cell function and aPL internalization. Finally, the implication of several non-coding RNAs in pathogenesis of obstetric APS is discussed, with special emphasis of their possible role in trophoblast dysfunction and the associated mechanisms.

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Section: Introductionmentioning

confidence: 99%

Trophoblast Cell Function in the Antiphospholipid Syndrome

Vrzić Petronijević,

Vilotić,

Bojić-Trbojević

et al. 2023

Biomedicines

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Heart valve disease in primary antiphospholipid syndrome

et al. 2023

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Objectives Antiphospholipid syndrome (APS)-associated heart valve disease (HVD) is well described. Nonetheless, limited data exist on clinical parameters associated with the course of primary APS (pAPS) patients with HVD. The goal of this study was to assess clinical features and related outcomes in patients with APS associated HVD. Methods In this multicentre retrospective study, we identified 33 pAPS patients with HVD (pAPS-HVD group) and compared their clinical course with 128 pAPS patients with normal heart valves on echocardiography (pAPS-control group). Results pAPS-HVD patients had more cerebrovascular events 56.3% vs 25% (p= 0.005) and livedo reticularis 24.2% vs 7.8% (p= 0.013) than pAPS-controls. Furthermore, catastrophic-APS (CAPS) (12.1% vs 2.4%, p= 0.034), recurrent thrombosis (33.3% vs 4.7%, p< 0.001), and need for advanced therapy (i.e. IVIG, plasmapheresis or rituximab) were more frequent in pAPS-HVD patients. Anti-B2GPI-IgG. [84.8% vs 63.2% (p= 0.034)], anti-cardiolipin IgG [90.9% vs. 64.8% (p= 0.005)] and triple positive aPL [75.8% vs 56.5% (p= 0.047)] were commoner in pAPS-HVD patients vs pAPS-controls. Ten of the 33 patients with pAPS-HVD underwent valve surgery which was associated with male gender, smoking, arterial limb ischaemia and livedo reticularis. Conclusion pAPS-HVD patients had a more severe APS clinical course including CAPS and thrombotic events as well as with specific serology namely IgG isotype aPL antibodies and triple positivity. Our data suggest that pAPS-HVD represents a high-risk subgroup of APS patients.

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Pregnancy in antiphospholipid syndrome: what should a rheumatologist know?

Andreoli,

Regola,

Caproli

et al. 2024

Rheumatology

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This review focuses on the management of reproductive issues in women who have antiphospholipid syndrome (APS) or are carriers of antiphospholipid antibodies (aPL). The importance of aPL detection during preconception counselling relies on their pathogenic potential for placental insufficiency and related obstetric complications. The risk of adverse pregnancy outcomes can be minimized by individualized risk stratification and tailored treatment aimed at preventing placental insufficiency. Combination therapy of low-dose acetylsalicylic acid and heparin is the mainstay of prophylaxis during pregnancy; immunomodulation, especially with hydroxychloroquine, should be considered in refractory cases. Supplementary ultrasound surveillance is useful to detect fetal growth restriction and correctly tailor the time of delivery. The individual aPL profile must be considered in the stratification of thrombotic risk, such as during assisted reproduction techniques requiring hormonal ovarian stimulation or during the follow-up after pregnancy in order to prevent the first vascular event.

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Long Term Follow up of Patients With Primary Obstetric Antiphospholipid Syndrome

Cited by 4 publications

References 31 publications

Trophoblast Cell Function in the Antiphospholipid Syndrome

Trophoblast Cell Function in the Antiphospholipid Syndrome

Heart valve disease in primary antiphospholipid syndrome

Pregnancy in antiphospholipid syndrome: what should a rheumatologist know?

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