Vasculopathy and arterial stenotic lesions in the antiphospholipid syndrome

Abstract

The antiphospholipid (Hughes) syndrome (APS) is characterized by recurrent arterial or venous thromboembolism, or pregnancy loss, in association with antiphospholipid antibodies. These antibodies may be associated with premature or accelerated atherosclerosis and emerging evidence supports the concept of a vasculopathy in the APS that may lead to arterial stenotic lesions, possibly contributing to vascular occlusions and pregnancy morbidity.

Superficial femoral artery thrombosis as a cause for distal embolism in primary antiphospholipid syndrome

“…Thrombosis due to premature or accelerated atherosclerosis in setting of traditional risk factors (smoking, diabetes, hypertension, and hypercholesterolemia) have been documented in APS patients. [19][20][21] Despite this view of vasculopathy in APS, our patient's histopathologic evaluation did not show evidence of atherosclerosis to support this concept.…”

Patients with antiphospholipid syndrome display endothelial perturbation

“…On the other hand, EC dysfunction may also be responsible for an accelerated atherosclerosis as shown in other systemic autoimmune diseases [28]. However, atherosclerosis in APS patients is still a matter of investigation since, in contrast with data in experimental models, clinical studies failed to show a clear evidence of accelerated atherosclerosis in patients with PAPS and no association between aPL and the accelerated atherosclerotic process was found in SLE patients [18,[29][30][31][32][33][34][35][36]. The normal IMT values and the lack of plaques in carotid arteries in our series are apparently against the evidence of an accelerated atherosclerosis.…”

Vascular Dysfunction in Women with Recurrent Pregnancy Loss

“…Immune complexes containing oxLDL, 2GPI, and/or CRP are known to be involved in atherosclerosis (Matsuura et al, 2006, Chekir et al, 2009). Autoantibodies to oxLDL/ 2GPI complex were detected in SLE and APS patients, and were strongly associated with arterial thrombosis (Christodoulou et al, 2007). Further studies may help evaluating clinical usefullness of these autoimmune antibodies involving in progression of atherosclerosis in women RPL.…”