Antiphospholipid Antibody Syndrome: From Bench to Bedside by Pier Luigi Meroni

By Pier Luigi Meroni

This booklet, a part of the sequence infrequent ailments of the Immune process, bargains finished, up to date assurance of the pathophysiology and administration of the antiphospholipid syndrome (APS). Immunologic and genetic points are mentioned and the pathogenic mechanisms answerable for such phenomena as APS-mediated thrombosis and being pregnant loss/complications are defined. the most scientific manifestations, category standards and diagnostic instruments are pointed out, and shut awareness is paid to the character of the involvement of assorted organs or organ structures in APS. particular chapters describe the remedy of the several indicators, treatments of worth in heading off recurrences, and leading edge remedy methods. The authors are senior specialists within the box who're aided via more youthful fellows, making sure that the publication is usually educationally orientated. this convenient quantity can be a important device for postgraduates in education and execs wishing to increase their wisdom of this particular syndrome.

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The addition of intravenous immunoglobulin (IVIg) has not been shown to be superior to heparin and aspirin in unselected patients, while it seems to be efficacious in obstetric APS patients selected for poor prognosis or autoimmune phenomena [59]. A possible explanation for the high proportion of refractory APS might be that not all the mechanisms underlying aPL-mediated pregnancy complications have been clarified. Novel alternative therapies are urgently needed [60]. Given the evidence that β2GPI and the related autoantibodies play a central role in aPL-mediated obstetric manifestations, new molecules able to interfere with β2GPI expression at the placental level have been recently investigated.

Di Simone (*) • S. L. 2 N. Di Simone and S. D’Ippolito The Human Implantation and Placentation Human implantation and placentation represent a complex process based on subsequent steps. In particular, trophoblast cells play a key role in placental development. After implantation, they differentiate into villous and extravillous trophoblast cells (VTC and EVTC, respectively) [6]. VTC support the maternal-fetal exchange of nutrients and the endocrine functions of the placenta. EVTC invade the maternal endometrium and, through the formation of cellular plugs, gradually erode local spiral arteries to provide access to the maternal blood.

McNeely PA et al (2001) β 2-glycoprotein I-dependent anticardiolipin antibodies preferentially bind the amino terminal domain of β 2-glycoprotein I. Thromb Haemost 86:590–595 14. Iverson GM et al (2002) Use of single point mutations in domain I of β2-glycoprotein I to determine fine antibody specificity of antiphospholipid autoantibodies. J Immunol 169: 7097–7103 15. Ioannou Y et al (2007) Binding of antiphospholipid antibodies to discontinuous epitopes on domain I of human beta(2)-glycoprotein I: mutation studies including residues R39 to R43.

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