Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome

Antiphospholipid syndrome is an autoimmune disorder characterized by vascular thrombosis and/or pregnancy morbidity associated with persistent antiphospholipid antibody positivity. Cases fulfilling the Sydney criteria for obstetric morbidity with no previous thrombosis are known as obstetric antipho...

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Autores: Alijotas-Reig, Jaume|||0000-0002-9212-3619, Esteve-Valverde, Enrique|||0000-0002-1403-8419, Anunciación-Llunell, Ariadna|||0000-0002-0468-1232, Marques-Soares, Joana Rita|||0000-0001-9726-4149, Pardos-Gea, Josep|||0000-0002-3725-6849, Miró-Mur, Francesc|||0000-0003-3936-2693
Tipo de documento: artigo
Data de publicação:2022
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:256044
Acesso em linha:https://ddd.uab.cat/record/256044
https://dx.doi.org/urn:doi:10.3390/jcm11030675
Access Level:Acceso aberto
Palavra-chave:Antiphospholipid antibody
Non-criteria antiphospholipid antibodies
Diagnosis
Pathogenesis
Management
Obstetric antiphospholipid syndrome
Review
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spelling Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid SyndromeA Comprehensive ReviewAlijotas-Reig, Jaume|||0000-0002-9212-3619Esteve-Valverde, Enrique|||0000-0002-1403-8419Anunciación-Llunell, Ariadna|||0000-0002-0468-1232Marques-Soares, Joana Rita|||0000-0001-9726-4149Pardos-Gea, Josep|||0000-0002-3725-6849Miró-Mur, Francesc|||0000-0003-3936-2693Antiphospholipid antibodyNon-criteria antiphospholipid antibodiesDiagnosisPathogenesisManagementObstetric antiphospholipid syndromeReviewAntiphospholipid syndrome is an autoimmune disorder characterized by vascular thrombosis and/or pregnancy morbidity associated with persistent antiphospholipid antibody positivity. Cases fulfilling the Sydney criteria for obstetric morbidity with no previous thrombosis are known as obstetric antiphospholipid syndrome (OAPS). OAPS is the most identified cause of recurrent pregnancy loss and late-pregnancy morbidity related to placental injury. Cases with incomplete clinical or laboratory data are classified as obstetric morbidity APS (OMAPS) and non-criteria OAPS (NC-OAPS), respectively. Inflammatory and thrombotic mechanisms are involved in the pathophysiology of OAPS. Trophoblasts, endothelium, platelets and innate immune cells are key cellular players. Complement activation plays a crucial pathogenic role. Secondary placental thrombosis appears by clot formation in response to tissue factor activation. New risk assessment tools could improve the prediction of obstetric complication recurrences or thromboses. The standard-of-care treatment consists of low-dose aspirin and prophylactic low molecular weight heparin. In refractory cases, the addition of hydroxychloroquine, low-dose prednisone or IVIG improve pregnancy outcomes. Statins and eculizumab are currently being tested for treating selected OAPS women. Finally, we revisited recent insights and concerns about the pathophysiology, diagnosis and management of OAPS. 22022-01-0120222022-01-01Article de revisióhttp://purl.org/coar/resource_type/c_dcae04bcVoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/256044https://dx.doi.org/urn:doi:10.3390/jcm11030675reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2560442026-06-06T12:50:31Z
dc.title.none.fl_str_mv Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
A Comprehensive Review
title Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
spellingShingle Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
Alijotas-Reig, Jaume|||0000-0002-9212-3619
Antiphospholipid antibody
Non-criteria antiphospholipid antibodies
Diagnosis
Pathogenesis
Management
Obstetric antiphospholipid syndrome
Review
title_short Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
title_full Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
title_fullStr Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
title_full_unstemmed Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
title_sort Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome
dc.creator.none.fl_str_mv Alijotas-Reig, Jaume|||0000-0002-9212-3619
Esteve-Valverde, Enrique|||0000-0002-1403-8419
Anunciación-Llunell, Ariadna|||0000-0002-0468-1232
Marques-Soares, Joana Rita|||0000-0001-9726-4149
Pardos-Gea, Josep|||0000-0002-3725-6849
Miró-Mur, Francesc|||0000-0003-3936-2693
author Alijotas-Reig, Jaume|||0000-0002-9212-3619
author_facet Alijotas-Reig, Jaume|||0000-0002-9212-3619
Esteve-Valverde, Enrique|||0000-0002-1403-8419
Anunciación-Llunell, Ariadna|||0000-0002-0468-1232
Marques-Soares, Joana Rita|||0000-0001-9726-4149
Pardos-Gea, Josep|||0000-0002-3725-6849
Miró-Mur, Francesc|||0000-0003-3936-2693
author_role author
author2 Esteve-Valverde, Enrique|||0000-0002-1403-8419
Anunciación-Llunell, Ariadna|||0000-0002-0468-1232
Marques-Soares, Joana Rita|||0000-0001-9726-4149
Pardos-Gea, Josep|||0000-0002-3725-6849
Miró-Mur, Francesc|||0000-0003-3936-2693
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Antiphospholipid antibody
Non-criteria antiphospholipid antibodies
Diagnosis
Pathogenesis
Management
Obstetric antiphospholipid syndrome
Review
topic Antiphospholipid antibody
Non-criteria antiphospholipid antibodies
Diagnosis
Pathogenesis
Management
Obstetric antiphospholipid syndrome
Review
description Antiphospholipid syndrome is an autoimmune disorder characterized by vascular thrombosis and/or pregnancy morbidity associated with persistent antiphospholipid antibody positivity. Cases fulfilling the Sydney criteria for obstetric morbidity with no previous thrombosis are known as obstetric antiphospholipid syndrome (OAPS). OAPS is the most identified cause of recurrent pregnancy loss and late-pregnancy morbidity related to placental injury. Cases with incomplete clinical or laboratory data are classified as obstetric morbidity APS (OMAPS) and non-criteria OAPS (NC-OAPS), respectively. Inflammatory and thrombotic mechanisms are involved in the pathophysiology of OAPS. Trophoblasts, endothelium, platelets and innate immune cells are key cellular players. Complement activation plays a crucial pathogenic role. Secondary placental thrombosis appears by clot formation in response to tissue factor activation. New risk assessment tools could improve the prediction of obstetric complication recurrences or thromboses. The standard-of-care treatment consists of low-dose aspirin and prophylactic low molecular weight heparin. In refractory cases, the addition of hydroxychloroquine, low-dose prednisone or IVIG improve pregnancy outcomes. Statins and eculizumab are currently being tested for treating selected OAPS women. Finally, we revisited recent insights and concerns about the pathophysiology, diagnosis and management of OAPS.
publishDate 2022
dc.date.none.fl_str_mv 2
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv Article de revisió
http://purl.org/coar/resource_type/c_dcae04bc
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/256044
https://dx.doi.org/urn:doi:10.3390/jcm11030675
url https://ddd.uab.cat/record/256044
https://dx.doi.org/urn:doi:10.3390/jcm11030675
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
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