Journal ArticleDOI
Anti-phospholipid antibodies and reproductive failures.
Asmaa Beltagy,Laura Trespidi,Maria Gerosa,Manuela Wally Ossola,Pier Luigi Meroni,Cecilia Beatrice Chighizola +5 more
TLDR
This review focuses on some of the several unanswered questions related to diagnostic, prognostic, and therapeutic aspects in obstetric APS.Abstract:
Anti-phospholipid syndrome (APS) recapitulates the link between autoimmunity and pregnancy failure: Acquired anti-phospholipid antibodies (aPL) play a pathogenic role in pregnancy complications. The diagnosis of obstetric APS can easily be pursued when women present with laboratory and clinical features fulfilling the international classification criteria. Standard therapeutic approach to obstetric APS consists in the association of anti-platelet agents and anticoagulants. Most patients achieve a live birth thanks to conventional treatment; however, approximately 20% fail to respond and are managed with additional therapeutic tools added on the top of conventional treatment. Surely, a refinement of risk stratification tools would allow early identification of high-risk pregnancies that warrant tailored treatment. In real life, obstetricians and rheumatologists face complex diagnostic scenarios including women with pregnancy morbidities other than those mentioned in classification criteria such as one or two early losses and premature birth after 34 weeks due to preeclampsia or placental insufficiency, women with low-titer aPL not fulfilling criteria laboratory requirements, women with positive non-criteria aPL, asymptomatic aPL carriers, and infertile women found to be aPL-positive. This review focuses on some of the several unanswered questions related to diagnostic, prognostic, and therapeutic aspects in obstetric APS.read more
Citations
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Journal ArticleDOI
The Weight of IgA Anti-β2glycoprotein I in the Antiphospholipid Syndrome Pathogenesis: Closing the Gap of Seronegative Antiphospholipid Syndrome.
Oscar Cabrera-Marante,Edgard Rodríguez de Frías,Manuel Moro Serrano,Fernando Lozano Morillo,Laura Naranjo,Francisco Javier Gil-Etayo,Estela Paz-Artal,Daniel E Pleguezuelo,Antonio Serrano +8 more
TL;DR: The molecular and clinical “state of the art” of the IgA aB2GP in the context of APS is summarized and some of the characteristics that may help to evaluate the real value of this isotype are discussed in basic research and clinical practice.
Journal ArticleDOI
Pediatric Antiphospholipid Syndrome: from Pathogenesis to Clinical Management.
Silvia Rosina,Cecilia Beatrice Chighizola,Angelo Ravelli,Angelo Ravelli,Angelo Ravelli,Rolando Cimaz +5 more
TL;DR: In this paper, the role of β2 glycoprotein I, which bridges innate immunity and coagulation, has been investigated in pediatric antiphospholipid syndrome (APS).
Journal ArticleDOI
Comparison of treatments for the prevention of fetal growth restriction in obstetric antiphospholipid syndrome: a systematic review and network meta-analysis.
Maria Letizia Urban,Alessandra Bettiol,Irene Mattioli,Giacomo Emmi,Gerardo Di Scala,Laura Avagliano,Niccolò Lombardi,Giada Crescioli,Gianni Virgili,Gianni Virgili,Caterina Serena,Federico Mecacci,Claudia Ravaldi,Alfredo Vannacci,Elena Silvestri,Domenico Prisco +15 more
TL;DR: In this article, a systematic review and network meta-analysis (NetMA) was performed to summarize current evidence on pharmacological treatments for the prevention of fetal growth restriction (FGR) in APS.
Journal ArticleDOI
Antiphospholipid antibodies and idiopathic infertility
TL;DR: It is confirmed that women affected by idiopathic infertility show a high prevalence of antiphospholipid antibodies, suggesting that these autoantibodies can also affect conception.
Journal ArticleDOI
Immunology of pregnancy and reproductive health in autoimmune rheumatic diseases. Update from the 11th International Conference on Reproduction, Pregnancy and Rheumatic Diseases.
Laura Andreoli,Cecilia Beatrice Chighizola,Luca Iaccarino,A. Botta,Maria Gerosa,Véronique Ramoni,Chiara Tani,Bonnie L. Bermas,Antonio Brucato,Jill P. Buyon,Irene Cetin,Christina D. Chambers,Megan E.B. Clowse,Nathalie Costedoat-Chalumeau,Maurizio Cutolo,Sara De Carolis,Radboud J E M Dolhain,Elisa Fazzi,Frauke Förger,Ian Giles,Isabell Haase,Munther A. Khamashta,Roger A. Levy,Pier Luigi Meroni,Marta Mosca,Catherine Nelson-Piercy,Luigi Raio,Jane Salmon,Peter M. Villiger,Marie Wahren-Herlenius,Maria Wallenius,C. Zanardini,Yehuda Shoenfeld,Angela Tincani +33 more
TL;DR: In this paper , a risk stratification and individualized treatment approach elaborated by a multidisciplinary team minimize the risk of adverse pregnancy outcomes (APO) was proposed to identify biomarkers that can be predictive of APO.
References
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Journal ArticleDOI
International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS).
Spiros Miyakis,Michael D. Lockshin,Tatsuya Atsumi,D W Branch,Robin L. Brey,Ricard Cervera,R. H. W. M. Derksen,P. G. De Groot,Takao Koike,Pier Luigi Meroni,Guido Reber,Yehuda Shoenfeld,Angela Tincani,Panayiotis G. Vlachoyiannopoulos,Steven A. Krilis +14 more
TL;DR: This document appraise the existing evidence on clinical and laboratory features of APS addressed during the forum and proposes amendments to the Sapporo criteria, including definitions on features ofAPS that were not included in the updated criteria.
Journal ArticleDOI
Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: a systematic review of the literature
TL;DR: The detection of lupus anticoagulants and, possibly, of immunoglobulin G (IgG) anticardiolipin antibodies at medium or high titers helps to identify patients at risk for thrombosis, however, to take full advantage of the conclusions provided by the available evidence, there is an urgent need to harmonize investigational methods.
Journal ArticleDOI
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients
Ricard Cervera,Munther A. Khamashta,Y Shoenfeld,M. T. Camps,Søren Jacobsen,Emese Kiss,Margit Zeher,Angela Tincani,I. Kontopoulou-Griva,Mauro Galeazzi,Francesca Bellisai,Pier Luigi Meroni,R. H. W. M. Derksen,P. G. De Groot,Erika Gromnica-Ihle,Marta Baleva,Marta Mosca,Stefano Bombardieri,Frédéric Houssiau,Jean-Christophe Gris,Isabelle Quéré,Eric Hachulla,Carlos Vasconcelos,B. Roch,Antonio Fernández-Nebro,J.C. Piette,Gerard Espinosa,Silvia Bucciarelli,C. N. Pisoni,Maria Laura Bertolaccini,M. C. Boffa,G. R. V. Hughes +31 more
TL;DR: Patients with APS still develop significant morbidity and mortality despite current treatment, and it is imperative to increase the efforts in determining optimal prognostic markers and therapeutic measures to prevent these complications.
Journal ArticleDOI
A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate
Roberto Romero,Jyh Kae Nien,Jimmy Espinoza,David Todem,Wenjiang J. Fu,Hwan Chung,Juan Pedro Kusanovic,Francesca Gotsch,Offer Erez,Shali Mazaki-Tovi,Ricardo Gomez,Sam Edwin,Tinnakorn Chaiworapongsa,Richard J. Levine,S. Ananth Karumanchi +14 more
TL;DR: The objective of this study was to determine if changes in maternal plasma concentration of these angiogenic and anti-angiogenic factors differ prior to development of disease among patients with normal pregnancies and those destined to develop PE (preterm and term) or to deliver a small for gestational age (SGA) neonate.
Journal ArticleDOI
Heparin prevents antiphospholipid antibody–induced fetal loss by inhibiting complement activation
TL;DR: The data indicate that heparins prevent obstetrical complications in women with APS because they block activation of complement induced by aPL antibodies targeted to decidual tissues, rather than by their anticoagulant effects.