Journal
LUPUS
Volume 17, Issue 10, Pages 937-942Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0961203308095140
Keywords
anti-phospholipid syndrome; beta2 glycoprotein I; innate immunity; thrombosis; toll-like receptors
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Funding
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [R01AR056745] Funding Source: NIH RePORTER
- NIAMS NIH HHS [R01 AR056745] Funding Source: Medline
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The anti-phospholipid syndrome (APS) is a systemic autoimmune disease characterized by an adaptive immune response against self phospholipid (PL)--binding proteins. Although APS is considered as an autoantibody-mediated disease, there is now evidence that anti-phospholipid antibodies (aPL) are necessary but not sufficient to trigger some of the clinical manifestations of the syndrome. For example, mediators of the innate immunity are recognized to be additional second hits able to induce the thrombotic events in the presence of aPL. Finally, environmental agents in particular infectious ones - were reported to act as triggers for the production of autoantibodies cross-reacting with PL-binding proteins as well as inflammatory stimuli that potentiate the aPL thrombogenic effect. Altogether, these findings suggest a role for the innate immunity in APS pathogenesis. Toll-like receptors (TLR) are receptors that induce prompt inflammatory responses and mediate functional activation in immune effector cells. There is evidence that aPL, and in particular TLR-4-dependent signalling. whether or not TLR may behave as surface receptors for beta(2)-GPI is still matter of research. Drugs or molecules able to interfere with TLR involvement may respresent new therapeutic approaches for APS. Lupus (2008) 17, 937-942.
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