Systemic Autoimmune Diseases Research Unit, UMAE CMN Manuel Avila Camacho, Instituto Mexicano del Seguro Social, Puebla, Mexico.
Immunology and Rheumatology, Medical School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
Curr Rheumatol Rep. 2018 Aug 20;20(10):62. doi: 10.1007/s11926-018-0773-x.
The antiphospholipid syndrome (APS) is characterized by the development of thrombotic events and pregnancy morbidity in the presence of antiphospholipid antibodies (aPL). An infectious etiology for this syndrome has been postulated. The present review is aimed to summarize recent evidence about the role of infections and vaccines in the pathogenesis of the APS (including its catastrophic variant).
There is an increased risk of developing aPL in various infections, particularly in viral infections. The most frequent infection related to aPL has been hepatitis C virus. These antibodies may be associated with thromboembolic events, including catastrophic APS. There is a link between vaccinations, such as the tetanus toxoid and aPL, due to molecular mimicry between the two molecules. Accumulated evidence supports that the presence of aPL is associated with a variety of infections, including viruses, bacteria, fungi, and parasites, and the main mechanism to explain this correlation is molecular mimicry. Moreover, a link between vaccinations, such as the tetanus toxoid, and APS has also been described.
抗磷脂综合征(APS)的特征是在存在抗磷脂抗体(aPL)的情况下发生血栓形成事件和妊娠并发症。有人提出该综合征的病因可能与感染有关。本篇综述旨在总结关于感染和疫苗在 APS(包括其灾难性变体)发病机制中的作用的最新证据。
在各种感染中,特别是在病毒感染中,发生 aPL 的风险增加。与 aPL 最相关的感染是丙型肝炎病毒。这些抗体可能与血栓栓塞事件相关,包括灾难性 APS。破伤风类毒素和 aPL 之间存在联系,这是由于两种分子之间的分子模拟。越来越多的证据支持 aPL 的存在与各种感染有关,包括病毒、细菌、真菌和寄生虫,解释这种相关性的主要机制是分子模拟。此外,还描述了破伤风类毒素等疫苗与 APS 之间的联系。