Division of Rheumatology, Hospital for Special Surgery, New York, NY, USA.
Barbara Volcker Center for Women and Rheumatic Diseases, Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY, USA.
Curr Opin Pharmacol. 2022 Aug;65:102212. doi: 10.1016/j.coph.2022.102212. Epub 2022 May 27.
Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis, pregnancy morbidity, or non-thrombotic manifestations in patients with persistently positive antiphospholipid antibodies (aPL). Conventional treatment strategies of antiphospholipid syndrome focuses on antithrombotic agents, however they are usually not effective for microvascular and non-thrombotic manifestations of aPL. In parallel to our increased understanding of the mechanisms of aPL-mediated clinical events, immunosuppression has been increasingly used in aPL-positive patients. This review focuses on the role of potential targeted immunosuppressive treatments in APS (B-cell inhibition, complement inhibition, mechanistic target of rapamycin inhibition, and traditional rheumatologic disease-modifying agents including hydroxychloroquine) and future perspectives.
抗磷脂综合征（APS）是一种系统性自身免疫性疾病，其特征是持续存在抗磷脂抗体（aPL）的患者发生血栓形成、妊娠并发症或非血栓性表现。抗磷脂综合征的常规治疗策略侧重于抗血栓药物，但它们通常对 aPL 的微血管和非血栓性表现无效。随着我们对 aPL 介导的临床事件机制的理解不断增加，免疫抑制已越来越多地用于 aPL 阳性患者。这篇综述重点介绍了潜在靶向免疫抑制治疗在 APS 中的作用（B 细胞抑制、补体抑制、雷帕霉素作用机制靶点和传统的风湿性疾病修饰剂，包括羟氯喹）和未来展望。
