Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy.
Department of Cardiovascular and Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy.
Biomolecules. 2023 Aug 5;13(8):1221. doi: 10.3390/biom13081221.
Oxidative stress is a well-known hallmark of Antiphospholipid Antibody Syndrome (APS), a systemic autoimmune disease characterized by arterial and venous thrombosis and/or pregnancy morbidity. Oxidative stress may affect various signaling pathways and biological processes, promoting dysfunctional immune responses and inflammation, inducing apoptosis, deregulating autophagy and impairing mitochondrial function. The chronic oxidative stress and the dysregulation of the immune system leads to the loss of tolerance, which drives autoantibody production and inflammation with the development of endothelial dysfunction. In particular, anti-phospholipid antibodies (aPL), which target phospholipids and/or phospholipid binding proteins, mainly β-glycoprotein I (β-GPI), play a functional role in the cell signal transduction pathway(s), thus contributing to oxidative stress and thrombotic events. An oxidation-antioxidant imbalance may be detected in the blood of patients with APS as a reflection of disease progression. This review focuses on functional evidence highlighting the role of oxidative stress in the initiation and progression of APS. The protective role of food supplements and Nuclear Factor Erythroid 2-Related Factor 2 (NRF2) activators in APS patients will be summarized to point out the potential of these therapeutic approaches to reduce APS-related clinical complications.
氧化应激是抗磷脂抗体综合征（APS）的一个众所周知的标志，APS 是一种以动脉和静脉血栓形成和/或妊娠发病率为特征的系统性自身免疫性疾病。氧化应激可能会影响各种信号通路和生物过程，促进功能失调的免疫反应和炎症，诱导细胞凋亡，调节自噬并损害线粒体功能。慢性氧化应激和免疫系统失调导致耐受性丧失，从而驱动自身抗体的产生和炎症，导致内皮功能障碍。特别是，针对磷脂和/或与磷脂结合蛋白的抗磷脂抗体（aPL），主要是β-糖蛋白 I（β-GPI），在细胞信号转导途径中发挥功能作用，从而导致氧化应激和血栓形成事件。APS 患者的血液中可能会检测到氧化-抗氧化失衡，这反映了疾病的进展。本综述重点介绍了氧化应激在 APS 发病和进展中的作用的功能证据。还将总结食物补充剂和核因子红细胞 2 相关因子 2（NRF2）激活剂在 APS 患者中的保护作用，以指出这些治疗方法降低 APS 相关临床并发症的潜力。
