Kortright-Maldonado Karen, Reyes-Torres Bruno Eduardo, Cabrera-Lopez Lilian Stephany, Rodríguez-Henríquez Pedro, Tenorio-Aguirre Erika Karina, Martínez-Sánchez Froylan D
Department of Internal Medicine, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico.
Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico.
Rheumatol Adv Pract. 2025 Jan 8;9(1):rkaf005. doi: 10.1093/rap/rkaf005. eCollection 2025.
APS is an autoimmune disorder characterized by thrombosis and pregnancy complications, primarily driven by aPLs such as LA, aCL and anti-β2 glycoprotein I (a-β2GPI). Despite advances in anticoagulation therapies, managing refractory APS cases remains challenging. Emerging therapies, including rituximab, eculizumab and HCQ, show potential in addressing the underlying mechanisms of APS. Additionally, research into genetic and environmental factors, particularly the gut microbiome's role through molecular mimicry, suggests new therapeutic pathways. Diagnostic advancements, such as the adjusted Global Antiphospholipid Syndrome Score (aGAPSS), metabolomic profiling and MRI, have improved risk stratification and early detection. Non-traditional biomarkers like anti-phosphatidylserine/prothrombin (aPS/PT) and anti-Domain I antibodies further enhance risk assessment. Future research should aim to validate these approaches, optimizing patient outcomes and minimizing long-term APS complications.
抗磷脂综合征（APS）是一种自身免疫性疾病，其特征为血栓形成和妊娠并发症，主要由狼疮抗凝物（LA）、抗心磷脂抗体（aCL）和抗β2糖蛋白I抗体（a-β2GPI）等抗磷脂抗体（aPLs）驱动。尽管抗凝治疗取得了进展，但管理难治性APS病例仍然具有挑战性。包括利妥昔单抗、依库珠单抗和羟氯喹在内的新兴疗法在解决APS的潜在机制方面显示出潜力。此外，对遗传和环境因素的研究，特别是肠道微生物群通过分子模拟所起的作用，提示了新的治疗途径。诊断方面的进展，如调整后的全球抗磷脂综合征评分（aGAPSS）、代谢组学分析和磁共振成像（MRI），改善了风险分层和早期检测。抗磷脂酰丝氨酸/凝血酶原抗体（aPS/PT）和抗结构域I抗体等非传统生物标志物进一步加强了风险评估。未来的研究应致力于验证这些方法，优化患者预后并尽量减少APS的长期并发症。
