Newman Thalia G, Knight Jason S
University of Michigan Medical School, Ann Arbor.
Arthritis Rheumatol. 2025 May 19. doi: 10.1002/art.43258.
Antiphospholipid syndrome (APS) is an autoimmune thromboinflammatory disease characterized by vascular thrombosis, pregnancy morbidity, and other manifestations driven by antiphospholipid autoantibodies. In this review, we present a clinical case that illustrates some diagnostic and therapeutic challenges in managing severe, relapsing APS manifestations, including microvascular injury and diffuse alveolar hemorrhage. We then discuss recent advances in our understanding of APS pathophysiology, emphasizing the critical role of anti-β-2 glycoprotein I antibodies in triggering cell-specific inflammatory and thrombotic pathways. Finally, we speculate that achieving definitive disease control will ultimately require strategies that eliminate or effectively neutralize these pathogenic antibodies.
抗磷脂综合征（APS）是一种自身免疫性血栓炎症性疾病，其特征为血管血栓形成、妊娠并发症以及由抗磷脂自身抗体引发的其他表现。在本综述中，我们展示了一个临床病例，该病例说明了在管理严重的、复发性APS表现（包括微血管损伤和弥漫性肺泡出血）时所面临的一些诊断和治疗挑战。然后，我们讨论了目前对APS病理生理学认识的最新进展，强调了抗β-2糖蛋白I抗体在触发细胞特异性炎症和血栓形成途径中的关键作用。最后，我们推测，要实现对疾病的彻底控制最终将需要采取消除或有效中和这些致病抗体的策略。
