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Origin of Antiphospholipid Antibodies

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Abstract

Antiphospholipid antibodies (aPL) are directed against phospholipid-binding proteins, such as β2-glycoprotein I (β2GPI), and may be either nonpathogenic or pathogenic. While low levels of aPL, particularly of the IgM subclass, can be found in apparently healthy individuals and may be protective, IgG aPL can be associated with pathogenicity. Infectious agents are among the main triggers for the production of anti-β2GPI. Other potential triggers include the intestinal microbiome and cell death. Innate immune activation is a common feature that likely serves as a second hit for aPL induction, whether from the initiating trigger itself or as a second stimulus. In a pro-inflammatory microenvironment, such as that triggered by infection, injury, or commensal microorganisms, and on the appropriate genetic background, pathogenic aPL may emerge. This chapter outlines the environmental and immune factors leading to aPL and antiphospholipid syndrome.

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Acknowledgments

The authors are grateful to David Salem for reviewing the manuscript.

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Authors and Affiliations

  1. Department of Medicine (Division of Rheumatology), Research Institute of the McGill University Health Centre, Programme in Infectious Diseases and Immunity in Global Health (IDIGH), Montreal, Quebec, Canada

    Joyce Rauch

  2. Research Unit, Sheba Medical Center, Zabludowizc Center for Autoimmune Diseases Tel-Hashomer, Ramat Gan, Israel

    Miri Blank

  3. Synapse Research Institute, Maastricht, The Netherlands

    Philip G. de Groot

  4. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Kathryn M. Dupnik

  5. Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA

    Martin Alexander Kriegel

  6. Department of Medicine (Section of Nephrology), University of Illinois at Chicago, and Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA

    Jerrold S. Levine

  7. Department of Autoimmunity, Sheba Medical Center, Tel Hashomer, Israel

    Yehuda Shoenfeld

  8. Department of Internal Medicine, Division of Rheumatology, University of Texas Medical Branch, Galveston, TX, USA

    Rohan Willis

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  1. Joyce Rauch
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Correspondence to Joyce Rauch .

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Editors and Affiliations

  1. The Barbara Volcker Center for Women and Rheumatic Diseases, Associate Attending Physician, Hospital for Special Surgery, Associate Professor of Medicine, Weill Cornell Medicine, New York, New York, USA

    Doruk Erkan

  2. The Barbara Volcker Center for Women and Rheumatic Diseases, Attending Physician, Hospital for Special Surgery, Professor of Medicine and Obstetrics-Gynecology, Weill Cornell Medicine, New York, New York, USA

    Michael D. Lockshin

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Rauch, J. et al. (2017). Origin of Antiphospholipid Antibodies. In: Erkan, D., Lockshin, M. (eds) Antiphospholipid Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-55442-6_3

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