Clinical Reviews in Allergy & Immunology

, Volume 34, Issue 3, pp 332–337

Updating on the Pathogenic Mechanisms 5 of the Antiphospholipid Antibodies-Associated Pregnancy Loss

  • Pier Luigi Meroni
  • Maria Gerosa
  • Elena Raschi
  • Silvia Scurati
  • Claudia Grossi
  • Maria O. Borghi
Article

DOI: 10.1007/s12016-007-8055-9

Cite this article as:
Meroni, P.L., Gerosa, M., Raschi, E. et al. Clinic Rev Allerg Immunol (2008) 34: 332. doi:10.1007/s12016-007-8055-9

Abstract

Anti-phospholipid antibodies (aPL) are risk factor for recurrent pregnancy loss and obstetrical complications. The mechanisms of aPL-mediated pregnancy failure are still a matter of research. Although aPL are associated with thrombosis, thrombotic events cannot explain all the miscarriages. There is evidence for a direct in vitro aPL effect on the trophoblast as shown by their binding; reduction of proliferation, human chorionic gonadotrophin release, in vitro invasiveness, adhesion molecule expression; and increased apoptosis. Such a direct reactivity is supported by the expression of beta2 glycoprotein (β2GP) I on trophoblast cell membranes. aPL/anti-β2GPI antibodies also bind to human decidual/endometrial cells in vitro and induce a pro-inflammatory phenotype. APL-mediated inflammatory processes at the placental level are apparently responsible for fetal loss at least in animal models. Both complement activation and pro-inflammatory cytokine/chemokine secretion have been shown to play a role. More recently, complement-induced tissue factor expression on infiltrating neutrophils was described as an additional pathogenic mechanisms mediated by aPL. As a whole, these findings do suggest that aPL may induce a defective placentation by acting at different levels without involving necessarily thrombotic events.

Keywords

Anti-phospholipid antibodies Pregnancy loss Beta2 glycoprotein I Trophoblast Decidual cells Complement Cytokines 

Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Pier Luigi Meroni
    • 1
    • 2
  • Maria Gerosa
    • 1
  • Elena Raschi
    • 1
  • Silvia Scurati
    • 1
  • Claudia Grossi
    • 1
  • Maria O. Borghi
    • 1
  1. 1.Department of Internal MedicineUniversity of MilanMilanItaly
  2. 2.Allergy, Clinical Immunology and Rheumatology UnitIRCCS Istituto Auxologico ItalianoMilanItaly

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