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Mechanisms of Antiphospholipid Antibody-Mediated Thrombosis

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Antiphospholipid Syndrome

Abstract

Antiphospholipid antibodies (aPL) are key elements responsible for thrombosis in antiphospholipid syndrome (APS) patients. Current evidence indicates that aPL have wide-ranging effects on vascular cells, coagulation factors, and regulators of the coagulation cascade that produce a procoagulant phenotype. However, the molecular mechanisms underlying these processes remain incompletely understood. Inflammation serves as a necessary link between the observed procoagulant phenotype and thrombus development, with the complement cascade, toll-like receptors, and cytokines playing key roles. In this chapter, we outline the mechanisms that contribute to thrombosis in APS. We also review the facets of this topic for which there is no consensus among experts in the field, for instance, the relative importance of various mechanisms in the precipitation of thrombosis. Finally, we outline ongoing studies, namely, those presented at the recent 15th International Congress on aPL and our vision of the future direction of APS thrombosis research.

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Authors and Affiliations

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

    Rohan Willis

  2. Department of Haematology, University College London, Haemostasis Research Unit, London, UK

    Hannah Cohen

  3. UCL Division of Medicine, University College London Hospital, Centre for Rheumatology Research, London, UK

    Ian Giles

  4. Department of Internal Medicine, Division of Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA

    Jason S. Knight

  5. Infectious Disease, Immunology and Sexual Health, St George, University of New South Wales, Sydney, NSW, Australia

    Steven A. Krilis

  6. Division of Medicine, University College London Hospitals, Centre for Rheumatology Research, London, UK

    Anisur Rahman

  7. Synapse Research Institute, Maastricht, The Netherlands

    Philip G. de Groot

Authors
  1. Rohan Willis
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  2. Hannah Cohen
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  3. Ian Giles
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  4. Jason S. Knight
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  5. Steven A. Krilis
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  6. Anisur Rahman
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  7. Philip G. de Groot
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Corresponding authors

Correspondence to Rohan Willis or Philip G. de Groot .

Editor information

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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Willis, R. et al. (2017). Mechanisms of Antiphospholipid Antibody-Mediated Thrombosis. In: Erkan, D., Lockshin, M. (eds) Antiphospholipid Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-55442-6_5

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  • DOI: https://doi.org/10.1007/978-3-319-55442-6_5

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