PHOSPHOLIPID-BINDING PLASMA-PROTEINS REQUIRED FOR ANTIPHOSPHOLIPID ANTIBODY DETECTION - AN OVERVIEW

PROBLEM: Antibodies to phospholipid antigens (aPA) are associated with thrombosis thrombocytopenia and recurrent pregnancy loss. Contemporar y data show many aPA target phospholipid-binding plasma proteins and n ot phospholipids. The purpose of this overview is to describe several phospholipid-binding proteins and provide data to demonstrate how the interaction between phospholipids and phospholipid binding proteins re sults in expression of neo-autoantigenic epitopes. METHOD: Review of e xisting data. RESULTS: Illustrations of how certain plasma proteins be ta(2) glycoprotein I, prothrombin, high and low molecular weight kinin ogens interact with the anionic phospholipids, cardiolipin and phospha tidylserine and the zwitterionic phospholipid, phosphatidylethanolamin e are shown and discussed. A model of aPA mediated thrombosis is prese nted. CONCLUSIONS: Some aPA recognize phospholipids directly, however, the majority and many which correlate with pathology target phospholi pid binding proteins. Published data indicate that aPA represent a con stellation of antibodies with multiple specificities. Insight into mec hanisms responsible for aPA-associated thrombosis should provide a bas is for treatment.