WHAT IS THE PATHOGENETIC ROLE OF ANTIPHOSPHOLIPID ANTIBODIES

The association between antiphospholipid antibodies (aPL) and arterial or venous thrombosis, fetal loss and thrombocytopenia defines the so- called ''antiphospholipid syndrome' (APS). Despite serial studies in r ecent years, a clear pathogenetic mechanism(s) has not vet been demons trated Several authors have investigated the interaction between aPL a nd the membranes of blood cells (endothelial cells and platelets) invo lved in coagulation. aPL is also thought to affect the balance between the procoagulant and anticoagulant states by interacting with plasma or tissue cofactors. Finally the strong association between aPL and ex perimental animal models of fetal loss supports a direct pathogenetic role for aPL in inducing a poor pregnancy outcome in APS women.