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MR Vol.11 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.11 No.2 |
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Antibody specificity and related clinical features
in antiphospholipid syndrome |
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| J. Kaburaki1 |
| (1)Department of Internal Medicine, Tokyo Electric
Power Company (TEPCO) Hospital, 9-2 Shinanomachi, Shinjuku-ku, Tokyo
160-0016, Japan |
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| Abstract |
| Abstract The concept of antiphospholipid syndrome
(APS) has been widely accepted. Antiphospholipid antibodies originally
included anticardiolipin antibodies and lupus anticoagulants. However,
recent advances have shown that most pathogenic antiphospholipid
antibodies are directed to phospholipid binding proteins such as
#2-glycoprotein I (#2-GPI) and prothrombin. Other candidates for
antigens of so-called antiphospholipid antibodies are protein C,
protein S, factor V, factor X, annexin V, high and low molecular
weight kininogens, and complex with #2-GPI and oxidized low-density
lipoprotein (LDL). These autoantibodies directed to different phospholipid
binding proteins are present in the blood stream, and contribute
to triggering procoagulant effects on endothelial cells and platelets,
leading to thrombosis. The heterogeneity of these antiphospholipid
antibodies appears to explain various clinical manifestations in
patients with APS. The preliminary classification criteria for
definite APS and a general management policy have been proposed,
although successful treatment of patients with antiphospholipid
antibodies have only been shown by retrospective studies. Further
prospective investigations are required to confirm the diagnostic
and therapeutic criteria for patients with APS. |
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| Key words |
| Key words Anti-&bgr; 2 -GPI antibodies
・ Anticardiolipin antibodies ・ Fetal loss ・ Lupus anticoagulants
・ Thrombosis |
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