1
|
Granada-Gómez M, Velásquez-Berrío M, Molina CR, Martín SS, Escudero C, Alvarez AM, Cadavid AP. Modulation of the activation of endothelial nitric oxide synthase and nitrosative stress biomarkers by aspirin triggered lipoxins: A possible mechanism of action of aspirin in the antiphospholipid syndrome. Am J Reprod Immunol 2023; 90:e13753. [PMID: 37491919 DOI: 10.1111/aji.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/20/2023] [Accepted: 07/04/2023] [Indexed: 07/27/2023] Open
Abstract
PROBLEM Antiphospholipid syndrome (APS) is characterized by the clinical manifestation of vascular thrombosis (VT) or pregnancy morbidity (PM) and antiphospholipid antibodies (aPL) that can modify the nitric oxide production. Low-dose aspirin is used in the prevention and treatment of diverse alterations of pregnancy. One of the mechanisms of action of aspirin is to induce the production of aspirin-triggered-lipoxins (ATL). The aim of this study was to evaluate the modulatory effect of ATL over the activation of endothelial nitric oxide synthase (eNOS) and nitrosative stress biomarkers induced by aPL. METHODS We used polyclonal IgG and sera from women with aPL and PM/VT or VT only, and from women with PM only and positive for non-criteria aPL (SN-OAPS). In these sera, biomarkers of nitrosative stress (nitrites and nitrotyrosine) were measured. The protein expression of nitrotyrosine and the phosphorylation of eNOS (at Ser1177) were estimated in human umbilical vein endothelial cells (HUVECs) stimulated with polyclonal IgG with or without ATL. RESULTS Women with SN-OAPS showed increased circulating levels of nitrites and nitrotyrosine. Likewise, polyclonal IgG from either SN-OAPS or VT patients stimulated nitrotyrosine expression in HUVECs. ATL decreased the nitrotyrosine expression induced by polyclonal IgG from the SN-OAPS group. ATL also recovered the reduced eNOS phosphorylation at Ser1177 in HUVECs stimulated with polyclonal IgG from women with PM/VT or SN-OAPS. CONCLUSIONS Increased nitrosative stress present in serum of women with SN-OAPS is associated with IgG-mediated impaired endothelial NO synthesis in endothelial cells. ATL prevent these cellular changes.
Collapse
Affiliation(s)
- Manuel Granada-Gómez
- Grupo Reproducción, Facultad de Medicina, Dpto. Microbiología y Parasitología, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Manuela Velásquez-Berrío
- Grupo Reproducción, Facultad de Medicina, Dpto. Microbiología y Parasitología, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Carolina Rúa Molina
- Grupo de Investigación en Trombosis, Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Sebastián San Martín
- Biomedical Research Center School of Medicine, Universidad de Valparaiso, Valparaiso, Chile
- Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillan, Chile
| | - Carlos Escudero
- Vascular Physiology Laboratory, Basic Sciences Department, Faculty of Sciences, Universidad del Bio-Bio, Chillán, Chile
- Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillan, Chile
- Red Iberoamericana de Alteraciones Vasculares Asociadas a TRanstornos del EMbarazo (RIVATREM)
| | - Angela M Alvarez
- Grupo Reproducción, Facultad de Medicina, Dpto. Microbiología y Parasitología, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Angela P Cadavid
- Grupo Reproducción, Facultad de Medicina, Dpto. Microbiología y Parasitología, Universidad de Antioquia UdeA, Medellín, Colombia
- Grupo de Investigación en Trombosis, Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia
- Red Iberoamericana de Alteraciones Vasculares Asociadas a TRanstornos del EMbarazo (RIVATREM)
| |
Collapse
|
2
|
Liu X, Qiu Y, Yu ED, Xiang S, Meng R, Niu KF, Zhu H. Comparison of therapeutic interventions for recurrent pregnancy loss in association with antiphospholipid syndrome: A systematic review and network meta‐analysis. Am J Reprod Immunol 2020; 83:e13219. [PMID: 31872490 DOI: 10.1111/aji.13219] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xiang Liu
- Department of Gynecology and Obstetrics West China Second University Hospital Sichuan University Chengdu China
- West China School of Medicine Sichuan University Chengdu China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu China
| | - Yuxuan Qiu
- Department of Thyroid & Parathyroid Surgery West China Hospital Sichuan University Chengdu China
| | | | - Shang Xiang
- West China School of Medicine Sichuan University Chengdu China
| | - Rui Meng
- West China School of Medicine Sichuan University Chengdu China
| | - Kai fan Niu
- West China School of Medicine Sichuan University Chengdu China
| | - Huili Zhu
- Department of Gynecology and Obstetrics West China Second University Hospital Sichuan University Chengdu China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu China
| |
Collapse
|
3
|
D'Angelo C, Franch O, Fernández-Paredes L, Oreja-Guevara C, Núñez-Beltrán M, Comins-Boo A, Reale M, Sánchez-Ramón S. Antiphospholipid Antibodies Overlapping in Isolated Neurological Syndrome and Multiple Sclerosis: Neurobiological Insights and Diagnostic Challenges. Front Cell Neurosci 2019; 13:107. [PMID: 30941020 PMCID: PMC6433987 DOI: 10.3389/fncel.2019.00107] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 03/04/2019] [Indexed: 01/19/2023] Open
Abstract
Antiphospholipid syndrome (APS) is characterized by arterial and venous thrombosis, pregnancy morbidity and fetal loss caused by pathogenic autoantibodies directed against phospholipids (PL) and PL-cofactors. Isolated neurological APS may represent a significant diagnostic challenge, as epidemiological, clinical and neuroimaging features may overlap with those of multiple sclerosis (MS). In an open view, MS could be considered as an organ-specific anti-lipid (phospholipid and glycosphingolipid associated proteins) disease, in which autoreactive B cells and CD8+ T cells play a dominant role in its pathophysiology. In MS, diverse autoantibodies against the lipid-protein cofactors of the myelin sheath have been described, whose pathophysiologic role has not been fully elucidated. We carried out a review to select clinical studies addressing the prevalence of antiphospholipid (aPL) autoantibodies in the so-called MS-like syndrome. The reported prevalence ranged between 2% and 88%, particularly aCL and aβ2GPI, with predominant IgM isotype and suggesting worse MS prognosis. Secondarily, an updated summary of current knowledge on the pathophysiological mechanisms and events responsible for these conditions is presented. We draw attention to the clinical relevance of diagnosing isolated neurological APS. Prompt and accurate diagnosis and antiaggregant and anticoagulant treatment of APS could be vital to prevent or at least reduce APS-related morbidity and mortality.
Collapse
Affiliation(s)
- Chiara D'Angelo
- Department of Clinical Immunology and IdISSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Oriol Franch
- Department of Neurology, Hospital Ruber Internacional, Madrid, Spain
| | - Lidia Fernández-Paredes
- Department of Clinical Immunology and IdISSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain
| | | | - María Núñez-Beltrán
- Department of Clinical Immunology and IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Alejandra Comins-Boo
- Department of Clinical Immunology and IdISSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain
| | - Marcella Reale
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Silvia Sánchez-Ramón
- Department of Clinical Immunology and IdISSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain
| |
Collapse
|
4
|
Intensidade da anticoagulação no tratamento da trombose na síndrome antifosfolípide: meta‐análise. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 55:159-66. [DOI: 10.1016/j.rbr.2014.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 06/13/2014] [Accepted: 08/17/2014] [Indexed: 12/29/2022] Open
|
5
|
Tuter DS, Kopylov FY, Kozlovskaya NL, Demyanova KA, Shchekochikhin DY, Shilov EM, Syrkin AL. Cardiac involvement in thrombotic microangiopathies. TERAPEVT ARKH 2015; 87:17-25. [DOI: 10.17116/terarkh201587917-25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
6
|
Plavsic A, Miskovic R, Raskovic S, Bogic M, Bonaci Nikolic B. Systemic Lupus Erythematosus and Antiphospholipid Syndrome. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Antiphospholipid syndrome is an autoimmune disorder defined as association of vascular thrombosis and/or pregnancy complications with presence of antiphospholipid antibodies (lupus anticoagulant, anticardiolipin and anti-β2 glycoprotein I). It is the most common cause of acquired thrombophilia, and can occur as an independent entity or in relation with other diseases, especially systemic lupus erythematosus. Presence of antiphospholipid syndrome in systemic lupus erythematosus is additional vaso occlusive factor in already present inflammation, bringing further risk for thrombotic events. Clinical and serological manifestations of antiphospholipid syndrome and systemic lupus erythematosus are very similar, so possible connection for these two autoimmune disorders is assumed.
Collapse
|
7
|
Cardiovascular risk factors in the antiphospholipid syndrome. J Immunol Res 2014; 2014:621270. [PMID: 25133195 PMCID: PMC4122060 DOI: 10.1155/2014/621270] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/28/2014] [Accepted: 06/11/2014] [Indexed: 01/05/2023] Open
Abstract
A major cause of morbidity and mortality in the context of the antiphospholipid syndrome (APS) is the occurrence of thrombotic events. Besides the pathogenic roles of antiphospholipid antibodies (aPL), other risk factors and medical conditions, which are conditions for traditional risk of an individual without the APS, can coexist in this patient, raising their risk of developing thrombosis. Therefore, the clinical and laboratory investigation of comorbidities known to increase cardiovascular risk in patients with antiphospholipid antibody syndrome is crucial for the adoption of a more complete and effective treatment. Experimental models and clinical studies show evidence of association between APS and premature formation of atherosclerotic plaques. Atherosclerosis has major traditional risk factors: hypertension, diabetes mellitus, obesity, dyslipidemia, smoking, and sedentary lifestyle that may be implicated in vascular involvement in patients with APS. The influence of nontraditional risk factors as hyperhomocysteinemia, increased lipoprotein a, and anti-oxLDL in the development of thromboembolic events in APS patients has been studied in scientific literature. Metabolic syndrome with all its components also has been recently studied in antiphospholipid syndrome and is associated with arterial events.
Collapse
|
8
|
Rheumatic fever associated with antiphospholipid syndrome: systematic review. J Immunol Res 2014; 2014:614591. [PMID: 24860836 PMCID: PMC4016946 DOI: 10.1155/2014/614591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/24/2014] [Indexed: 02/05/2023] Open
Abstract
Objective. To evaluate the clinical associations between rheumatic fever and antiphospholipid syndrome and the impact of coexistence of these two diseases in an individual. Methods. Systematic review in electronics databases, regarding the period from 1983 to 2012. The keywords: “Rheumatic Fever,” “Antiphospholipid Syndrome,” and “Antiphospholipid Antibody Syndrome” are used. Results. were identified 11 cases described in the literature about the association of rheumatic fever and antiphospholipid syndrome. Clinical presentation of rheumatic fever was characterized by the predominance of carditis (11/11) and chorea (7/11). Regarding the manifestations of APS, the stroke was observed in 7/11 (63.6%), with one of them having probable embolic origin. Conclusion. The present study brings the information that the association between APS and RF is quite rare, however, is of great clinical importance. Doctors who deal with the RF should include in their differential diagnosis the APS, especially in the presence of stroke in patients with RF and whose echocardiogram does not show intracavitary thrombi.
Collapse
|
9
|
|
10
|
Dabar G, Harmouch C. [Alveolar haemorrhage associated with the primary antiphospholipid syndrome]. Rev Mal Respir 2013; 30:71-6. [PMID: 23318193 DOI: 10.1016/j.rmr.2012.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 09/21/2012] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Thrombotic events, particularly pulmonary embolism, are well known presentations of the antiphospholipid syndrome. Other pulmonary manifestations of the disease like alveolar haemorrhage are rare but can represent a catastrophic aspect of this disease. Alveolar haemorrhage in this context is important to recognize since it can be either a complication of anticoagulation therapy or a manifestation of the disease. The therapeutic implications are then very different. CASE PRESENTATION We present the case of a woman with massive pulmonary embolism treated with thrombolytic therapy. This was complicated by alveolar hemorrhage initially attributed to thrombolytics and recurrent bleeding considered to be a manifestation of the antiphospholipid syndrome. The complicated course necessitated a protracted stay in the intensive care unit, mechanical ventilation, and treatment with intravenous corticosteroids and plasmapheresis. CONCLUSION Alveolar haemorrhage associated with the antiphospholipid syndrome can be catastrophic and require prompt and aggressive therapy. Plasmapheresis, usually reserved for the catastrophic aspects of this condition, was felt to be useful in this case.
Collapse
Affiliation(s)
- G Dabar
- Service de pneumologie et de réanimation, hôpital Hôtel Dieu, BP 16-6830, Beyrouth, Liban.
| | | |
Collapse
|
11
|
Salle V, Mazière JC, Brulé A, Schmidt J, Smail A, Duhaut P, Mazière C, Makdassi R, Choukroun G, Betsou F, Ducroix JP. Antibodies against the N-terminal domain of annexin A2 in antiphospholipid syndrome. Eur J Intern Med 2012; 23:665-8. [PMID: 22939813 DOI: 10.1016/j.ejim.2012.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 01/03/2012] [Accepted: 04/10/2012] [Indexed: 11/29/2022]
Abstract
Annexin A2 (ANXA2, an endothelial cell receptor for plasminogen and tissue plasminogen activator) has been identified as a new autoantigen in antiphospholipid syndrome (APS). The aim of the present study was to evaluate the presence of antibodies against the N-terminal domain of annexin A2 (ANXA2) in primary APS (PAPS). By using a synthetic peptide corresponding to the 31N-terminal amino acids of ANXA2 (ANXA2(N31)) as an antigen, we performed an enzyme-linked immunosorbent assay (ELISA) to measure anti-ANXA2(N31) IgG and IgM antibodies in the serum of PAPS patients (n=19), systemic lupus erythematosus (SLE) patients (n=50) and healthy blood donors (n=106). We did not find any statistically differences between the three groups in terms of IgG and IgM anti-ANXA2(N31) titres. Elevated IgG anti-ANXA2(N31) titres were not observed in the serum of PAPS or SLE patients who had previously tested positive for anti-ANXA2 antibodies. Thus, the ANXA2 N-terminal domain does not appear to be the target antigen for anti-ANXA2 antibodies in APS.
Collapse
Affiliation(s)
- V Salle
- Department of Internal Medicine, Amiens University Hospital, Amiens, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Turini RBF, Chechia TE, Fernandes TA, Bom APKP, Bandeira M. Síndrome antifosfolípide e trombocitopenia na infância. REVISTA PAULISTA DE PEDIATRIA 2012. [DOI: 10.1590/s0103-05822012000300021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Relatar o caso de uma criança com diagnóstico de síndrome do anticorpo antifosfolípide associada à trombocitopenia grave e realizar uma revisão de literatura sobre o assunto. DESCRIÇÃO DO CASO: Criança de nove anos e oito meses de idade com trombocitopenia grave associada a anticorpo anticardiolipina positivo. Os dados foram coletados por meio de anamnese, exame físico e exames complementares da paciente. O diagnóstico foi determinado de acordo com os critérios estabelecidos para a síndrome antifosfolípide, associados às manifestações mais comuns na faixa etária pediátrica: livedo reticular e trombocitopenia. COMENTÁRIOS: A síndrome do anticorpo antifosfolípide é uma doença incomum na população pediátrica e suas manifestações clínicas, com a redução do número de plaquetas, devem ser consideradas.
Collapse
|
13
|
Armentia A, Mazón A, Pineda F, Palacios R, Crespo J, Inglada L, Martín-Santos JM, García-Frade J, Martín-Armentia B. Food anaphylaxis in antiphospholipid syndrome and thrombosis. Allergol Immunopathol (Madr) 2011; 39:212-21. [PMID: 21216082 DOI: 10.1016/j.aller.2010.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 06/29/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND We have observed that some cases of food anaphylaxis were followed by severe thrombosis associated to anticardiolipin antibodies. Food anaphylaxis associated with antiphospholipid syndrome has seldom been published. OBJECTIVE The aims were: 1) to test anticardiolipin antibodies in an important number of patients with anaphylaxis due to vegetal foods and their relationship with possible thrombosis; and 2) to study seed and fruit hypersensitivity in patients with previous thrombotic events associated with antiphospholipid antibodies (aCL). METHODS We included 30 patients diagnosed of thrombosis associated with aCL, 52 patients who suffered from anaphylaxis due to seeds or fruits, and 120 control patients. Haematological, cardiopulmonary vascular and rheumatologic studies had been performed as needed. In vivo and in vitro allergy tests with a large battery of vegetal allergens were carried out in all the patients. Measurement of IgG aCL antibodies and specific IgE to vegetal food was done by ELISA and CAP-FEIA (Phadia). Immunodetection and inhibitions with lipoproteins belonging to seeds were performed. RESULTS Seventy-five percent of the patients diagnosed as having antiphospholipid primary syndrome had specific IgE against different proteins from different vegetable allergens, most of them seeds, and clearly against lipoproteins that were also recognised by the patients with food anaphylaxis but not by the control cases. Among the patients with anaphylaxis, 28% had anticardiolipin antibodies and 17.3% thrombosis. CONCLUSION Our study suggests that seed lipoproteins which cause severe food anaphylaxis might have a potential role in the antiphospholipid syndrome and related thrombosis.
Collapse
Affiliation(s)
- A Armentia
- Allergy Section, UMDAI, Hospital Universitario Rio Hortega, Valladolid, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Cherian J, Duculan R, Amigues I, Crow MK, Kirou KA. A 26-year-old white man with a systemic lupus erythematosus flare and acute multiorgan ischemia: Vasculitis or thrombosis? Arthritis Care Res (Hoboken) 2011; 63:766-74. [DOI: 10.1002/acr.20439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
15
|
Antiphospholipid syndrome. J Hand Surg Am 2010; 35:1890-2; quiz 1892. [PMID: 20870361 DOI: 10.1016/j.jhsa.2010.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 07/05/2010] [Indexed: 02/02/2023]
|
16
|
Mayer M, Cerovec M, Rados M, Cikes N. Antiphospholipid syndrome and central nervous system. Clin Neurol Neurosurg 2010; 112:602-8. [PMID: 20417026 DOI: 10.1016/j.clineuro.2010.03.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 03/23/2010] [Indexed: 12/01/2022]
Abstract
Classification criteria, etiology, pathogenesis, major central nervous system (CNS) manifestations of the antiphospholipid syndrome (APS), as well as diagnostic and therapeutic approach are discussed in the article, supported by several MRI findings to illustrate differential complexity of selected topics. Close interplay of inflammation, autoimmunity, coagulation cascade, vasculature bed, neuron physiology and demyelinization in APS is elaborated. Cerebrovascular disease, multiple sclerosis-like syndrome, seizures, cognitive disfunction, headache and migraine, chorea and catastrophic antiphospholipid syndrome (CAPS) are discussed as the most prominent CNS manifestations of the APS.
Collapse
Affiliation(s)
- Miroslav Mayer
- University Hospital Center Zagreb, University of Zagreb, School of Medicine, Department of Medicine, Division of Clinical Immunology and Rheumatology, Kispaticeva ulica 12, Zagreb, Croatia.
| | | | | | | |
Collapse
|
17
|
Trifiletti A, Scamardi R, Bagnato GF, Gaudio A. Hemostatic changes in vasculitides. Thromb Res 2009; 124:252-5. [PMID: 19525001 DOI: 10.1016/j.thromres.2009.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2009] [Revised: 05/16/2009] [Accepted: 05/19/2009] [Indexed: 02/01/2023]
Abstract
The systemic vasculitides are an heterogeneous group of rare diseases characterized by inflammation and fibrinoid necrosis of blood vessel walls. Today it is well known that the inflammatory process characterizing vasculitides activates coagulation factors, inhibits anticoagulant factors, inhibits fibrinolytic processes, increases platelet activity and production and determines endothelial dysfunction. So far the mortality in vasculitides, even if falling, remains substantially high. Patients with vasculitic syndrome are at increased risk of developing atherosclerosis and in these patients prevalence of cardiovascular disease and cardiovascular events is higher than in the general population. Vasculitides can be associated with antiphospholipid syndrome. It is important to establish a strategy of antithrombotic therapy management in vasculitic patients, but this has not yet been clearly achieved.
Collapse
Affiliation(s)
- A Trifiletti
- Department of Internal Medicine, University of Messina, Italy
| | | | | | | |
Collapse
|