Management of Women with Recurrent Pregnancy Losses and Antiphospholipid Antibody Syndrome

Kwak‐Kim, Joanne; Agcaoili, Maria Socorro L.; Aleta, Lara; Liao, Aihua; Ota, Kuniaki; Dambaeva, Svetlana; Beaman, Kenneth D.; Kim, Joon‐Woo; Gilman‐Sachs, Alice

doi:10.1111/aji.12114

Cited by 41 publications

(36 citation statements)

References 111 publications

(121 reference statements)

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“…Data indicate that aPLA may reduce decidual and vascular trophoblast invasion, induce extravillous and syncytiotrophoblast activation, disrupt syncytium formation and promote thromboembolism in decidual vessels leading to preeclampsia [22,23].…”

Section: Cell Activation By Aplamentioning

confidence: 99%

Receptors involved in cell activation by antiphospholipid antibodies

Brandt

Kruithof

Moerloose

2013

Thrombosis Research

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The antiphospholipid syndrome (APS) is an autoimmune disease associated with arterial or venous thrombosis and/or recurrent fetal loss and is caused by pathogenic antiphospholipid antibodies (aPLA). The plasma protein β2-glycoprotein 1 (β2GP1) has been identified as a major target of aPLA associated with APS. Cell activation by aPLA appears to be a major pathogenic cause in the pathogenesis of APS. Receptors, co-receptors and accessory molecules are known to assist the pathogenic effects of aPLA. Members of the TLR family and the platelet receptor apolipoprotein E receptor 2' (apoER2'), a receptor belonging to the low-density lipoprotein receptor (LDL-R) family, as well as GPIbα, were identified as putative candidates for aPLA recognition. CD14, a co-receptor for TLR2 and TLR4, and annexin A2, a ubiquitous Ca2+ -binding protein that is essential for actin-dependent vesicle transport, could serve as important accessory molecules in mediating the pathogenic effects of aPLA. Finally, complement activation has been reported in association with the pathogenicity of APS. The relative contribution of these different mechanisms in the pathogenesis of APS is controversial. Here, we review the various in vivo and in vitro models that have been used to investigate the pathogenic mechanisms of aPLA in APS

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Section: Cell Activation By Aplamentioning

confidence: 99%

Receptors involved in cell activation by antiphospholipid antibodies

Brandt

Kruithof

Moerloose

2013

Thrombosis Research

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“…Thrombophilic mutations have generally been associated with an increased risk of spontaneous abortions (8)(9)(10)(11)(12). However, whether each thrombophilic factor is related to recurrent miscarriages or not is still under debate (11, 12), so that in pregnancy anticoagulant prophylaxis is recommended only in women with a previous thrombosis or history of miscarriages (4,12). To our knowledge, among all pro-thrombothic factors APCresistance, which was observed in 6/ I0 ofour patients, was that mainly related to pregnancy morbidity (II).…”

mentioning

confidence: 99%

Recurrent Miscarriages in Women Not Fulfilling Classification Criteria for Antiphospholipid Antibody Syndrome

Proietta

Ferrero

Ferri

et al. 2014

Int J Immunopathol Pharmacol

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Obstetric antiphospholipid antibody syndrome (APS), is well defined by classification criteria. It is well known that women with APS should receive prophylactic anticoagulation therapy with subcutaneous low weight heparin all throughout pregnancy and in the first 6 weeks postpartum. However, the optimal treatment for pregnant women having positive anti-phospholipid antibodies, but not fulfilling classification criteria for APS is still unclear. In this retrospective study we report pregnancy outcomes of 10 patients affected by recurrent miscarriages and positive anti-cardiolipin or aβ2GP1 antibodies with titers ranging from 10 to 20 GPL/MPL demonstrated at least twice before pregnancy.

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“…Such changes occur in the blood fl ow, vascular wall and coagulation factors (increased levels of factors VII, VII, X and von Willebrand's factor, decreased activity levels of protein C and protein S, and increased activity level of fi brinolytic inhibitors) 4 . Whereas in recent years numerous studies have established the association between acquired thrombo-philias and adverse pregnancy outcome [5][6][7] , inherited thrombophilia and related complications in pregnancy still remain debatable 8,9 . Available evidence does not support an association between inherited thrombophilia and preeclampsia, fetal growth restriction, or abruption, and, in turn, it does not support prophylactic anticoagulation to prevent the possible adverse pregnancy outcomes in patients with hereditary thrombophilias 10 .…”

Section: Introductionmentioning

confidence: 99%

The Role of Low Molecular Weight Heparin in Women With Hereditary Thrombophilia for Good Perinatal Outcome

Sokol

Ivanišević

Herman

et al. 2016

ACC

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SUMMARY -Th e aim of the study was to establish the importance of low molecular weight heparin (LMWH) treatment for good pregnancy outcome in patients with hereditary thrombophilia. Th is retrospective study included 70 patients with inherited thrombophilia who gave birth at Zagreb University Hospital Center in the period from January 2014 to January 2015. Fifty-seven women were treated and 13 women were not treated with LMWH. Perinatal outcome was signifi cantly better in women with hereditary thrombophilia who were treated with heparin during pregnancy as compared with women without LMWH (p=0.006). Regardless of heparin therapy, patients with hereditary thrombophilia alone had a signifi cantly better perinatal outcome as compared with women who, along with hereditary thrombophilia, had a history of habitual abortions (p=0.035) or intrauterine fetal death (p=0.033). Women treated with heparin had better perinatal outcome if they were without a history of recurrent or non-recurrent fetal loss (p=0.088). In the group without LMWH, perinatal outcome was signifi cantly better in women with no history of habitual abortions as compared with women with recurrent miscarriages (p=0.047). Administration of LMWH is justifi ed in women with hereditary thrombophilia and a history of adverse perinatal outcome.

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Management of Women with Recurrent Pregnancy Losses and Antiphospholipid Antibody Syndrome

Cited by 41 publications

References 111 publications

Receptors involved in cell activation by antiphospholipid antibodies

Receptors involved in cell activation by antiphospholipid antibodies

Recurrent Miscarriages in Women Not Fulfilling Classification Criteria for Antiphospholipid Antibody Syndrome

The Role of Low Molecular Weight Heparin in Women With Hereditary Thrombophilia for Good Perinatal Outcome

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