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Systemic Antiphospholipid Syndrome and Atherosclerosis

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Abstract

Atherosclerosis (AT) is a metabolic, systemic inflammatory/immune disease characterized by lipoproteins metabolism alteration that leads to immune/inflammatory system activation with the consequent proliferation of smooth-muscle cells, narrowing arteries and atheroma formation. Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombophilic state and circulating antiphospholipid antibodies (aPL) including anti β2-GPI. Experimental studies and human observations suggest that APS is associated with AT. In fact, innate and adaptive immune responses participate in the pathogenesis of both diseases. Anti-oxLDL, anti-aPL, anti β2GPI, anti-HSP antibodies, among others, has been found in patients with APS and AT. Endothelial dysfunctions, oxidative stress, increase of cell adhesion molecules, active platelets, are common findings in both diseases. Macrophages, dendritic cells, T-cell activation, CD40–CD40 ligand interaction, are considered as pathogenic mechanism of AT and APS. Premature AT may be the first symptom of APS. Thrombophilia, aPL antibodies, and APS may be present in patients with premature AT. An association between AT and venous thrombosis (a clinical hallmark of APS) has been proposed in unselected patients with deep venous thrombosis of the legs without symptomatic AT. Asymptomatic AT, defined in terms of carotid intima media thickness and lumen diameter decrease, was observed in patients with APS. Premenopausal female patients with PAPS have a higher prevalence of cerebrovascular disease in comparison with male patients. Accelerated AT and hormones could be the explanation of these findings. High levels of aCLs, significantly predict the risk of future ischemic stroke in women but not in men. AT is one of the main features of systemic APS and offer opportunities for new treatment strategies.

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Authors and Affiliations

  1. Research Division, Hospital de Especialidades Centro Médico La Raza, IMSS, Seris y Zaachila s/n, Colonia La Raza, Mexico City, 02990, Mexico

    Luis J. Jara

  2. Clinical Epidemiology Research Unit, Hospital de Especialidades Centro Médico La Raza, IMSS, Seris y Zaachila s/n, Colonia La Raza, Mexico City, 02990, Mexico

    Gabriela Medina

  3. Internal Medicine Department, Hospital de Especialidades Centro Médico La Raza, IMSS, Seris y Zaachila s/n, Colonia La Raza, Mexico City, 02990, Mexico

    Olga Vera-Lastra

  4. Universidad Nacional Autónoma de México, Mexico City, Mexico

    Luis J. Jara & Olga Vera-Lastra

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  1. Luis J. Jara
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  2. Gabriela Medina
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Correspondence to Luis J. Jara.

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Jara, L.J., Medina, G. & Vera-Lastra, O. Systemic Antiphospholipid Syndrome and Atherosclerosis. Clinic Rev Allerg Immunol 32, 172–177 (2007). https://doi.org/10.1007/s12016-007-0008-9

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