Several, and not necessarily alternative, pathogenic mechanisms have been suggested to sustain the thrombophilic diathesis of the anti-phospholipid syndrome. Among them, interference of anti-phospholipid antibodies with cell acting in the coagulation cascade likely plays a major role. Anti-phospholipid antibodies have been shown to react with endothelial cells mainly by reacting with beta 2 glycoprotein I expressed on the cell membrane surface. Beta 2 glycoprotein I can adhere to endothelial cell surface through the Annexin II receptor and through negatively charged structures (heparin-like molecules) that are bound by the phospholipid-binding site of the molecule. The autoantibody binding involves a yet unknown receptor that activates a signalling pathway able to translocate NFkappaB from the cytoplasm to the nucleus and to activate genes for adhesion molecule, pro-inflammatory cytokine and Tissue Factor up-regulation. The ultimate effect is the induction of a pro-inflammatory and a pro-coagulant endothelial phenotype that has been reproduced both in vitro and in vivo experimental models. Additional effects of anti-phospholipid-mediated endothelial cell activation are the interference with the protein C/S system, with the Annexin V binding, the up-regulation of endothelin I synthesis and the induction of apoptosis. Altogether these effects cooperate in switching endothelium from an anti-coagulant to a pro-coagulant surface.
Endothelium as a target for antiphospholipid antibodies / P. Riboldi, M. Gerosa, E. Raschi, C. Testoni, P.L. Meroni. - In: IMMUNOBIOLOGY. - ISSN 0171-2985. - 207:1(2003 Feb), pp. 29-36.
|Titolo:||Endothelium as a target for antiphospholipid antibodies|
RIBOLDI, PIERSANDRO (Primo)
GEROSA, MARIA (Secondo)
MERONI, PIERLUIGI (Ultimo)
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
|Data di pubblicazione:||feb-2003|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1078/0171-2985-00211|
|Appare nelle tipologie:||01 - Articolo su periodico|