Antiphospholipid Syndrome: Insights and Highlights from the 13th International Congress on Antiphospholipid Antibodies

313 Pages·2012·3.694 MB·English

by  Eon Nigel Harris MD, DM, Silvia S. Pierangeli PhD (auth.), Doruk Erkan, Silvia S. Pierangeli (eds.)

Antiphospholipid Syndrome

Doruk Erkan Silvia S. Pierangeli
●
Editors
Antiphospholipid Syndrome
Insights and Highlights
from the 13th International Congress
on Antiphospholipid Antibodies
Editors
Doruk Erkan, MD Silvia S. Pierangeli, PhD
Associate Physician-Scientist Professor
The Barbara Volcker Center for Women Departments of Internal Medicine,
and Rheumatic Diseases Pathology, and Microbiology
and and
Associate Attending Physician Director
Hospital for Special Surgery Antiphospholipid
and Standardization Laboratory
Associate Professor of Medicine University of Texas Medical Branch
Weill Medical College of Cornell University Galveston, TX, USA
New York, NY, USA
ISBN 978-1-4614-3193-0 ISBN 978-1-4614-3194-7 (eBook)
DOI 10.1007/978-1-4614-3194-7
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2012935102
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Preface
“APLA 2010”
The International Congress on Antiphospholipid Antibodies is held every 3 years to
discuss the recent advances and future directions in antiphospholipid syndrome
(APS). The 13th International Congress on Antiphospholipid Antibodies (APLA
2010) was hosted in Galveston, TX, USA on April 13–16, 2010. The goal of the
chairperson (Dr. Silvia Pierangeli) and the meeting organizers was to make this
event a truly international and multispecialty one, and to provide the attendees with
the latest evidence-based science on APS. More than 40 invited speakers from dif-
ferent specialties and more than 400 attendees from 28 countries came together for
a very comprehensive and thorough program; the congress was accredited and sup-
ported by the University of Texas Medical Branch (UTMB) as a CME event.
The three-and-half day event included state-of-the-art lectures, “meet the profes-
sor” sessions tailored to the interest of junior scientists and clinicians, selected abstract
oral presentations, poster sessions, a laboratory wet workshop to evaluate the perfor-
mance of various diagnostic antiphospholipid antibody (aPL) tests, and preconfer-
ence “consensus” workshops for the task forces to report and discuss their conclusions.
These task forces that were created by the meeting organization committee to review
the controversial aspects of APS in an evidence-based manner were:
• Task force on “criteria” aPL tests
• Task force on “non-criteria” aPL tests
• Task force on obstetric APS
• Task force on the management of thrombosis
• Task force on clinical research
• Task force on the brain involvement in APS
• Task force on catastrophic APS and non-criteria aPL manifestations.
Patients were also invited to actively participate in APLA 2010 for the fi rst time
in the history of aPL congresses; we are extremely appreciative for the monetary
contributions and their volunteer work. Furthermore, 3 patient–doctor forums were
v
vi Preface
included in the program that were extremely well attended and provided the venue
for productive as well as informative discussions between patients and clinicians.
Around the time of “APLA 2010,” Springer contacted us with the idea of editing
a new book on “Antiphospholipid Syndrome.” We immediately liked the proposal
but we thought the new project should be unique and different from previously
published APS books. Although signifi cant progress has been made in the fi eld of
APS over the last 25 years, we knew that different opinions, uncertainties, and
areas of great discussion still exist. For instance, questions still remain on how aPL
is acquired, what factors infl uence the production of “pathogenic aPL,” or what is
the role of infl ammation in aPL-mediated clinical problems. We thought that the
best way to address unknown and controversial aspects of APS would be to include
chapters that address simple questions with complex answers (e.g., what is the
origin of aPL) and then letting a team of scientists with different opinions answer
these questions. We also decided to invite “APLA 2010” task force members to
contribute to the project by presenting (and expanding as needed) their conclusions
and recommendations.
The idea seemed initially almost impossible. It was critical for us to produce this
book in a relatively short period so that the APLA 2010 “momentum” would not be
lost, knowing that this would be an additional challenge to the authors. In order to
bring the idea to fruition: (a) we determined “team leaders” for each chapter; (b) we
conveyed our goals to the “team leaders” throughout the world (many actively par-
ticipated at APLA 2010) and thankfully most of them accepted the challenge with
enthusiasm; (c) with the guidance of “team leaders,” we invited other contributors
to complete this challenging work in a professional and evidence-based manner;
and (d) we decided to organize each chapter in an uniform and systematic fashion
based on the following sections:
• Introduction
• What is known?
• What is controversial and/or unknown?
• Current research
• Future research directions
• Group conclusions
In addition to the scientifi c discussions included in the book, we believe that
three chapters deserve special attention: a historical perspective of the past 25 years
of APS and the preceding 12 International Congresses on Antiphospholipid
Antibodies; a future perspective on where the APS fi eld is going; and a very special
chapter is dedicated to patients that describes—in lay language—what patients need
to know in order to better understand APS.
Hence, after a little bit over a year, we are pleased to introduce the fi rst edition
of: “ Antiphospholipid Syndrome: Insights and Highlights from the 13th International
Congress on Antiphospholipid Antibodies.” Needless to say, we are extremely grate-
ful to all the contributors (many of them participated in more than one chapter) and
to the staff of Springer for their hard work and enthusiasm. Specifi cally, we are
grateful for the organizational skills of Michael D. Sova from Springer, who managed
Preface vii
to keep us on time and track on this project with his extraordinary organizational
skills. We are also thankful to our patients for their unlimited support, enthusiasm,
and encouragement to go on with our research and clinical work.
Finally, we do hope that this book will be useful to clinicians who are involved in
managing APS patients that can be challenging in many ways, to trainees in various
subspecialties of the medical sciences, and to researchers who are intrigued—as
much as we are—on a better understanding of this complex and evolving disease.
We also hope that our book will guide the researchers and “APLA 2010” task forces;
we aim to publish the updated second edition of this book following the next
International Congress on aPL, which will be held in Rio de Janeiro, Brazil in 2013.
New York, NY, USA Doruk Erkan
Galveston, TX, USA Silvia S. Pierangeli

Contents
Part I History of Antiphospholipid Syndrome
1 Overview of the Last 25 Years and 13 International
Congresses on Antiphospholipid Antibodies .......................................... 3
Eon Nigel Harris and Silvia S. Pierangeli
Part II Basic Science Aspects of Antiphospholipid Syndrome
2 What is the Origin of Antiphospholipid Antibodies? ............................. 23
Rohan Willis, Yehuda Shoenfeld, Silvia S. Pierangeli,
and Miri Blank
3 What is the Genetics of Antiphospholipid
Antibodies/Syndrome? ............................................................................. 41
Thomas L. Ortel, Pier Luigi Meroni, Marta E. Alarcón-Riquelme,
Maria O. Borghi, and Joan T. Merrill
4 What is the Mechanism(s) of Antiphospholipid
Antibody-Mediated Thrombosis? ............................................................ 57
Rohan Willis, Ian P. Giles, Pojen P. Chen, Chary López-Pedrera,
María José Cuadrado, and Silvia S. Pierangeli
5 What is the Mechanism(s) of Antiphospholipid
Antibody-Mediated Pregnancy Morbidity? ........................................... 79
Vikki M. Abrahams, Maria O. Borghi, Pier Luigi Meroni,
Jacob H. Rand, Elena Raschi, Jane E. Salmon,
Francesco Tedesco, and Angela Tincani
ix
x Contents
6 What are the Target Cells and Receptors that are Recognized
by Antiphospholipid Antibodies?........................................................... 103
Philip G. de Groot, Elena Raschi, Keith R. McCrae,
Silvia S. Pierangeli, Panayiotis G. Vlachoyiannopoulos,
and Rolf T. Urbanus
Part III 13th International Congress on Antiphospholipid
Antibodies Task Force Reports
7 Task Force Report on “Criteria” Antiphospholipid
Antibody Tests ......................................................................................... 117
Robert A.S. Roubey and Silvia S. Pierangeli
8 Task Force Report on “Non-criteria” Antiphospholipid
Antibody Tests ......................................................................................... 133
Maria Laura Bertolaccini, Olga Amengual, Tatsuya Atsumi,
Walter L. Binder, William H. Kutteh, Bas de Laat,
Ricardo Forastiero, Marc Lambert, Hidehiko Matsubayashi,
Vijaya L. Murthy, Michelle Petri, Jacob H. Rand,
Marielle Sanmarco, Anne E. Tebo, and Silvia S. Pierangeli
9 Task Force Report on Obstetric Antiphospholipid Syndrome ............ 147
D. Ware Branch, Benjamin Leader, and Carl A. Laskin
10 Task Force Report on Brain Involvement in Antiphospholipid
Syndrome ................................................................................................. 159
Joab Chapman, Eyal Muscal, and Robin L. Brey
11 Task Force Report on the Management of Thrombosis
in Antiphospholipid Syndrome .............................................................. 167
Guillermo Ruiz-Irastorza, Vittorio Pengo, Maria G. Tektonidou,
Ioana Ruiz-Arruza, María José Cuadrado, and Munther A. Khamashta
12 Task Force Report on Catastrophic Antiphospholipid
Syndrome ................................................................................................. 181
Gerard Espinosa, Horacio Berman, Doruk Erkan,
and Ricard Cervera
13 Task Force Report on Non-criteria Manifestations:
Thrombocytopenia .................................................................................. 195
Gabriela Hernández-Molina, Xavier López-Karpovitch,
Emilio B. González, and Antonio R. Cabral
14 Task Force Report on Non-criteria Manifestations:
Nephropathy ............................................................................................ 207
Maria G. Tektonidou, Horacio E. Adrogué, and Smita Vaidya