Title: ANTIPHOSPHOLIPID ANTIBODIES: CLINICAL AND DIAGNOSTIC PROBLEM AS AN INTRIGUING NOTIONS ON IMMUNOLOGY

Biography:

Ljudmila Stojanovich received her Ph.D. in Medicine, with the thesis “Neuropsychiatric manifestations in patients with Systemic Lupus Erythematosus” in 1999. She is the scientific director in the Bezhanijska Kosa, University Medical Center of Belgrade University, where she is currently a Full Research Professor. Dr. Stojanovich’s research focuses on Systemic Lupus Erythematosus, Antiphospholipid Syndrome, and Vaccination in patients with Autoimmune Rheumatic diseases. She is an author of three monographs and of about 250 articles.  She is in Editorial Boards (LUPUS/LONDON), the reviewer in the “CURRENT CONTENSTS” or “Science citation index”, like Cellular and Molecular Neurobiology, and others. She is a member of number International Projects. She was in Invited Speaker for many lectures in Congresses and Symposia; Prof. Stojanovich is EULAR Honorary Member; the Chairman in the International Congress “Antiphospholipid syndrome (Hughes syndrome)”, 2013, co- chairman and the lector “LUPUS ACADEMY EASTERN EUROPEAN ROADSHOW of EULAR”, 2016.

Abstract

Antiphospholipid syndrome (APS) is defined by clinical manifestations that include thrombosis and/or fetal loss or pregnancy morbidity in patients with antiphospholipid antibodies (aPL). DIAGNOSTIC PROBLEM. Antiphospholipid antibodies are among the most common causes of acquired thrombophilia, but unlike most of the genetic thrombophilias are associated with both venous and arterial thrombosis. Antiphospholipid antibodies are directed primarily toward phospholipid binding proteins rather than phospholipid per se, with the most common antigenic target being β2-glycoprotein 1 (β2GPI) although antibodies against other targets such as prothrombin are well described. Laboratory diagnosis of aPL depends upon the detection of a lupus anticoagulant (LA), which prolongs phospholipid-dependent anticoagulation tests, and/or anticardiolipin and anti-β2-glycoprotein 1 antibodies. Indefinite anticoagulation remains the mainstay of therapy for thrombotic APS, although new strategies that may improve outcomes are emerging. CLINICAL PROBLEM.  While the clinical presentation of APS can be quite diverse because the disease can affect virtually any organ system, patients typically present with symptoms relating to joint, skin or mucosal inflammation, or with a varying degree of haematological abnormality or constitutional features. However, the lack of a gold standard test to confirm diagnosis often results in delays or misdiagnosis. CONCLUSIONS.  Despite updates of the diagnostic criteria, the diagnosis of APS remains difficult. Some aspects of the Sydney criteria were debated after their introduction. Further research on clinically relevant antibodies and standardization of their detection are needed to improve clinical risk assessment in APS.  Funding: This work was supported by research grant number 175041 for 2011 – 2018, and by research grant number TR 32040 for 2011-2018, issued by the Ministry of Science of the Republic of Serbia.