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Lupus
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review-article

Resistance to annexin A5 anticoagulant activity: a thrombogenic mechanism for the antiphospholipid syndrome

JH Rand

Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA jrand{at}montefiore.org

XX Wu

Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA

AS Quinn

Department of Pathology and Microscopy Imaging Center, College of Medicine, University of Vermont, Burlington, Vermont, USA

DJ Taatjes

Department of Pathology and Microscopy Imaging Center, College of Medicine, University of Vermont, Burlington, Vermont, USA

The phospholipid binding protein, annexin A5 (AnxA5), has potent anticoagulant properties that result from its forming 2-dimensional crystals over phospholipids, blocking the availability of the phospholipids for critical coagulation enzyme reactions. This article reviews the evidence that antiphospholipid antibodies can disrupt this anticoagulant shield and unmask thrombogenic anionic phospholipids, which may thereby contribute to thrombosis in patients with the antiphospholipid syndrome (APS). This mechanism for thrombosis in APS can be monitored with coagulation assays for resistance to anticoagulant activity of AnxA5.

Key Words: anticardiolipin antibodies • antiphospholipid syndrome • Hughes syndrome • lupus anticoagulant • pregnancy • thrombosis

Lupus, Vol. 17, No. 10, 922-930 (2008)
DOI: 10.1177/0961203308095029
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