Clinical and Molecular Allergy最新文献

{"title":"Anticonvulsant hypersensitivity syndrome after phenytoin administration in an adolescent patient: a case report and review of literature.","authors":"Malik Ghannam,&nbsp;Shaden Mansour,&nbsp;Aya Nabulsi,&nbsp;Qusay Abdoh","doi":"10.1186/s12948-017-0069-0","DOIUrl":"https://doi.org/10.1186/s12948-017-0069-0","url":null,"abstract":"<p><strong>Background: </strong>Hypersensitivity is a rare adverse drug reaction (ADR) associated with anti-epileptic medications. Phenytoin is one of the commonly used drugs for treatment of epilepsy that encounters a hypersensitivity reaction. This reaction can be ranged from mild cutaneous rash to anticonvulsant hypersensitivity syndrome (AHS) or drug reaction with eosinophilia and systemic symptoms (DRESS) that includes fever, rash, eosinophilia and involvement of multiple internal organs.</p><p><strong>Case presentation: </strong>A 15 year old middle eastern female patient from Gaza strip with free past medical and allergic history. She presented to An-Najah National University Hospital (NNUH) in Nablus with intermittent high grade fever, jaundice, rash and skin peeling. On examination, she had axillary and inguinal lymphadenopathy, moderate splenomegaly and diffuse maculopapular rash. The patient was on phenytoin which started 1 month prior to her presentation as a seizure prophylaxis due to previous head injury. Eventually, the patient was diagnosed with AHS/DRESS.</p><p><strong>Conclusions: </strong>AHS is a diagnosis of exclusion and it is significantly underreported that requires a high index of suspicion. We liked to share this case and shed the light in more details on AHS/DRESS. Our goal was to help making AHS more reported in the literature in adolescent patients, as well as to make physicians more alert of this condition's seriousness when they prescribe antiepileptic medications in particular. In this report, we included the first case of AHS which was reported in an adolescent patient in Palestine. Moreover, we reviewed the available literature for a better understanding of the pathophysiology and management of AHS. We still believe that the full understanding of the pathogenesis of AHS is lacking, and also we are lacking a clinical tool or scoring system to determine the severity of AHS/DRESS.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2017-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0069-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35109050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between HMGB1 and asthma: a literature review.","authors":"Egidio Imbalzano,&nbsp;Sebastiano Quartuccio,&nbsp;Eleonora Di Salvo,&nbsp;Teresa Crea,&nbsp;Marco Casciaro,&nbsp;Sebastiano Gangemi","doi":"10.1186/s12948-017-0068-1","DOIUrl":"https://doi.org/10.1186/s12948-017-0068-1","url":null,"abstract":"<p><strong>Background: </strong>Recently, some studies demonstrated that HMGB1, as proinflammatory mediator belonging to the alarmin family, has a key role in different acute and chronic immune disorders. Asthma is a complex disease characterised by recurrent and reversible airflow obstruction associated to airway hyper-responsiveness and airway inflammation.</p><p><strong>Objective: </strong>This literature review aims to analyse advances on HMGB1 role, employment and potential diagnostic application in asthma.</p><p><strong>Methods: </strong>We reviewed experimental studies that investigated the pathogenetic role of HMGB in bronchial airway hyper-responsiveness, inflammation and the correlation between HMGB1 level and asthma.</p><p><strong>Results: </strong>A total of 19 studies assessing the association between HMGB1 and asthma were identified.</p><p><strong>Conclusions: </strong>What emerged from this literature review was the confirmation of HMGB-1 involvement in diseases characterised by chronic inflammation, especially in pulmonary pathologies. Findings reported suggest a potential role of the alarmin in being a stadiation method and a marker of therapeutic efficacy; finally, inhibiting HMGB1 in humans in order to contrast inflammation should be the aim for future further studies.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2017-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0068-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35102496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma management among allergists in Italy: results from a survey.","authors":"M S Magnoni,&nbsp;M Caminati,&nbsp;G W Canonica,&nbsp;F Arpinelli,&nbsp;A Rizzi,&nbsp;G Senna","doi":"10.1186/s12948-017-0067-2","DOIUrl":"https://doi.org/10.1186/s12948-017-0067-2","url":null,"abstract":"<p><strong>Background: </strong>In Europe more than 50% of asthmatic treated patients have not well-controlled asthma. Asthma affects about 2.5 million of patients in Italy.</p><p><strong>Aims and objectives: </strong>The present survey aims at investigating how Italian allergists approach asthmatic patients, in order to highlight pitfalls and unmet needs concerning real-life asthma management.</p><p><strong>Methods: </strong>An anonymous 16 item web questionnaire was available (April-October 2015) to all allergists who visited the web site of SIAAIC (Società Italiana di Allergologia, Asma Immunologia Clinica). Those who wished to give their contribution had the opportunity to answer about epidemiology, risk factors, treatment approaches, and adherence to therapy.</p><p><strong>Results: </strong>One hundred and seventy four allergists answered the survey. 54% of them reported up to 10 patient visits per week and 35.3% between 10 and 30. The most frequent reasons of follow up visits are routine check-up (56.5% of allergists), and worsening of symptoms (41% of allergists). Nocturnal apnoeas, gastro-esophageal reflux and obesity are the most important comorbidities/risk factors of poorly controlled asthma. Bronchial hyper-responsiveness, increased NO levels and reduced exercise tolerance are the most important indicators of asthma severity. Concerning therapy, ICS combined with LABA is the treatment of choice suitable for the majority of patients. A rapid onset of action and a flexible ICS dosage are indicated as the optimal characteristics for achieving the therapeutic goals. Poor adherence to therapy is an important reason for symptom worsening for the majority of allergists. Complex dosage regimens and economic aspects are considered the most important factors impacting on adherence.</p><p><strong>Conclusions: </strong>Allergists are involved in the management of asthma, regularly seeing their patients. Co-morbidities are frequent in asthmatic patients and may impact negatively on disease control, thus identifying patients who need a more careful and strict monitoring. Airway hyper-responsiveness to methacholine challenge test and nitric oxide are considered important indicators of asthma severity. The combination of LABA and inhaled steroids is considered the treatment of choice for most asthmatic patients, in keeping with broad evidence indicating that the combination therapy is more effective and rapid in gaining asthma control than inhaled corticosteroids alone. Adherence to medication regimens is considered of essence to achieve the therapeutic goals.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2017-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0067-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34994437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of specific allergen immunotherapy on biological markers and clinical parameters in asthmatic children: a controlled-real life study.","authors":"I Djuric-Filipovic,&nbsp;Marco Caminati,&nbsp;D Filipovic,&nbsp;C Salvottini,&nbsp;Z Zivkovic","doi":"10.1186/s12948-017-0064-5","DOIUrl":"https://doi.org/10.1186/s12948-017-0064-5","url":null,"abstract":"<p><strong>Background: </strong>Allergen-specific immunotherapy (AIT) is the only treatment able to change the natural course of allergic diseases. We aimed at investigating the clinical efficacy of SLITOR (Serbian registered vaccine for sublingual allergen specific immunotherapy).</p><p><strong>Methods: </strong>7-18 years old children with allergic asthma and rhinitis were enrolled and addressed to the active (AIT plus pharmacological treatment) or control (standard pharmacological treatment only) group. Clinical and medications scores, lung function and exhaled FeNO were measured at baseline and at every follow-up.</p><p><strong>Results: </strong>There was a significant improvement in both nasal and asthma symptom scores as well as in medication score in SLIT group. SLIT showed an important influence on lung function and airway inflammation.</p><p><strong>Conclusions: </strong>Our data showed that SLITOR was effective not only in terms of patient reported outcomes but an improvement of pulmonary function and decrease of lower airway inflammation were also observed.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0064-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34899066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypersensitivity pneumonitis: a complex lung disease.","authors":"Gian Galeazzo Riario Sforza,&nbsp;Androula Marinou","doi":"10.1186/s12948-017-0062-7","DOIUrl":"https://doi.org/10.1186/s12948-017-0062-7","url":null,"abstract":"<p><p>Hypersensitivity pneumonitis (HP), also called extrinsic allergic alveolitis, is a respiratory syndrome involving the lung parenchyma and specifically the alveoli, terminal bronchioli, and alveolar interstitium, due to a delayed allergic reaction. Such reaction is secondary to a repeated and prolonged inhalation of different types of organic dusts or other substances to which the patient is sensitized and hyper responsive, primarily consisting of organic dusts of animal or vegetable origin, more rarely from chemicals. The prevalence of HP is difficult to evaluate because of uncertainties in detection and misdiagnosis and lacking of widely accepted diagnostic criteria, and varies considerably depending on disease definition, diagnostic methods, exposure modalities, geographical conditions, agricultural and industrial practices, and host risk factors. HP can be caused by multiple agents that are present in work places and in the home, such as microbes, animal and plant proteins, organic and inorganic chemicals. The number of environment, settings and causative agents is increasing over time. From the clinical point of view HP can be divided in acute/subacute and chronic, depending on the intensity and frequency of exposure to causative antigens. The mainstay in managing HP is the avoidance of the causative antigen, though the complete removal is not always possible due to the difficulties to identify the agent or because its avoidance may lead to major changes in life style or occupational settings. HP is a complex syndrome that needs urgently for more stringent and selective diagnostic criteria and validation, including wider panels of IgG, and a closer collaboration with occupational physicians, as part of a multidisciplinary expertise.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2017-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0062-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34806055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergic diseases in the elderly: biological characteristics and main immunological and non-immunological mechanisms.","authors":"Maria Teresa Ventura,&nbsp;Nicola Scichilone,&nbsp;Roberto Paganelli,&nbsp;Paola Lucia Minciullo,&nbsp;Vincenzo Patella,&nbsp;Matteo Bonini,&nbsp;Giovanni Passalacqua,&nbsp;Carlo Lombardi,&nbsp;Livio Simioni,&nbsp;Erminia Ridolo,&nbsp;Stefano R Del Giacco,&nbsp;Sebastiano Gangemi,&nbsp;Giorgio Walter Canonica","doi":"10.1186/s12948-017-0059-2","DOIUrl":"https://doi.org/10.1186/s12948-017-0059-2","url":null,"abstract":"<p><p>Life expectancy and the number of elderly people are progressively increasing around the world. Together with other pathologies, allergic diseases also show an increasing incidence in geriatric age. This is partly due to the growing emphasis on a more accurate and careful diagnosis of the molecular mechanisms that do not allow to ignore the real pathogenesis of many symptoms until now unknown, and partly to the fact that the allergic people from 20 years ago represent the elderly population now. Moreover, environmental pollution predisposes to the onset of allergic asthma and dermatitis which are the result of internal pathologies more than the expression of allergic manifestations. At the same time the food contamination permits the onset of allergic diseases related to food allergy. In this review we provide the state of the art on the physiological changes in the elderly responsible for allergic diseases, their biological characteristics and the major immunological and extra immunological mechanisms. Much emphasis is given to the management of several diseases in the elderly, including anaphylactic reactions. Moreover, some new features are discussed, such as management of asthma with the support of physical activity and the use of the AIT as prevention of respiratory diseases and for the purpose of a real and long lasting benefit. The mechanisms of adverse reactions to drugs are also discussed, due to their frequency in this age, especially in polytherapy regimens. Study of the modifications of the immune system is also of great importance, as regards to the distribution of the lymphocytes and also the presence of a chronic inflammatory disease related to the production of cytokines, especially in prevision of all the possible therapies to be adopted to allow an active and healthy aging.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"15 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2017-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-017-0059-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71435100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug induced exfoliative dermatitis: state of the art.","authors":"Mona-Rita Yacoub,&nbsp;Alvise Berti,&nbsp;Corrado Campochiaro,&nbsp;Enrico Tombetti,&nbsp;Giuseppe Alvise Ramirez,&nbsp;Andrea Nico,&nbsp;Elisabetta Di Leo,&nbsp;Paola Fantini,&nbsp;Maria Grazia Sabbadini,&nbsp;Eustachio Nettis,&nbsp;Giselda Colombo","doi":"10.1186/s12948-016-0045-0","DOIUrl":"https://doi.org/10.1186/s12948-016-0045-0","url":null,"abstract":"<p><p>Drug induced exfoliative dermatitis (ED) are a group of rare and severe drug hypersensitivity reactions (DHR) involving skin and usually occurring from days to several weeks after drug exposure. Erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the main clinical presentations of drug induced ED. Overall, T cells are the central player of these immune-mediated drug reactions. Here we provide a systematic review on frequency, risk factors, pathogenesis, clinical features and management of patients with drug induced ED. </p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"14 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2016-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-016-0045-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34384020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot study: assessing the clinical diagnosis of allergy in atopic children using a microarray assay in addition to skin prick testing and serum specific IgE.","authors":"Ru-Xin Foong,&nbsp;Graham Roberts,&nbsp;Adam Tobias Fox,&nbsp;George du Toit","doi":"10.1186/s12948-016-0046-z","DOIUrl":"https://doi.org/10.1186/s12948-016-0046-z","url":null,"abstract":"<p><strong>Background: </strong>Children with atopic dermatitis (AD) are at risk of developing allergy. Alongside clinical history, testing modalities include skin prick tests (SPT), specific immunoglobulin-E (sp-IgE) and recently, microarray assays. The aim of this pilot study was to assess current tests and the ISAC sIgE-112 system in the diagnosis of food and aeroallergen allergy.</p><p><strong>Methods: </strong>Children aged 0-11 years with moderate to severe AD were included. An initial allergy assessment including clinical history, SPT and sp-IgE was performed to determine food and aeroallergen sensitization. A second independent clinical assessment using the same information given to the first assessor and ISAC test results for food and aeroallergen sensitization was also made for each participant. The results from both were compared.</p><p><strong>Results: </strong>30 children [mean age 3.91 years (SD 3.3)] were included; 53.3 and 46.7 % had moderate and severe AD, respectively. Sp-IgE tests had a higher percentage of positive results compared to SPT and ISAC tests for common allergens. There was a significant difference between the three tests in detecting aeroallergen sensitization (p = 0.038), especially between sp-IgE and ISAC tests, but no significant difference between the tests for food allergen sensitization. There was good agreement between the two assessors; 70 % of the children had a change in diagnosis, with 60 % having at least one diagnosis added and 40 % having at least one diagnosis removed.</p><p><strong>Conclusions: </strong>There is a role for the use of ISAC testing in diagnosing sensitization and allergy in children with AD as it leads to a change in diagnosis for many patients. Further work is required to assess its clinical and cost effectiveness.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"14 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2016-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-016-0046-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34324508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D3 improves the effects of low dose Der p 2 allergoid treatment in Der p 2 sensitized BALB/c mice.","authors":"Claudia Petrarca,&nbsp;Emanuela Clemente,&nbsp;Valentina Amato,&nbsp;Alessia Gatta,&nbsp;Sara Cortese,&nbsp;Alessia Lamolinara,&nbsp;Cosmo Rossi,&nbsp;Stefania Zanotta,&nbsp;Gianni Mistrello,&nbsp;Roberto Paganelli,&nbsp;Mario Di Gioacchino","doi":"10.1186/s12948-016-0044-1","DOIUrl":"https://doi.org/10.1186/s12948-016-0044-1","url":null,"abstract":"<p><strong>Background: </strong>Airborne allergens can induce an immunological chronic disease characterized by airway hyper responsiveness and inflammation, mediated by exaggerated Th2 immune response. Allergen-specific immunotherapy (AIT) is effective for treating this condition because it is able to modify its natural course by opposing the underlying pathogenic mechanisms and determining immune suppression, immune deviation and tolerance. The rational for the present study was to investigate the possibility of improving allergoid-based IT in terms of efficacy and safety. Recently, 1α,25-dihydroxyvitamin D3 (VD3), the active metabolite of vitamin D3, was described to be a potent inducer of T regulatory cells and to be a good adjuvant in AIT settings.</p><p><strong>Methods: </strong>We investigated whether the co-administration of VD3 could potentiate the effect of AIT even when added to a low dose of chemically-modified monomeric allergoid of Der p 2 (d2-OID), in a Derp p 2 (d2)-sensitized BALB/c mice model. Control groups where treated with sham, VD3 alone or d2-OID only.</p><p><strong>Results: </strong>The d2-OID alone was not fully successful, as expected for a low dose. VD3 administration was associated with some valuable, although limited, changes in the immunological parameters in the lung. On the contrary, the VD3 adjuvated allergoid vaccine induced the most prominent reduction of airway eosinophilia and Th2 cytokines and concomitant increase of T regulatory cells and IL-10 in the lung and Der p 2-specific IgG2a in the serum.</p><p><strong>Conclusions: </strong>The addition of VD3 to a conventional AIT protocol would allow the reduction of allergoid dose needed and therefore, the production costs. Moreover, beneficial immunomodulatory effects have been achieved by the oral administration which might favour the management of the therapy by the patients and their adherence, possibly enhancing the efficacy of the treatment.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"14 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2016-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-016-0044-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34349450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombotic risk assessment in antiphospholipid syndrome: the role of new antibody specificities and thrombin generation assay.","authors":"Savino Sciascia,&nbsp;Simone Baldovino,&nbsp;Karen Schreiber,&nbsp;Laura Solfietti,&nbsp;Massimo Radin,&nbsp;Maria J Cuadrado,&nbsp;Elisa Menegatti,&nbsp;Doruk Erkan,&nbsp;Dario Roccatello","doi":"10.1186/s12948-016-0043-2","DOIUrl":"https://doi.org/10.1186/s12948-016-0043-2","url":null,"abstract":"<p><p>Antiphospholipid syndrome (APS) is an autoimmune condition characterized by the presence of antiphospholipid antibodies (aPL) in subjects presenting with thrombosis and/or pregnancy loss. The currently used classification criteria were updated in the international consensus held in Sidney in 2005. Vascular events seem to result of local procoagulative alterations upon triggers influence (the so called \"second-hit theory\"), while placental thrombosis and complement activation seem to lead to pregnancy morbidity. The laboratory tests suggested by the current classification criteria include lupus anticoagulant, a functional coagulation assay, and anticardiolipin and anti-β2-glycoprotein-I antibodies, generally detected by solid phase enzyme-linked immunosorbent assay. The real challenge for treating physicians is understanding what is the actual weight of aPL in provoking clinical manifestations in each case. As thrombosis has a multi-factorial cause, each patient needs a risk-stratified approach. In this review we discuss the role of thrombotic risk assessment in primary and secondary prevention of venous and arterial thromboembolic disease in patients with APS, focusing on new antibody specificities, available risk scoring models and new coagulation assays. </p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"14 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2016-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-016-0043-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34581052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}