APS Causes

Antibodies are proteins known as Immunoglobulins. They are made by your system to fight things that your body feels are foreign to it, like viruses and bacteria. There are nine classes of immunoglobulins; 4 types of IgG, 2 types of IgA, IgM, IgE (allergies), and IgD (cell activation). We are most concerned with IgG and IgM. One of the considerations of IgG is that it can enter tissue spaces. It coats microorganisms to speed their uptake by other cells in the immune system. It is considered by some to be the major predictor of thrombosis and pregnancy loss. IgM is usually associated with hemolytic anemia as well as thrombosis. It is considered to be very good at killing bacteria. IgA guards the entrances to our body through our tears, saliva, and respiratory tract or gastrointestinal tract secretions

For people with APS, the body recognizes the PHOSPHOLIPIDS that are in your blood cells as foreign. Therefore, it attacks the tissues that contain phospholipids: your body’s blood vessels. The phospholipids are a type of fat that contains phosphorous. They are found in your cell membranes. The antiphospholipid antibodies not only attack the body's own phospholipids but the proteins that bind to the phospholipids

Antibodies and Antigens - What are they and how do they work? The molecules of the blood have distinctive shapes designating one from the other. They also have projections (epitopes) on them that mark their identity. When your body encompasses a substance that is considered foreign (an antigen), the body produces an antibody that can match each of the antigens. Envision the electric plugs and receptacles in the more recent buildings. If you put the plug into the socket upside down, nothing happens, and, as a matter of fact, it doesn't fit. If you put it in correctly, you get the flow of current. Another example would be a picture puzzle. Each piece has projections that allow it to fit next to/into only one other piece. The antibodies recognize their associated antigens and take them out of commission. In APS, there is a breakdown in recognition and the phosphorous in your phospholipids is seen as the enemy

Information

The Lymphatic System of the body is found in your tonsils and adenoids, thymus, lymph nodes, Peyer’s patches of the upper abdomen, appendix and bone marrow. Each of these sites produce white blood cells, the key operatives of the immune system. The white cells can either engulf and digest the offending particles (phagocytes like macrophages and neutrophils) or can zap them with chemicals to destroy them (granulocytes like neutrophils, eosinopils, basophils, and mast cells). When your doctor orders a blood test listing a white blood cell count, a count of monocytes, neutrophils, eosinophils and basophils, he/she is evaluating your immune system. The monocytes and neutrophils might be considered “fighters.” The eosinophils and basophils are inflammatory cells

The production of Phagocytes is not only distributed throughout the body but they may be specialized according to the part of the body in which they exist. For example: The brain contains microglial cells. The lungs have alveolar macrophages. The liver contains Kupffer cells. The spleen contains macrophages; the kidney, mesanglial phagocytes, and the blood, monocytes. Your joins have Synovial A cells to battle inflammation. Your lymph nodes have both circulating macrophages and resident macrophages. The lymph nodes are bean shaped structures where the immune cells congregate. This is where the antigens are encountered

Your bone marrow produces the cells that eventually become immune cells from “stem cells.”

Stem Cells generate two types of cells - the myeloid cells contain those cited above as well as a few others, and the lymphoid cells such as the lymphocytes. LYMPHOCYTES are classed as B CELLS or T CELLS. When triggered, the B cell creates plasma cells that manufacture many antibodies specific to that B cell

Each of the Antibodies is a “Y” shaped cell. The bottom (stem) is always constant so that it can link with other participants in the immune system. The upper arms are shaped in a way that is specific to the particular antigen that it will encounter. Think of locks and keys. Your house key may unlock several doors in your house but if you take it next door, it won't open any. The neighbor's house requires a different shaped key to gain access

T cells perform two functions. When they are assisting the regulation of the immune system, they can be found activating B cells and other T cells or suppressing (turning off) the immune cells. When they are destroying infected cells on contact (cytotoxic), they rid the body of infected cells (viruses) or cells transformed by cancer. These are the cells that function in the rejection of tissue and organ grafts

Each of the lymphatic sites is connected through lymphatic vessels similar to blood vessels. Your immune cells, along with foreign matter, are conveyed through a clear fluid that bathes the body's tissues (lymphatics). T cells use Cytokines, a chemical secreted by the immune system cells to recruit other cells and substances to the area of “infection.” The cytokines (also called Interleukins) are like an air traffic controller. They determine who takes off, in what number, in what area, and can clear traffic. They have one function not common to an air traffic controller, they can destroy target cells

T cells are not the only tools of destruction when it comes to the immune system. Your body contains cells called natural killer cells. The T cells need to recognize the enemy because it needs to attach to it in a way that fits (eg. lock and key) to kill it. The natural killer cells simply attach themselves to the enemy and secrete its poisons

Ok. Now, you have different areas of your body producing antibodies. The antibodies are, in part, specific to a location in your body. The phagocytes, lymphocytes, and natural killer cells are either floating through your blood or found in your tissues. A foreign body is found and either “eaten” or killed. The antibodies are attached to the antigens (foreign bodies) and floating around in your blood. So, how do you get rid of them. Enter the Complement Proteins. These inactive proteins also float through your blood. When they find an antibody attached to an antigen, they form a chain, each with a specific function, from the antibody’s stem portion. Remember, there is a stem and two projections. The two projections on the upper part of the “Y” have already formed the lock and key function with the antigen to form t he antibody-antigen connection. In the final process of the complement proteins, they form a cylinder which punctures the antigen/cell membrane. This puncture allows fluids and molecules to flow into and out of the target cell, “dooming” it

How do the B cells and T cells recognize the enemy antigens? Differently, of course. B cells contain a sample of the antibody it is prepared to make. It recognizes the antigen in its natural state and uses its antigen-specific receptors to make the connection. A class II protein marker is attached identifying the antigen. The B cell “swallows” the class II protein and processes the antigen creating a new entity - B cell with antigen and identifying class II protein, its marker

T cells can only recognize antigens which are already attacked by macrophages and/or B cells and have the special cell marker attached. This assures that T cells only act at close range on specific targets. Furthermore, there are helper T cells and cytotoxic (killer) T cells. The helper T cells connect with the antigen carrying B cell described above. When the antigen/B cell is connected, the T cell releases the lymphokines or interleukins that turn the B cell into an antibody-secreting plasma cell. If a macrophage is involved, it follows a similar process but is it presents its class II marker protein to a T cell with a T4 receptor. These T cells are helper cells. The macrophage releases interleukins, creating a “mature” helper T cell

The cytotoxic T cell matures through a similar process. The antigen (say a virus protein) is engulfed by a macrophage and processed creating a macrophage cell+class I protein marker. An immature cytotoxic T cell recognizes the marker and attaches itself. A mature helper T cell comes along and also attaches itself to the macrophage. Interleukins are secreted and the cytotoxic T cell matures. The mature cytotoxic T cell can now recognize a cell infected with a virus via the class I protein marker, connect and kill the target cell

In the case of atherosclerosis, researchers in Tel Aviv have found that atherosclerotic plaques contain many cells containing T lymphocytes and macrophages. The macrophages are laden with fat (oxidized LDL?). These cells (foam cells) are found at the center of the plaque. In addition, the tissues in the area of the plaques tend to be inflamed.

What happens when the immune system fails?

We have disorder or a disease that we don't particularly want. For those of us here, it is APS

When we first started this journey, it was acknowledged that there were nine classes of immunoglobulins or antibody proteins: 4 types of IgG, 2 types of IgA, IgM, IgE, and IgD. The normal way that the system works will be illustrated using IgE

IgE is most frequently associated with allergies such as hayfever and hives. If you are prone to allergies, the first time that you encounter, say … tree pollen, your B cells will make lots of antibodies to it using the system mentioned before: Antigen+B cell; Antigen is processed and B cell is marked; a mature helper T cell attaches and interleukins are released; the marked B cell matures and produces plasma cells which in turn produce many IgE antibodies. The antibodies attach to the mast cells containing the tree pollen allergens. The pollen-primed mast cells put out powerful chemicals. These chemicals are what cause the symptoms that you have, like wheezing, sneezing, etc. The mast cells are found in your nose, eyes, tongue, skin, lungs, and gastrointestinal tract

Sometimes, as we have found out through personal experience, the body will manufacture antibodies and T cells that fight our own systems. Our body systems do not work in isolation. Our nervous system communicates frequently with the immune system. It is thought that on their part, the immune cells may actually function as “sensory” cells. They detect the arrival of foreign bodies and through the use of chemical signals, they alert the brain. Also, there are times when the antibody-antigen process does not take place in relatively small numbers. Sometimes the process is completed in great numbers called Immune Complexes. These complexes contain clusters of interlocking antigens and antibodies that are usually rapidly removed from the bloodstream. Sometimes, however, they continue to circulate or get trapped in the various tissues of the body or blood vessels

Unfortunately, with APS, the trigger to the clot formation has not yet been discovered

Most autoimmune disorders apparently follow a less complicated system of functioning. You have too little or too much of an antibody and its reaction to the body creates a disease or disorder. Clots formed through the atherosclerotic process are multi-stepped. There is injury to the vessel wall, macrophages appear in the wall itself and form foam cells, and smooth muscle cells move into the area. Sometimes, the blood vessel lining overlying the plaque splits open allowing platelets and clots to form. If they stay put, they are thromboses. If they are carried by the blood stream, they are embolisms, the stuff heart attacks and strokes are made of. The researchers in Tel Aviv suggest that heat shock proteins, an anti-clotting protein (B2GPI=B2-glycoprotein I), and oxidized LDL may be autoimmune factors leading to the formation of atherosclerotic plaque. For many of us, atherosclerosis is a factor. Dr. Hughes, in an article in IMAJ in 1999, states that the antiphospholipid antibodies require a plasma protein “co-factor” to bind cardiolipins. The co-factor was B2GPI. Prothrombin and Protein C are other suggested co-factors - plus the phospholipid, of course