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. Author manuscript; available in PMC: 2024 Sep 11.
Published in final edited form as: Science. 2021 Mar 12;371(6534):1100–1101. doi: 10.1126/science.abg6449

Figure . aPLs bind to EPCR/LBPA and promote thrombosis and tissue damage.

Figure .

Under conditions of homeostasis, EPCR bound to phospholipids like phosphatidylcholine, activates protein C (PC) with downstream anti-thrombotic and anti-inflammatory effects. In contrast, lipid-reactive aPLs interact with EPCR bound to LBPA. This interaction promotes prothrombotic and proinflammatory responses, potentiation and activation of the endosomal TLR/type-I IFN pathway, further synthesis of autoantibodies and tissue inflammation, with effects on thrombosis and fetal loss.

aPL, phospholipid antibody; EPCR, endothelial protein C receptor; IFN, interferon; IRF7, interferon regulatory factor 7; LBPA, lysobiphosphatidic acid; MyD88, myeloid differentiation primary response protein; NFkB, nuclear factor-kb; TLR, Toll-like receptor.