Table 1.

Pathways and mechanisms resulting in a prothrombotic state in APLS

Pathway	Mechanism
Activation of endothelial cells:	expression of adhesion molecules or tissue factor (2,13,14)
Activation of thrombocytes:	induction of thromboxane A2, increased adhension (15)
Activation of coagulation cascade:	A. tissue factor production (activation of extrinsic pathway: monocytes (14)
	B. via thrombin activation (direct mechanism) (2,10)
	C. via cell activation (indirect mechanism) (2)
Inhibition of anticoagulation:	A. inhibition of plasminogen/plasmin (2,16)
	B. inhibition of t-PA by displacement from annexin II (16)
	C. inhibition of protein C by thrombomodulin (2,11)
	D. inhibition of protein S (11)