Figure 2.

β2GPI is recognized as the primary antigen driving aPL production in APS. It is produced in liver. Only its oxidized form is antigenic. Its oxidization is promoted by mTOR dependent mitochondrial dysfunction. mTOR inhibitors, can be used to reduce the oxidative stress in liver and trials have shown they reduce the aPL production in SLE. Immunosuppressant medications and plasmapheresis are used to reduce the pathogenic antibodies in CAPS. Anticoagulation, and lipid lowering therapy like statin also benefits in thrombosis and atherosclerosis respectively. Abbreviations: aCL – anti cardiolipin, β2GPI – β 2 glycoprotein- I, CAPS – catastrophic anti phospholipid syndrome, mTOR – mammalian target of rapamycin, NAC – N-acetylcysteine, LDL – low density lipoprotein, aPL – Anti phospholipid antibodies, SLE – systemic lupus erythematosus.