Le terme "d'anticorps antiphospholipides" d~signe des anticorps dirig~s contre des phospholipides anioniques ou neutres, mais aussi, contre diverses prot~ines plasmatiques. Parmi eux, les anticorps antiphosphatidyl~thanofamine (aPE) et les anticorps antiprothrombine (aPT) ont fait l'objet d'une attention particuli~re dans cette revue de la litt~rature. Les aPE ont ~t~ d~crits, avec une fr~quence variable, dans les maladies auto-immunes, lupus et/ou syndrome des antiphospholipides. Dans ces contextes cliniques, ils sont le plus souvent associ~s ~ la presence d'autres anticorps antiphospholipides anioniques. Mais l'int~r~t de ces anticorps r~side dans le fait qu'ils peuvent exister de fa~on isol~e chez des patients ayant des thromboses ou des pathologies vasculaires cutan~es. Les aPT sont retrouv~s chez 55 % ~ 74 % de patients ayant un anticorps anticoagulant lupique. La reconnaissance des ~pitopes antig~niques sur la prothrombine est conditionn~e par son interaction avec des phospholipides anioniques ou des surfaces charg~es n~gativement. D'apr~s la litt~rature, il appara~t que la plupart des aPE et des LA reconnaissent des prot~ines plasmatiques com-plex~es aux phospholipides, respectivement, les kinino-g~nes li~s ~ la phosphatidyl~thanolamine et la prothrombine li~e ~ la phosphatidyls~rine. Enfin, des anticorps capables de reconna~tre d'autres prot~ines engag~es dans l'h~mostase ont ~t~ d~crits, la prot~ine C activ~e, la pro-t~ine S et l'annexine V. D'autres ~tudes sont n~cessaires pour appr~cier la valeur predictive et diagnostique de chacun de ces anticorps.
MOTS-CLES
anticorps -phosphatidyl~thanolamine -prothrombine -kininog~nes -prot~ine C -prot~ine S -annexine V.
The term "antiphospholipid antibodies" includes antibodies directed against anionic or zwitterionic phospholipids, but also, against various plasmatic proteins. In this review of the literature, particular attention is focused on anti-phosphatidylethanolamine (aPE) and anti-prothrombin antibodies (aPT). aPE have been described, with varying frequency, in autoimmune diseases, lupus and~or antiphospholipid syndrome. In these clinical contexts, they are usually associated with the presence of other anionic phospholipid antibodies. However, the interest of these antibodies lies in the fact that they may occur in an isolated way in patients with thrombosis or cutaneous vascular pathologies. aPT are found in 55 % to 74 % of patients with a lupus anticoagulant (LA). The recognition of antigenic epitopes on prothrombin is conditioned by its interaction with anionic phospholipids or negatively charged surfaces. According to the literature, it would appear that most aPE and LA recognize plasmatic proteins complexed to phospholipids, respectively kininogens bound to phosphatidylethanolamine and prothrombin bound to phosphatidylserine. Finally, antibodies able to recognize other proteins involved in hemostasis, such as activated protein C, protein S and annexin V, have been described. Further studies are required to assess the predictive and diagnos= tic value of each of these antibodies.