I have seen quite a bit of discussion of personal experiences with and management of APS/Hughs; but I have not seen much on the science of it, which I believe is important for us to understand, at least at some basic level. Therefore, I am posting what folllows regarding the possible infectious origin of APS.
What is important to understand is that the immune system has a pro-inflammatory side and an anti-inflammatory side. Ideally, there is a balance. But very frequently we see so much modern disease benig traced back to inflammation, and all autoimmunity is linked to inflammation. In fact, an immnue response is, by definition, inflammatory in nature, where cytokines and other agents rise to meet a real or perceived threat.
The following article discusses the science of APS etiology:
The most pertinent part of the article, I belive, comes at the end where the author discuss the nature of an APS thrombophilic incident. Essentially, the author points to a 2-step immune response, with some infectious agent FIRST being responsible, through molecular mimicry, for the development of the APS anti-bodies.
But, AND THIS IS IMPORTANT, the author traces actual thrombotic events (DVT, pulmonary embolism, etc.) to a SECOND factor, that TRIGGERS the clotting event. One such infectious factor is Lipopolysaccharide (LPS).
A description of LPS can be found here:
LPS is basically found as a protective substance in the membranes of gram negative bacteria (e.g. E.coli, salmonella, H.pilori, etc.). LPS is an endotoxin that can cause severe immune responses. Endotxins are discussed more here:
The final 2 sentences in the article are most pertinent to those of us suffering APS:
"The presence of endotoxins in the blood is called endotoxemia. It can lead to septic shock, if the immune response is severely pronounced.
Moreover, endotoxemia of intestinal origin is considered to be an important factor in the development of alcoholic hepatitis, which is likely to develop on the basis of the small bowel bacterial overgrowth syndrome and an increased intestinal permeability."
Now I know that most of us are not alcoholics. But in people with autoimmunity, there is often an issue with intestinal permeability (leaky gut), small bowel bacterial overgrowth and H.pilori. H.Pilori can be handled with antibioctics, and bowel dysbiosis and dysfunction can be addressed through diet.
Not all of this may apply directly to all of us, but I think it is worth researching more into using those lifestyle options within our control to help prevent any event that might lead to an APS flare.
Just as a disclaimer, I am not a scientist, nor am I doctor, but the article I have cited is something you may want to present to your doctor for proper interpretation.
Good luck to all.