In vitro and in vivo analyses of a genetically-restricted antigen specific factor from mixed cell cultures of macrophage, T and B lymphocytes

An immunostimulatory factor was identified to be secreted by antigen-pulsed maorophages. This factor was able to induce the generation of antigen specific T helper lymphocytes in vitro as well as in vivo. Further in vitro experiments testing for the genetic restriction of this factor indicated that it is a genetically-restricted antigen specific factor (ASF). The Cunningham plaque assay was used to quantify the generation of T helper lymphocytes by measuring the number of plaque forming cells after sequential incubations of antigen-pulsed maorophages with T lymphocytes, and then spleen cells, and finally the TNP-coated sheep red blood cells.

Association of Haplotypes in Exon 4 of KLK2 Gene with Raised Serum Prostate-Specific Antigen

The standard diagnostic modalities for Prostate Cancer (PC) include serum Prostate-Specific Antigen (PSA) assay, Digital Rectal Examination (DRE), and histological examination of prostate biopsy. They are limited by low predictive potential and inability to predict which patients are at risk of developing metastatic disease. The aim of this study is to investigate the exon 4 of the KLK2 gene of subjects for changes in its nucleotide sequences (SNPs) and determine the correlation of these changes with serum PSA in an Igbo population of Nigeria. One hundred male subjects aged 40 years and above, who gave their consent, were used for the study. Their PSA determinations were done using ELISA technique while genetic studies were carried out using real-time PCR. tPSA, fPSA, and % fPSA of the subjects ranged between 0.8% - 18.30%, 0.10% - 1.60% and 0.0% - 0.7% respectively. Of the 100 subjects, 28 subjects had tPSA levels above 4.0 ng/ml with a mean of 7.10 (±3.30) ng/ml. Those with tPSA less than 4 ng/ml had a mean of 1.87 (±0.85) ng/m. 15 subjects showed SNPs with a mean tPSA of 6.87 (±4.82) ng/ml while the remaining 85 subjects without SNPs had a mean of 1.86 (±0.80) ng/ml. Results from direct DNA sequencing showed 11 SNPs. Ten subjects are curated in SNP database while one is uncurated. The Chi-square test showed significant association (p = 0.00) between tPSA levels and SNPs mutation (X2 = 17.35, p = 0.00). A Kruskal-Wallis test demonstrated that the positional arrangement of the SNP mutations had no effect on PSA-total or free-values (H (10) = 10.92, p = 0.28;H (10) = 10.07, p = 0.38 respectively). Two SNPs: rs6072 and rs74478031 were associated with elevated PSA levels (p < 0.05). Their presence, therefore, has the potential to serve, in conjunction with raised PSA, as biomarkers of prostate cancer in the study population.

原发性胆汁性胆管炎遗传易感性的研究现状

原发性胆汁性胆管炎(PBC)是一种以胆管上皮细胞变性坏死为主,好发于中老年女性,具有强烈的遗传倾向性的肝脏自身免疫性疾病。随着全基因组关联分析(GWAS)的不断发展,PBC的遗传易感性备受关注。本文阐述了与PBC密切相关的遗传易感基因的研究进展,以期为PBC治疗提供有效靶点。

16株新型H3N3亚型禽流感病毒的遗传变异分析

为了解新出现的H3N3亚型禽流感病毒(AIV)的遗传变异特征,对2022—2023年分离鉴定的H3亚型AIV进行了全基因组测序分析,并对代表株进行了抗原差异分析。结果共分离鉴定出15株家禽源和1株野鸟源H3N3亚型AIV。全基因遗传演化分析结果显示,16株分离株均属于欧亚分支,其HA基因均源自H3N8亚型AIV,与人源H3N8亚型AIV的核苷酸相似性为97.3%~99.2%;NA基因均源自H10N3亚型AIV,与人源H10N3亚型毒株的核苷酸相似性为98.1%~98.4%;内部基因片段均来自H9N2亚型AIV。分离株HA基因裂解位点均符合低致病性AIV的分子特征。分离毒株存在多个能增强病毒对哺乳动物适应性及致病性的突变位点,如PB2蛋白的A588V和E627V突变、PB1蛋白的I368V和S375N突变等。抗原差异性分析结果表明,分离株与华东地区早期流行株的HI抗体滴度相差1 log2~3 log2。因此,本研究分离的16株H3N3亚型AIV均为三源重组病毒,由H9N2亚型AIV提供全部内部基因,毒株存在多个哺乳动物适应性及致病性增强的突变,并已传播给野禽。本研究揭示了新型H3N3亚型AIV的遗传特征、变异和多宿主分布情况,为禽流感的防控提供理论支持。

人源化基因修饰猪红细胞与人血清免疫相容性的体外研究

目的 探讨野生型(WT)、四基因修饰(TKO/hCD55)和六基因修饰(TKO/hCD55/hCD46/hTBM)猪红细胞与人血清的免疫相容性和免疫差异。方法 收集20名不同血型志愿者的血液,将WT、TKO/hCD55和TKO/hCD55/hCD46/hTBM猪红细胞、ABO-相容(ABO-C)及ABO-不相容(ABO-I)人红细胞分别暴露于不同血型人血清中,检测血凝集、抗原抗体结合(IgG、IgM)水平和补体依赖细胞毒性,评估2种基因修饰猪红细胞与人血清的免疫相容性。结果 ABO-C组未出现明显凝集;WT组和ABO-I组凝集水平高于TKO/hCD55组和TKO/hCD55/hCD46/hTBM组(均为P<0.001)。WT组猪红细胞裂解水平高于ABO-C组、TKO/hCD55组和TKO/hCD55/hCD46/hTBM组;ABO-I组猪红细胞裂解水平高于TKO/hCD55组、TKO/hCD55/hCD46/hTBM组(均为P<0.01)。TKO/hCD55组猪红细胞IgM和IgG结合水平均低于WT组和ABO-I组;TKO/hCD55/hCD46/hTBM组猪红细胞IgG和IgM结合水平低于WT组,IgG低于ABO-I组(均为P<0.05)。结论基因修饰猪红细胞的免疫相容性优于野生型猪,并接近于ABO-C,人源化猪红细胞在血资源奇缺时可考虑作为血液来源。

人类白细胞抗原-DQA1、细胞色素P4503A5*3基因多态性与特发性膜性肾病遗传易感性关联性研究

目的:探讨分析人类白细胞抗原(HLA)-DQA1、细胞色素P450(CYP)3A5*3基因多态性与特发性膜性肾病(IMN)遗传易感性的关联性。方法:将IMN患者62例作为研究组,另将健康者62例作为对照组。采用聚合酶链反应(PCR)技术和基因测序技术检测入组患者的HLA-DQA1(rs2187668)、CYP3A5*3(rs776746)基因型,判断各基因型与IMN患者的关系。结果:研究组中HLA-DQA1 rs2187668基因型AA占比高于对照组(P<0.05),基因型GG、AG占比低于对照组(均P<0.05);研究组等位基因A占比高于对照组(P<0.05)。研究组与对照组CYP3A5*3 rs776746不同基因型占比及等位基因占比比较无统计学差异(均P>0.05)。HLA-DQA1 rs2187668AA基因型IMN患者24 h尿蛋白量和血肌酐水平显著高于AG和GG型,肾小球滤过率显著低于AG和GG型(均P<0.05)。结论:HLA-DQA1 rs2187668位点的基因多态性与IMN的发生有关,AA基因型和等位基因A可增加IMN易感性。

一株高病毒载量PCV2毒株的基因组特征及序列分析

【目的】了解广东省某猪群中猪圆环病毒2型(Porcine circovirus type 2,PCV2)流行毒株的遗传进化情况,丰富PCV2分子流行病学数据,为当地PCV2疫苗候选株的选用和研发提供参考。【方法】使用qPCR方法对疑似PCV2的样品进行检测,发现1株具有高病毒载量的PCV2毒株,命名为GD222858。通过PCR方法进行全基因组分子克隆及遗传进化分析。使用MegAlign软件将该毒株ORF1、ORF2基因编码的氨基酸序列与PCV2同亚型参考毒株进行比对,分析氨基酸序列的相似性;采用DNAStar预测该毒株的Cap蛋白二级结构及B细胞表位,并与4株疫苗株DBN-SX07-2(HM641752)、LG(HM038034)、SH(HM038027)、ZJ(AY686764)的Cap蛋白抗原指数进行比对分析。【结果】GD222858毒株基因组长度为1767 bp。遗传进化分析表明该毒株属于PCV2d亚型。与国内外82株参考毒株的核苷酸相似性为91.4%~99.6%,与越南毒株Han8(GenBank登录号:JQ181600)的亲缘关系最近。在ORF1编码的Rep蛋白处发现多个特异性突变位点F70Y、F77L、W202R、N256S;ORF2编码的Cap蛋白相对保守。Protean预测Cap蛋白的氨基酸第5~18、24~25、39~41、48~49、57~65、99、101、112~114、139~140、145~150、162~165、175~181、188~189、205~211、227~232位置处均可能存在潜在的B细胞表位。GD222858毒株的Cap蛋白抗原指数与4株疫苗株均有差异,在氨基酸45~57、124~132、223~233位置处抗原指数明显高于4株疫苗株,且与疫苗株HM038034差异最大。【结论】GD222858毒株感染猪群的原因可能是Rep蛋白多个位点发生特异性突变及疫苗株选用不当所致。

Immunogenetic characteristics of patients with autoimmune gastritis

AIM:To explore whether predisposition to autoimmune gastritis (AIG) is found in human leukocyte antigen (HLA), cytokine or killer cell immunoglobulin-like receptor (KIR) gene variations.METHODS: Twelve Finnish patients with autoimmunetype severe atrophy of the gastric corpus were included. The patients' serum was analyzed for pepsinogen-interleukin (IL)-1 gene cluster, IL-2, IL-4, IL-6, IL-10, IL-12, interferon γ, transforming growth factor β, and tumor necrosis factor α. Variation in KIR genes was also explored. The results were compared with prevalence of the polymorphisms in Finnish or European populations.RESULTS: All patients had pepsinogen-CONCLUSION: As explored with modern DNA-based methods, HLA-DRB1*04 and DQB1*03 alleles, but not HLA-B8-DRB1*03, may predispose to AIG.

Radioiodine therapy for castration-resistant prostate cancer following prostate-specific membrane antigen promoter-mediated transfer of the human sodium iodide symporter

Radioiodine therapy, the most effective form of systemic radiotherapy available, is currently useful only for thyroid cancer because of the thyroid-specific expression of the human sodium iodide symporter （hNIS）. Here, we explore the efficacy of a novel form of gene therapy using prostate-specific membrane antigen （PSMA） promoter-mediated hNIS gene transfer followed by radioiodine administration for the treatment of castration-resistant prostate cancer （CRPC）. The androgen-dependent C33 LNCaP cell line and the androgen-independent C81 LNCaP cell line were transfected by adenovirus. PSMA promoter-hNIS （Ad.PSMApro-hNIS） or adenovirus.cytomegalovirus-hNIS containing the cytomegalovirus promoter （Ad.CMM-hNIS） or a control virus. The iodide uptake was measured in vitro. The in vivo iodide uptake by C81 cell xenografts in nude mice injected with an adenovirus carrying the hNIS gene linked to PSMA and the corresponding tumor volume fluctuation were assessed. Iodide accumulation was shown in different LNCaP cell lines after Ad.PSMApro-hNIS and Ad.CMV-hNIS infection, but not in different LNCaP cell lines after adenovirus.cytomegalovirus （Ad.CMV） infection. At each time point, higher iodide uptake was shown in the C81 cells infected with Ad.PSMApro-hNIS than in the C33 cells （P 〈 0.05）. An in vivo animal model showed a significant difference in 1311 radioiodine uptake in the tumors infected with Ad.PSMApro-hNIS, Ad.CMV-hNIS and control virus （P 〈 0.05） and a maximum reduction of tumor volume in mice infected with Ad.PSMApro-hNIS. These results show prostate-specific expression of the hNIS gene delivered by the PSMA promoter and effective radioiodine therapy of CRPC by the PSMA promoter-driven hNIS transfection.

Novel genetic markers in inflammatory bowel disease

Genetic factors play a significant role in determining inflammatory bowel disease(IBD)susceptibility.Epidemiologic data support genetic contribution to the pathogenesis of IBD,which include familial aggregation,twin studies,racial and ethnic differences in disease prevalence.Linkage studies have identified several susceptibility genes contained in different genomic regions named IBD1 to IBD9.Nucleotide oligomerization domain(NOD2)and human leukocyte antigen(HLA)genes are the most extensively studied genetic regions(IBD1 and IBD3 respectively)in IBD.Mutations of the NOD2 gene are associated with Crohn's disease(CD)and several HLA genes are associated with ulcerative colitis(UC)and CD.Toll like receptors(TLRs)have an important role in the innate immune response against infections by mediating recognition of pathogen-associated microbial patterns.Studying single-nucleotide polymorphisms(SNPs)in molecules involved in bacterial recognition seems to be essential to define genetic backgrounds at risk of IBD.Recently,numerous new genes have been identified to be involved in the genetic susceptibility to IBD:NOD1/Caspase-activation recruitment domains 4(CARD4),Chemokine ligand 20(CCL20),IL-11,and IL-18 among others.The characterization of these novel genes potentially will lead to the identification of therapeutic agents and clinical assessment of phenotype and prognosis in patients with IBD.

Genetic epidemiology of primary sclerosing cholangitis

The aetiology of primary sclerosing cholangitis (PSC) is not known. A more than 80-fold increased risk of PSC among first-degree relatives emphasizes the importance of genetic factors. Genetic associations within the human leukocyte antigen (HLA) complex on chromosome 6p21 were detected in PSC 25 years ago. Subsequent studies have substantiated beyond doubt that one or more genetic variants located within this genetic region are important. The true identities of these variants,however,remain to be identified. Several candidate genes at other chromosomal loci have also been investigated. However,according to strict criteria for what may be denominated a susceptibility gene in complex diseases,no such gene exists for PSC today. This review summarises present knowledge on the genetic susceptibility to PSC,as well as genetic associations with disease progression and clinical subsets of particular interest (inflammatory bowel disease and cholangiocarcinoma).

Genetics of inflammatory bowel disease: The role of the HLA complex

The human leucocyte antigen （HLA） complex on chromosome 6p21.3 is the most extensively studied genetic region in Inflammatory bowel disease （IBD）. Consistent evidence of linkage to IBD3 （6p21.1-23）, an area which encompasses the HLA complex, has been demonstrated for both Crohn＇s disease and ulcerative colitis, and a number of replicated associations with disease susceptibility and phenotype have recently emerged. However, despite these efforts the HLA susceptibility gene （s） for IBD remain elusive, a consequence of strong linkage disequilibrium, extensive polymorphism and high gene density across this region. This article reviews current knowledge of the role of HLA complex genes in IBD susceptibility and phenotype, and discusses the factors currently limiting the translation of this knowledge to clinical practice.

Human leukocyte antigen class II DQB1*0301, DRB1*1101 alleles and spontaneous clearance of hepatitis C virus infection: A meta-analysis

AIM： To assess the associations of human leukocyte antigen （HI_A） class Ⅱ DQB1＊0301 and/or DRB1＊1101 allele with spontaneous hepatitis C virus （HCV） clearance by meta-analysis of individual dataset from all studies published till date. METHODS： To clarify the impact of HLA class Ⅱ polymorphisms on viral clearance, we performed a metaanalysis of the published data from 11 studies comparing the frequencies of DQB1＊0301 and DRB1＊1101 alleles in individuals with spontaneous resolution to those with persistent infection. As we identified the heterogeneity between studies, summary statistical data were calculated based on a random-effect model. RESULTS： Meta-analyses yielded summary estimatesodds ratio （OR） of 2.36 [95%CI （1.62, 3.43）, P〈0.00001] and 2.02 [95%CI （1.56, 2.62）, P〈0.00001] for the effects of DQB1＊0301 and DRB1＊1101 alleles on spontaneous clearance of HCV, respectively. CONCLUSION： These results support the hypothesis that specific HLA class Ⅱ alleles might influence the susceptibility or resistance to persistent HCV infection. Both DQB1＊0301 and DRB1＊1101 are protective alleles and present HCV epitopes more effectively to CD4^＋T lymphocytes than others, and subjects with these two alleles are at a lower risk of developing chronic HCV infection. Large, multi-ethnic confirmatory and welldesigned studies are needed to determine the host genetic determinants of HCV infection.

Prostate cancer risk-associated genetic markers and their potential clinical utility

Prostate cancer （PCa） is one of the most common cancers among men in Western developed countries and its incidence has increased considerably in many other parts of the world, including China. The etiology of PCa is largely unknown but is thought to be multifactorial, where inherited genetics plays an important role. In this article, we first briefly review results from studies of familial aggregation and genetic susceptibility to PCa. We then recap key findings of rare and high-penetrance PCa susceptibility genes from linkage studies in PCa families. We devote a significant portion of this article to summarizing discoveries of common and Iow-penetrance PCa risk-associated single-nucleotide polymorphisms （SNPs） from genetic association studies in PCa cases and controls, especially those from genome-wide association studies （GWASs）. A strong focus of this article is to review the literature on the potential clinical utility of these implicated genetic markers. Most of these published studies described PCa risk estimation using a genetic score derived from multiple risk-associated SNPs and its utility in determining the need for prostate biopsy. Finally, we comment on the newly proposed concept of genetic score; the notion is to treat it as a marker for genetic predisposition, similar to family history, rather than a diagnostic marker to discriminate PCa patients from non-cancer patients. Available evidence to date suggests that genetic score is an objective and better measurement of inherited risk of PCa than family history. Another unique feature of this article is the inclusion of genetic association studies of PCa in Chinese and Japanese populations.

Genetic testing vs microforceps biopsy in pancreatic cysts:Systematic review and meta-analysis

BACKGROUND Carcinoembryonic antigen(CEA)and cytology in pancreatic cystic fluid are suboptimal for evaluation of pancreatic cystic neoplasms.Genetic testing and microforceps biopsy are promising tools for pre-operative diagnostic improvement but comparative performance of both methods is unknown.AIM To compare the accuracy of genetic testing and microforceps biopsy in pancreatic cysts referred for surgery.METHODS We performed a literature search in Medline,Scopus,and Web of Science for studies evaluating genetic testing of cystic fluid and microforceps biopsy of pancreatic cysts,with endoscopic ultrasound with fine-needle aspiration(EUSFNA)prior to surgery and surgical pathology as reference standard for diagnosis.We evaluated the diagnostic accuracy for:1-benign cysts;2-mucinous low-risk cysts;3-high-risk cysts,and the diagnostic yield and rate of correctly identified cysts with microforceps biopsy and molecular analysis.We also assessed publication bias,heterogeneity,and study quality.RESULTS Eight studies,including 1206 patients,of which 203(17%)referred for surgery who met the inclusion criteria were analyzed in the systematic review,and seven studies were included in the meta-analysis.Genetic testing and microforceps biopsies were identical for diagnosis of benign cysts.Molecular analysis was superior for diagnosis of both low and high-risk mucinous cysts,with sensitivities of 0.89(95%CI:0.79-0.95)and 0.57(95%CI:0.42-0.71),specificities of 0.88(95%CI:0.75-0.95)and 0.88(95%CI:0.80-0.93)and AUC of 0.9555 and 0.92,respectively.The diagnostic yield was higher in microforceps biopsies than in genetic analysis(0.73 vs 0.54,respectively)but the rates of correctly identified cysts were identical(0.73 with 95%CI:0.62-0.82 vs 0.71 with 95%CI:0.49-0.86,respectively).CONCLUSION Genetic testing and microforceps biopsies are useful second tests,with identical results in benign pancreatic cysts.Genetic analysis performs better for low-and high-risk cysts but has lower diagnostic yield.

The interplay of host genetic factors and Epstein-Barr virus in the development of nasopharyngeal carcinoma

The interplay between host cell genetics and Epstein-Barr virus(EBV) infection contributes to the development of nasopharyngeal carcinoma(NPC). Understanding the host genetic and epigenetic alterations and the influence of EBV on cell signaling and host gene regulation will aid in understanding the molecular pathogenesis of NPC and provide useful biomarkers and targets for diagnosis and therapy. In this review, we provide an update of the oncogenes and tumor suppressor genes associated with NPC, as well as genes associated with NPC risk including those involved in carcinogen detoxification and DNA repair. We also describe the importance of host genetics that govern the human leukocyte antigen(HLA) complex and immune responses, and we describe the impact of EBV infection on host cell signaling changes and epigenetic regulation of gene expression. High-power genomic sequencing approaches are needed to elucidate the genetic basis for inherited susceptibility to NPC and to identify the genes and pathways driving its molecular pathogenesis.

Effect of cytotoxic T-lymphocyte antigen-4,TNF-alpha polymorphisms on osteosarcoma: evidences from a meta-analysis

Objective： Previous studies have investigated the role of cytotoxic T-lymphocyte antigen-4 （CTLA-4） and tumor necrosis factor-alpha （TNF-a） in carcinogenesis of osteosarcoma, but their results were inconsistent. We aimed to clarify the associations between CTLA-4, TNF-a polymorphism and osteosarcoma risk by using meta-analysis. Methods： We searched relevant studies without language restriction in PubMed, EMbase, Cochrane Library, Google Scholar databases, Chinese National Knowledge Infrastructure （CNKI） and conference literature in humans published prior to March 2013. The strengths of the associations between genetic variants and osteosarcoma risk were estimated by odds ratio （OR） with 95% confidence interval （95% CI）. Results： A total of seven studies with 1,198 osteosarcoma patients and 1,493 controls were selected. Four studies were eligible for CTLA-4 （1,003 osteosarcoma and 1,162 controls）, and three studies for TNF-a （195 osteosarcoma and 331 controls）. Pooled results showed that rs231775 polymorphism of CTLA-4 was associated with osteosarcoma risk （GG vs. AA： OR=1.63, 95% CI=1.24-2.13; GG ＋ GA vs. AA： OR=1.56, 95% CI=1.21-2.01; AA ＋ GA vs. GG： OR=0.83, 95% CI=0.71-0.97; G vs. A： OR=1.21, 95% CI=1.08-1.36）. No significant heterogeneity was observed across the studies. No significant associations were found between rs5742909 polymorphism of CTLA-4 or rs1800629 polymorphism of TNF-a and osteosarcoma risk. Conclusions： These results suggest that the rs231775 polymorphism of CTLA-4 may play an important role in carcinogenesis of osteosarcoma.

Subcloning and expression of two conserved regions （Ⅰ，Ⅴ） onP190 antigen of Plasmodium falciparum in E．coli

Two DNA fragments, designated as P190CRI (AA1-55) and P190CRV (AA1597-1667)respectively, which encode amino acid residues of conserved region Ⅰ and Ⅴ on the P190 antigen were amplified by polymerase chain reaction from genomic DNA in FCCl/HN strain of Plasmodium falciparum isolated from Hainan Province, China. It was found that there were five base substitutions in the P190CR V, in comparison with the nucleotide sequences of MAD20 strain. These two fragments sequenced were inserted into pGEX-2T plasmid. E. coli JM109 (DE3) were transformed with the recombinant plasmids and the parental plasmid. The results showed that the two fragments were expressed as high-level C-terminal fusions with glutathione S-transferase (GST). The fusion proteins were easily purified from bacterial lysates by affinity chromatography using glutathione Sepharose 4B.

Chimeric antigen receptors:On the road to realising their full potential

Chimeric antigen receptors （CARs） are fusion molecules that may be genetically delivered ex-vivo to T-cells and other immune cell populations, thereby conferring specifcity for native target antigens found on the surface of tumour and other target cell types. Antigen recognition by CARs is neither restricted by nor dependent upon human leukocyte antigen antigen expression, favouring widespread use of this technology across transplantation barriers. Signalling is delivered by a designer endodomain that provides a tailored and target-dependent activation signal to polyclonal circulating T-cells. Recent clinical data emphasise the enormous promise of this emer-ging immunotherapeutic strategy for B-cell malignancy, notably acute lymphoblastic leukaemia. In that context, CARs are generally targeted against the ubiquitous B-cell antigen, CD19. However, CAR T-cell immunotherapy is limited by potential for severe ontarget toxicity, notably due to cytokine release syndrome. Furthermore, effcacy in the context of solid tumours remains unproven, owing in part to lack of availability of safe tumourspecific targets, inadequate CAR T-cell homing and hostility of the tumour microenvironment to immune effector deployment. Manufacture and commercial development encountered with more traditional drug products. Finally, there is increasing interest in the application of this technology to the treatment of non-malignant disease states, such as autoimmunity, chronic infection and in the suppression of allograft rejection. Here, we consider the background and direction of travel of this emerging and highly promising treatment for malignant and other disease types.

Pathogenetic mechanisms of antiphospholipid antibody production in antiphospholipid syndrome

Antiphospholiipid syndrome(APS) is an autoimmune disease characterized by the pathological action of antiphospholipid antibodies(a PL),that leads to recurrent pregnancy loss and thrombosis.Despite limited evidence,it is clear that there are both inherited and acquired components of the ontogeny of these antibodies.Animal genetic studies and human familial and population studies highlight the influence of genetic factors in APS,particularly human leukocyte antigen associations.Similarly,both animal and human studies have reported the importance of acquired factors in APS development and infectious agents in particular have a great impact on a PL production.Bacterial and viral agents have been implicated in the induction of autoimmune responses by various mechanisms including molecular mimicry,cryptic autoantigens exposure and apoptosis.In this review we highlight the latest updates with regards to inherited and acquired factors leading to the manufacturing of pathogenic antibodies and APS.