Role of antiphospholipid antibodies in kidney disease: Risk factors, immunopathogenesis, and diagnosis

Figure 3 Pathogenesis of antiphospholipid syndrome: The dual hit theory explained. Schematic representation of the two-hit theory in antiphospholipid syndrome-mediated renal injury. “First hit” involves the presence of antiphospholipid antibodies in the circulation. “Second hit” refers to any triggering event that leads to thrombus formation when circulating antiphospholipid antibodies bind to β2 glycoprotein I (B2GPI), triggering complement activation, recruitment of inflammatory cells, and thrombus formation.