Abstract
Antiphospholipid syndrome (APS) is a potentially devastating clinical condition that is usually associated with recurrent arterial or venous thrombotic events and/or pregnancy morbidity. This condition can also affect the kidneys. APS nephropathy (APSN) is an increasingly recognized and studied renal small vessel vasculopathy that is characterized by non-inflammatory occlusion of renal blood vessels. Renin angiotensin aldosterone blockers and anticoagulants are frequently used to treat APS nephropathy. In 2014, the study by Canaud et al, demonstrated the interaction of antiphospholipid antibodies with endothelial cells through mammalian target of rapamycin (mTOR) pathway and the relationship between activation of mTOR complex and proliferation of endothelial cells, suggesting a possible mechanism for the efficacy of mTOR inhibitors in APSN. This study provided a new possible pathogenetic mechanism and a new possible therapeutic avenue for APSN. This review aims to to cover the increasing number of animal studies, in vitro studies and clinical studies on the role of mTOR pathyway in APS and the available clinical data on the efficacy of mTOR inhibitors in APSN.