Letter to the Editor Anticardiolipin Antibodies and Severe Leptospirosis

In leptospirosis, as in other infections, the trigger of ACL production remains elusive. Are ACL induced by the release of endothelial cryptic autoantigens, or by cross reactivity, or by an hypothetical leptospire superantigen? Indeed, infections are reported as precipitating conditions of the catastrophic antiphospholipid syndrome, supposedly by a mechanism of molecular mimicry. However, studies of Lyme disease, another spirochete infection, have not provided convincing clues to molecular mimicry: anticardiolipin and anti spirochete antibodies were described as separate populations. In human leptospirosis, the induction of ACL by molecular mimicry remains unproved yet and deserves to be addressed by dedicated studies.