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New Tests to Detect Antiphospholipid Antibodies: Anti-Domain I Beta-2-Glycoprotein-I Antibodies

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Abstract

Beta-2 glycoprotein I (β2GPI) is the main antigenic target for antiphospholipid antibodies (aPL), the serological markers of antiphospholipid syndrome (APS). Domain I (DI) of β2GPI has lately been identified as the main epitope targeted by antibodies reacting against β2GPI. DI is a cryptic epitope, becoming available for autoantibody binding when β2GPI opens from a circular to a fish-hook configuration. Antibodies targeting β2GPI-DI are more frequently detected in patients with a full-blown syndrome than in asymptomatic aPL carriers or in patients with infectious diseases that have reactivity toward the whole molecule. Interestingly, anti-DI antibodies are strongly positively correlated with thrombotic and pregnancy manifestations, enabling identification of patients at higher risk of clinical events. However, available tests to detect anti-DI antibodies still lack standardization. Moreover, some APS patients develop antibodies reacting against β2GPI epitopes other than DI, suggesting that other anti-β2GPI antibody subsets may be clinically relevant. Available evidence on anti-DI antibodies in APS is herein critically reviewed.

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Pier Luigi Meroni received an honorarium for attendance at an INOVA advisory board meeting. Cecilia Beatrice Chighizola and Maria Gerosa declare that they have no conflict of interest.

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Correspondence to Pier Luigi Meroni.

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This article is part of the Topical Collection on Antiphospholipid Syndrome

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Chighizola, C.B., Gerosa, M. & Meroni, P.L. New Tests to Detect Antiphospholipid Antibodies: Anti-Domain I Beta-2-Glycoprotein-I Antibodies. Curr Rheumatol Rep 16, 402 (2014). https://doi.org/10.1007/s11926-013-0402-7

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  • DOI: https://doi.org/10.1007/s11926-013-0402-7

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