Summary
Autoimmune antiphospholipid antibodies are a hallmark of patients with antiphospholipid syndrome, and require a protein cofactor, β2-glycoprotein I, to bind anionic phospholipids. In these same patients, moreover, IgG directly binding β2-glycoprotein I are described. We found high plasma titres of both IgM and IgG anti β2-glycoprotein I antibodies in a patient with catastrophic antiphospholipid syndrome. After passing plasma through a Sephacryl S-300 column, an identical distribution pattern between anti β2-glycoprotein I and anticardiolipin antibodies was observed. Moreover, when IgG immunocomplexes were isolated from a high molecular fraction, IgM anti-β2-glycoprotein I and anticardiolipin antibodies were detected. Thus IgG, IgM and IgG-IgM complexes of anti-β2-glycoprotein I antibodies are present at the same time in a patient with antiphospholipid syndrome.
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References
Harris, E.N., Gharavi, A.E., Hughes, G.R.V. Anti-phospholipid antibodies. Clin Rheum Dis 1985, 11, 591–609.
McNeil, H.P., Simpson, R.J., Chesterman, C.N., Krillis, S.A. Antiphospholipid antibodies are directed against a complex antigen that includes a lipid binding inhibitor of coagulation: β2-Glycoprotein-I (Apolipoprotein H). Proc Natl Acad Sci USA 1990, 87, 4120–4124.
Galli, M., Comfurius, P., Maassen, C., Hemker, H.C., De Baets, M.H., Van Brieda-Vriesman, P.J.C., Barbui, T., Zwaal. R.F.A., Bevers, E.M. Anticardiolipin antibodies (ACA) directed not to cardiolipin but to a plasma protein cofactor. Lancet 1990, 335, 1544–1547.
Matsuura, E., Igarashi, Y., Fujimoto, M., Ichikava, K., Koike, T. Anticardiolipin cofactor(s) and differential diagnosis of autoimmune disease. Lancet 1990, 336, 177–178.
Viard, J.P., Amoura, Z., Bach, J.F. Association of anti β2-glycoprotein I antibodies with lupus-type circulating anticoagulant and thrombosis in systemic lupus erythematosus. Am J Med 1992, 93, 181–186.
Ruffatti, A., De Silvestro, G., Ghirardello, A., Calligaro, A., Del Ross, T., Thiene, G., Todesco, S. A catastrophic antiphospholipid syndrome: the importance of high levels of warfarin anticoagulation. J Int Med 1994, 235, 81–83.
Gharavi, A.E., Harris, E.N., Asherson, R.A., Hughes, G.R.V. Anticardiolipin antibodies: isotype distribution and phospholipid specificity. Ann Rheum Dis 1987, 46, 1–6.
Biasiolo, A., Pengo, V. Antiphospholipid antibodies are not present in the membrane of gel-filtered platelets of patients with IgG anticardiolipin antibodies, lupus anticoagulant and thrombosis. Blood Coag Fibrinol 1993, 4, 425–428.
Thiagarajan, P., Pengo, V., Shapiro, S.S. The use of dilute Russell Viper Venom Time for the diagnosis of lupus anticoagulants. Blood 1986, 68, 869–873.
Polz, E., Wurm, H., Kostner, G.M. Investigation on β2-glycoprotein I in the rat: isolation from serum and demonstration in lipoprotein density fractions. Int J Biochem 1980, 11, 265–270.
Pengo, V., Ruffatti, A., Baritussio, A., De Marco, L., Todesco, S., Girolami, A. Serum of normal subjects contain IgG with antibody-like specificity for phospholipids. Folia Haematol 1984, 111, 681–685.
Pengo, V., Thiagarajan, P., Shapiro, S.S., Heine, M.J. Immunologic specificity and mechanism of action of IgG lupus anticoagulant. Blood 1987, 70, 69–76.
Roubey, R.A.S., Pratt, C.W., Buyon, J.P., Winfield, J.B. Lupus anticoagulant activity of autoimmune antiphospholipid antibodies is dependent upon β2-glycoprotein I. J Clin Invest 1992, 90, 1100–1104.
Ordi, J., Selva, A., Monegal, F., Porcel, J.M., Martinez-Costa, X., Vilardell, M. Anticardiolipin antibodies and dependence of a serum cofactor. A mechanism of thrombosis. J Rheumatol 1993, 20, 1321–1324.
Gharavi, A.E. Antiphospholipid cofactor. Stroke 1992, 23(suppl I), I-7–I-10.
Verrier Jones, J. Antiphospholipid antibodies: new perspective on antigenic specificity. J Rheumatol 1992, 19, 1774–1777.
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Pengo, V., Biasiolo, A., Grazia Fior, M. et al. Anti β2-glycoprotein I antibodies in a patient with catastrophic antiphospholipid syndrome. Clin Rheumatol 14, 646–649 (1995). https://doi.org/10.1007/BF02207930
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DOI: https://doi.org/10.1007/BF02207930