Immunologic characterization and functional properties of murine antibodies raised against deleted mutants of human beta 2-glycoprotein I

Anti-β2GP1 antibodies have variable effects on platelet aggregation

AIM

To investigate the effects of affinity-purified rabbit anti-β2GP1, and anti-β2GP1 purified from patients with systemic lupus erythematosus (SLE), on adenosine diphosphate (ADP)-induced aggregation.

METHODS

Whole blood was collected and processed to obtain platelet poor plasma (PPP) from normal controls (n = 15) and SLE patients (n = 15). Using PPP, anti-β2GP1 titres were determined using an ELISA and IgG fractions isolated using a HiTrap protein G column. Anti-β2GP1 was purified from two SLE patients using purified β2GP1 coupled to a HiTrap NHS-activated HP column.

RESULTS

The effect of rabbit and human derived anti-β2GP1 (0-100 μg/mL), on ADP (2.5, 5 μM) induced platelet aggregation were investigated using light transmission aggregometry. Rabbit anti-β2GP1 significantly inhibited all parameters of 5 μM ADP-induced platelet aggregation; %Max (p = 0.028), %AUC (p = 0.014) and slope (p < 0.001). In contrast, anti-β2GP1 purified from SLE patients significantly enhanced the %Max (p = 0.031) and %AUC (p = 0.007) in a concentration dependent manner, but inhibited the slope (p < 0.05) of 5 μM ADP-induced platelet aggregation.

CONCLUSION

Our data suggest anti-β2GP1 purified from different species have variable effects on in vitro platelet aggregation. The disparity between rabbit and human anti-β2GP1 may be due to the heterogeneous nature of anti-β2GP1, varying avidity or different antibody binding specificities between species.

Beta2-glycoprotein I and its clinical significance: from gene sequence to protein levels

In order to elucidate beta2-GPI at the DNA level and characterize its polymorphisms, mRNA expression, protein levels and clinical significance at each of these steps, a molecular review of beta2-GPI literature was performed. The human beta2-GPI complete nucleotide sequence has been reported and it consists of 8 exons separated by large introns. The beta2-GPI gene is polymorphic with four alleles. The distribution of point mutations can be significantly different between various racial populations. DNA variation studies of the beta2-GPI gene identified a total of 151 single-nucleotide polymorphisms, 26 of which are within regions with potential clinical significance. Southern blot analysis indicated the presence of one gene product only. An atypical TATA box and a hepatic nuclear factor-1 element are both essential for beta2-GPI promoter activity. Transcription factor binding sites for STAT, CREB, C/EBPbeta, NF-1, AP-1, NFAT, HNF-3beta and HNF-1 have been identified in the promoter region of the beta2-GPI gene by computer analysis. The beta2-GPI transcriptional signal of 1.5 kb was detected in Northern blot analysis and its 326-amino-acid sequence was found to be one of the most proline-rich eukaryotic proteins. Amino acid substitutions have been shown to be associated with loss of phospholipid binding, development and recognition of antiphospholipid antibodies.

Research around beta 2-glycoprotein I: a major target for antiphospholipid antibodies

Beta2-glycoprotein I (beta2GPI), a phospholipid-binding protein, is one of the major target antigens for antiphospholipid antibodies (aPL) found in patients with antiphospholipid syndrome (APS). Thrombophilic disorders in APS patients are strongly associated with aPL, and their pathogenic properties depend on the presence of beta2GPI. Procoagulant cell stimulation by aPL, via beta2GPI, is one of the most plausible mechanisms of thrombosis in APS, and p38 mitogen activated protein kinase (MAPK) pathway plays a crucial role in such activation. beta2GPI is proteolytically cleaved in domain V by activated factor X or plasmin, leading to the generation of the nicked form of beta2GPI. Recently, increasing attention is focused on the role of nicked-beta2GPI as a regulator of extrinsic fibrinolysis pathway.

Accelerated atheroma, antiphospholipid antibodies, and the antiphospholipid syndrome

Indirect data coming from animal studies and in vitro observations support the contention that the mere presence of antiphospholipid antibodies may be sufficient to increase atheroma development, regardless of other predisposing factors. It seems that humoral and cellular immune responses to beta 2-glycoprotein I can play an important role in mediating the increased propensity to atherosclerosis.

Autoimmunity in atherosclerosis: lessons from experimental models

The modern view of atherosclerosis is of a chronic inflammatory disorder. In accord with this paradigm, the process of uninhibited influx of fat to the vessel wall results from an 'adequate' response to various forms of injury (i.e. turbulence, infections, modified lipoproteins). This idea has been further extended by several groups, to assume that the atherosclerotic lesion can be the target of an autoimmune mediated attack. According to this hypothesis, the site of initiation of the plaque should bear/express the target autoantigen, whereas concomitantly a respective immune response is generated in the periphery. The examples illuminating this notion are beta2GPI as a target autoantigen, HSP60/65 an oxidized-LDL. Herein we present evidence to support the involvement of autoimmune mechanisms in atherogenesis based on the experience from experimental models and human studies.

Immunization as a model for systemic lupus erythematosus

BACKGROUND

Immunization of laboratory animals is a new model system for systemic lupus erythematosus (SLE) and the autoimmunity of SLE.

OBJECTIVE

Review the published reports describing immunization as a model of SLE and describe the state of this research as well as future objectives as related to human illness.

METHODS

Medline search for relevant articles as well as review of cited bibliographies.

RESULTS

Either rabbits or mice can be immunized with proteins or oligopeptides that are lupus autoantigens with a resulting immune response not just to the immunogen but instead to a host of other self components that are also SLE-associated autoantigens. Several studies have noted clinical illness in these animals that resembles human SLE. In addition, injection of pristane (a component of mineral oil) also results in SLE-like autoimmunity, even though lupus autoantigens are not present. Pristane injected animals may also develop an SLE-like illness. There are reports of human SLE having its onset after immunization, but there have been no prospective studies.

CONCLUSIONS

Studies are needed to determine whether human SLE tends to begin soon after immunization. Meanwhile, continued study of animal models developed after immunization is needed in order to determine the relevance of this model to human disease.

RELEVANCE

SLE and/or SLE-like autoimmunity can be triggered after immunization of animals. This may be a model for an environmental trigger of human SLE.

Increased endothelial cell expression of alpha3beta1 integrin in cardiac valvulopathy in the primary (Hughes) and secondary antiphospholipid syndrome

The objective of this work was to determine markers of endothelial cell activation in valves from patients with antiphospholipid syndrome (APS) and heart valve involvement, in order to establish a role for endothelial cells in the pathogenesis of the valvular disease. Sixteen valves from ten patients with APS, obtained from autopsies or removed during valve replacement, were studied. Two groups of valves were used as controls. One group included seven normal valves from patients who died from non-cardiac diseases. The other group of valves were obtained from patients with bacterial endocarditis during autopsies or valve replacement operations. Immunoperoxidase and immunofluorescence stainings with antibodies to human immunoglobulins, endothelial cells, alpha3beta1 integrin, collagen IV, laminin and fibronectin were employed. Three histopathological patterns were apparent: normal valves, valves with verrucous endocarditis and valves with fibrocalcific changes. In all the valves with verrucous endocarditis the following findings were observed: (1) increased expression of the alpha3beta1 integrin on the endothelial cells, (2) increased amount of collagen IV, laminin and fibronectin, (3) proliferation of blood vessels and (4) linear subendothelial deposition of immunoglobulins and complement. The valves with fibrocalcific changes were deformed and showed a thick layer of collagen IV, laminin and fibronectin, yet in two valves the indothelial cells showed an expression of the alpha3beta1 integrin. The control valves did not express the integrin and had only a thin subendothelial band of collagen IV. In valves from patients with APS, 1 markers of endothelial cell activation are upregulated while the inflammatory exudate is scant. There is also a prominent deposition of immunoglobulins in the valves from patients with APS, suggesting a possible association between the deposition of the antibodies and the activation of the endothelial cells in APS.

The involvement of beta2-glycoprotein I (beta2-GPI) in human and murine atherosclerosis

Atherosclerosis is a multifactorial process, the hallmark of which is fat deposition in the vessel wall. Autoimmune factors have recently been shown to play an important role in the initiation and progression of atherosclerosis; candidate autoantigens are oxidized lipids and heat shock proteins. beta2-glycoprotein I (beta2-GPI) is a highly glycosylated plasma protein that serves as a major antigenic target for autoimmune type antiphospholipid antibodies. Its major relevant property is binding to negatively charged phospholipids/surfaces. In the set of studies presented in this paper, we provide evidence pointing towards beta2-GPI as an influential determinant in murine and human atherogenesis. Thus, immunization of transgenic atherosclerosis-prone mice (apolipoprotein E and low-density lipoprotein receptor knockouts) with human beta2-GPI results in a brisk and sustained respective response that extends to cross-react with the 'self' murine beta2-GPI. Atherosclerosis is accelerated in both strains concomitant with the infiltration of CD4 lymphocytes in the aortic sinus of the mice. When human plaques were studied, it was found that beta2-GPI resides in the subendothelial regions and co-localizes with CD4 lymphocytes. Thus, the immune response towards beta2-GPI may play an important role in atherogenesis, serving as a possible target for antigen specific therapies.

Target Recognition of β2-Glycoprotein I (β2GPI)-Dependent Anticardiolipin Antibodies: Evidence for Involvement of the Fourth Domain of β2GPI in Antibody Binding

β2-glycoprotein I (β2GPI) is an absolute requirement for the binding of autoimmune anticardiolipin Abs (aCL) to cardiolipin (CL). We evaluated the target recognition of human β2GPI by IgG derived from two patients with primary and two with secondary antiphospholipid syndrome. The total IgG serum fractions and β2GPI affinity-purified IgGs were assessed by using various domain-deleted mutants (DM) of human β2GPI (DMs: I-III, I-IV, II-V, III-V, IV-V, and V) and mouse mAbs against individual β2GPI domains. The four IgGs bound slightly to CL in the absence of β2GPI and showed increased binding in the β2GPI presence. Following affinity purification of the IgGs on a β2GPI column, reactivity toward CL was absent. DMs containing domain V inhibited the binding of biotinylated β2GPI to CL. The addition to CL-coated plates of DM V, but not the other DMs, reduced the binding of all four IgGs. The anti-β2GPI IgGs bound only to complete β2GPI and DM I-IV coated on the plates. The binding to plate-adsorbed β2GPI could be inhibited by complete β2GPI and DM I-IV, the latter being a more efficient inhibitor. Further, the human anti-β2GPI IgGs could compete with the binding to β2GPI of Cof-21 mouse mAb (directed at domain IV), but not with the two other mouse mAbs. The results suggest that some “autoimmune:” β2GPI-dependent anticardiolipin Abs recognize a β2GPI target that is distinct from the CL-binding site in domain V. The target site for some antiphospholipid syndrome IgGs appear to reside in domain IV of β2GPI.