1
|
Philip R, Aouba A, Martin Silva N, Mariotte D, Hamidi H, Rhouni S, Darnige L, Dragon-Durey MA. Autoantibodies against complement proteins in patients with antiphospholipid syndrome: Prevalence and clinical associations. Eur J Immunol 2024; 54:e2350832. [PMID: 38700064 DOI: 10.1002/eji.202350832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
Abstract
Seventy-seven patients with antiphospholipid syndrome were tested for autoantibodies against C1q, C3, FB, FH, and C4bp. Fifty-seven patients had at least one anti-complement antibody. IgM anti-FH positivity was associated with thrombosis when anti-C3 and anti-FB were, negatively or positively, associated with various noncriteria manifestations of antiphospholipid syndrome.
Collapse
Affiliation(s)
- Rémi Philip
- Department of Clinical Immunology and Internal Medicine, CHU of Caen Normandie, Caen, France
- INSERM UMRS 1138 Team "Inflammation, Complement and Cancer", Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, France
- UNICAEN, CHU de Caen Normandie, Normandie University, Caen, France
| | - Achille Aouba
- Department of Clinical Immunology and Internal Medicine, CHU of Caen Normandie, Caen, France
- UNICAEN, CHU de Caen Normandie, Normandie University, Caen, France
| | - Nicolas Martin Silva
- Department of Clinical Immunology and Internal Medicine, CHU of Caen Normandie, Caen, France
| | - Delphine Mariotte
- Laboratory of Immunology and Histocompatibility, Department of Biology, CHU of Caen Normandie, Caen, France
| | - Houcine Hamidi
- INSERM UMRS 1138 Team "Inflammation, Complement and Cancer", Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, France
- Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique Hopitaux de Paris (APHP), Paris, France
| | - Sanae Rhouni
- Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique Hopitaux de Paris (APHP), Paris, France
| | - Luc Darnige
- Hematology Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Université Paris Cité, Innovative Therapies in Haemostasis, INSERM UMR-S1140, Paris, France
| | - Marie-Agnès Dragon-Durey
- INSERM UMRS 1138 Team "Inflammation, Complement and Cancer", Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, France
- Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique Hopitaux de Paris (APHP), Paris, France
| |
Collapse
|
2
|
Grosso G, Sandholm K, Antovic A, Gunnarsson I, Zickert A, Vikerfors A, Truedsson L, Bruzelius M, Nilsson B, Nilsson-Ekdahl K, Svenungsson E. The Complex Relationship between C4b-Binding Protein, Warfarin, and Antiphospholipid Antibodies. Thromb Haemost 2021; 121:1299-1309. [PMID: 33412597 DOI: 10.1055/a-1347-5655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Low levels of total C4b-binding protein (C4BPt), a circulating inhibitor of the classical/lectin complement pathways, were observed in patients with antiphospholipid antibodies (aPLs) and during warfarin treatment. OBJECTIVES To investigate the associations between aPL and C4BPt in patients with persistently positive (++) aPL, with/without clinical manifestations and systemic lupus erythematosus (SLE), and in controls. Furthermore, we explored the impact of anticoagulation on C4BPt and in relation to complement activation. METHODS In a cross-sectional design we investigated defined subgroups: primary (p) antiphospholipid syndrome (APS, N = 67), aPL++ individuals without clinical manifestations (aPL carriers, N = 15), SLE-aPL++ (N = 118, among them, secondary [s] APS, N = 56), aPL negative (-) SLE (SLE-aPL-, N = 291), and 322 controls. Clinical characteristics, including treatment, were tabulated. C4BPt was determined with a magnetic bead method. Complement proteins (C1q, C2, C3, C4, C3a, C3dg, sC5b-9, factor I [FI]) were measured. A mediation analysis was performed to decompose the total effect of aPL++ on C4BPt into the direct and indirect effects of aPL++ through warfarin. RESULTS Overall, C4BPt is 20% decreased in aPL++ patients, regardless of SLE, APS, clinical manifestations, and aPL profile. C4BPt levels associate positively with complement proteins C1q, C2, C3, and C4, and negatively with complement activation product C3dg. In the SLE group, warfarin treatment contributes to approximately half of the C4BPt reduction (9%) CONCLUSION: Both aPLs and warfarin are associated with C4BPt reduction. Complement activation in aPL++ patients may partly be explained by impaired inhibition through depressed C4BPt levels. Further studies are needed to understand the clinical implications.
Collapse
Affiliation(s)
- Giorgia Grosso
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Kerstin Sandholm
- Linnaeus Center for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
| | - Aleksandra Antovic
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Iva Gunnarsson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Zickert
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | | | - Lennart Truedsson
- Department of Microbiology, Immunology and Glycobiology, Lund University Hospital, Lund, Sweden
| | - Maria Bruzelius
- Department of Haematology, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bo Nilsson
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Kristina Nilsson-Ekdahl
- Linnaeus Center for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden.,Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Elisabet Svenungsson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
3
|
Ferluga J, Kishore U, Sim RB. A potential anti-coagulant role of complement factor H. Mol Immunol 2014; 59:188-93. [DOI: 10.1016/j.molimm.2014.02.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 02/17/2014] [Indexed: 12/20/2022]
|
4
|
Pengo V, Banzato A, Bison E, Denas G, Padayattil Jose S, Ruffatti A. Antiphospholipid syndrome: critical analysis of the diagnostic path. Lupus 2010; 19:428-31. [PMID: 20353982 DOI: 10.1177/0961203309360543] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Antiphospholipid syndrome (APS) is diagnosed in the presence of vascular thrombosis or pregnancy morbidity occurring in patients with circulating antiphospholipid antibodies (lupus anticoagulant [LA] and/or IgG/IgM anticardiolipin [aCL] and/or IgG/IgM anti-beta2glycoprotein I [abeta2GPI] antibodies). Each test may identify different autoantibodies; a single test makes the diagnosis possible when positive on two or more occasions at least 12 weeks apart. However, single test positivity may be unrelated to pathogenic antibodies, which are now considered to be a subclass of abeta2GPI antibodies directed against the domain I of this protein. Conversely, all three positive tests identify a single class of abeta2GPI antibodies, thus identifying high-risk patients with APS.
Collapse
Affiliation(s)
- V Pengo
- Clinical Cardiology, Thrombosis Centre, University of Padova, School of Medicine, Padova, Italy.
| | | | | | | | | | | |
Collapse
|
5
|
Rossetto V, Spiezia L, Franz F, Salmaso L, Pozza LVD, Gavasso S, Simioni P. The role of antiphospholipid antibodies toward the protein C/protein S system in venous thromboembolic disease. Am J Hematol 2009; 84:594-6. [PMID: 19565645 DOI: 10.1002/ajh.21466] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The association between venous thromboembolism (VTE) and antibodies anti-Protein C (PC)/Protein S (PS) is still uncertain. We performed a case-control study to determine the risk of VTE related to the presence of these auto-antibodies considered independently of the presence of lupus anticoagulant (LAC) or anti-cardiolipin antibodies (ACA). One hundred thirty-five patients with idiopathic VTE and 164 healthy subjects were enrolled. Anti-PC and anti-PS antibodies (both IgG and IgM) were assessed using commercially available ELISA kits. Among cases there was a higher prevalence of elevated anti-PC IgM antibodies than in controls (OR 2.44, 95%CI 1.00-5.94). The presence of anti-PC IgG and anti-PS IgG and IgM antibodies was also higher in cases than in controls, but the difference was not statistically significant. Only five patients had both anti-PC or anti-PS antibodies and LAC or ACA. We performed a stepwise multivariate logistic regression analysis showing that anti-PC IgM>958 percentile was a significant predictor of VTE after adjustment for LAC or ACA (OR 2.52, 95%CI 1.01-6.24)). Larger prospective studies are needed to confirm this finding.
Collapse
|
6
|
Lieby P, Poindron V, Roussi S, Klein C, Knapp AM, Garaud JC, Cerutti M, Martin T, Pasquali JL. Pathogenic antiphospholipid antibody: an antigen-selected needle in a haystack. Blood 2004; 104:1711-5. [PMID: 15166038 DOI: 10.1182/blood-2004-02-0462] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Antiphospholipid antibodies represent a heterogeneous group of autoantibodies directed against anionic phospholipids (PLs) usually linked to protein cofactors. Their presence during the antiphospholipid syndrome is associated with risks of thrombosis and fetal losses. Among 5 randomly selected monoclonal antiphospholipid antibodies, all originating from a single patient suffering from this autoimmune disease, only 1 induced fetal losses when passively injected into pregnant mice. Its antiphospholipid activity was dependent on annexin A5, and its variable regions contained mainly 3 replacement mutations. To clarify the role of these mutations in the pathogenicity of the antibody, they were in vitro reverted to the germ line configuration. The resulting “germ line” antibody reacted with multiple self-antigens and only partially lost its reactivity against PLs, but it was no more dependent on annexin A5 and, more importantly, was no more pathogenic. This study illustrates that the in vivo antigen-driven maturation process of natural autoreactive B cells can be responsible for pathogenicity. (Blood. 2004;104:1711-1715)
Collapse
MESH Headings
- Adult
- Animals
- Annexins/metabolism
- Antibodies, Antiphospholipid/chemistry
- Antibodies, Antiphospholipid/genetics
- Antibodies, Antiphospholipid/immunology
- Antibodies, Antiphospholipid/toxicity
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/genetics
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/toxicity
- Antigens/immunology
- Antiphospholipid Syndrome/immunology
- Autoantibodies/chemistry
- Autoantibodies/genetics
- Autoantibodies/immunology
- Autoantibodies/toxicity
- Base Sequence
- Enzyme-Linked Immunosorbent Assay
- Female
- Fetal Death/chemically induced
- Fetal Death/immunology
- Germ-Line Mutation/genetics
- Humans
- Mice
- Models, Molecular
- Molecular Sequence Data
- Pregnancy
- Protein Structure, Tertiary
Collapse
Affiliation(s)
- Patricia Lieby
- Laboratoire d'Immunopathologie, Institut de la Santé et de la Recherche Medicale, Equipe Mixte Inserum 0222, Institut d'Immunohématologie, Hôpital central, Hôpitaux Universitaires de Strasbourg, 67091, France
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Pasquali JL, Nehme H, Korganow AS, Martin T. Antiphospholipid antibodies: recent progresses on their origin and pathogenicity. Joint Bone Spine 2004; 71:172-4. [PMID: 15182785 DOI: 10.1016/j.jbspin.2003.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2003] [Accepted: 11/07/2003] [Indexed: 11/26/2022]
|
8
|
Yang CD, Hwang KK, Yan W, Gallagher K, FitzGerald J, Grossman JM, Hahn BH, Chen PP. Identification of Anti-Plasmin Antibodies in the Antiphospholipid Syndrome That Inhibit Degradation of Fibrin. THE JOURNAL OF IMMUNOLOGY 2004; 172:5765-73. [PMID: 15100323 DOI: 10.4049/jimmunol.172.9.5765] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The combined presence of anti-phospholipid Ab (aPL) and thrombosis is recognized as the antiphospholipid syndrome (APS). The aPL represent a heterogeneous group of Ab that recognize various phospholipids (PL), PL-binding plasma proteins, and/or PL-protein complexes. Recently, we found the presence of antithrombin Ab in some APS patients and that some of these anti-thrombin Ab could inhibit thrombin inactivation by antithrombin. Considering that thrombin is homologous to plasmin, which dissolves fibrin, we hypothesize that some APS patients may have Ab that react with plasmin, and that some anti-plasmin Ab may interfere with the plasmin-mediated lysis of fibrin clots. To test this hypothesis, we searched for anti-plasmin Ab in APS patients and then studied those found for their effects on the fibrinolytic pathway. The results revealed that seven of 25 (28%) APS patients have IgG anti-plasmin Ab (using the mean OD plus 3 SD of 20 normal controls as the cutoff) and that six of six patient-derived IgG anti-thrombin mAb bind to plasmin with relative K(d) values ranging from 5.6 x 10(-8) to 1 x 10(-6) M. These K(d) values probably represent affinities in the higher ranges known for human IgG autoantibodies against protein autoantigens. Of these mAb, one could reduce the plasmin-mediated lysis of fibrin clots. These findings suggest that plasmin may be an important driving Ag for some aPL B cells in APS patients, and that the induced anti-plasmin Ab may act either directly, by binding to plasmin and inhibiting its fibrinolytic activity, or indirectly, by cross-reacting with other homologous proteins in the coagulation cascade to promote thrombosis.
Collapse
Affiliation(s)
- Cheng-De Yang
- Department of Medicine, Division of Rheumatology, University of California, Los Angeles, CA 90095, USA
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Fuchikami K, Togame H, Sagara A, Satoh T, Gantner F, Bacon KB, Reinemer P. A versatile high-throughput screen for inhibitors of lipid kinase activity: development of an immobilized phospholipid plate assay for phosphoinositide 3-kinase gamma. ACTA ACUST UNITED AC 2003; 7:441-50. [PMID: 14599360 DOI: 10.1177/108705702237676] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The family of phosphoinositide 3-kinases (PI3K) regulates fundamental cellular responses such as proliferation, apoptosis, motility, and adhesion. In particular, the PI3K gamma isoform plays a critical role in the control of cell migration. Despite the attractiveness of PI3-kinases as drug targets, drug discovery efforts have been hampered by the lack of appropriate lipid kinase assay formats suitable for high-throughput screening. The authors report the development of a simple and robust 384-well plate assay that is based on(33) P-phosphate transfer from radiolabeled [gamma(33) P]ATP to phosphatidylinositol immobilized on Maxisorp plates. The established assay format for PI3K gamma was easily adapted to the automated screening platform and was successfully employed for high-throughput screening. Enzymatic and inhibition characteristics of recombinant human PI3K gamma determined with the plate assay are in very good agreement with previously reported values determined in other assay formats. Maximal catalytic activity of PI3K gamma was observed at pH 7.0. The apparent K(m) value for ATP using a 1:1 mixture of phosphatidylinositol and phosphatidylserine was determined to be 7.3 microM (6.0-8.6 microM, 95% confidence interval [CI]). IC(50) values for known PI3-kinase inhibitors were determined to be 1.45 nM (1.17-1.80 nM, 95% CI) for wortmannin and estimated from partial inhibition data to be 1400, 2830, and 21,400 nM for quercetin, LY294002, and staurosporine, respectively. This novel assay approach allows for screening of inhibitors of lipid kinases in high-throughput mode and thereby may facilitate the identification of novel inhibitory structures for drug development.
Collapse
Affiliation(s)
- Kinji Fuchikami
- Asthma Research, Bayer Yakuhin Ltd., Research Center Kyoto, Japan
| | | | | | | | | | | | | |
Collapse
|
10
|
Visvanathan S, Scott JK, Hwang KK, Banares M, Grossman JM, Merrill JT, FitzGerald J, Chukwuocha RU, Tsao BP, Hahn BH, Chen PP. Identification and characterization of a peptide mimetic that may detect a species of disease-associated anticardiolipin antibodies in patients with the antiphospholipid syndrome. ARTHRITIS AND RHEUMATISM 2003; 48:737-45. [PMID: 12632428 PMCID: PMC2206208 DOI: 10.1002/art.10836] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To test the feasibility of applying a mimetic (specific for a patient-derived prothrombotic anticardiolipin antibody [aCL]) to study the homologous, disease-associated aCL in patients with antiphospholipid syndrome (APS). METHODS We used the CL15 monoclonal aCL to screen 17 phage-display peptide libraries. Peptides (corresponding to recurrent peptide sequences) and their derivatives were synthesized and analyzed for binding to CL15 and for their abilities to inhibit CL15 from binding to cardiolipin. A peptide was chosen and used to study CL15-like IgG aCL in plasma samples from patients with APS, patients with systemic lupus erythematosus (SLE) but without APS, and normal healthy donors. RESULTS Library screening with CL15 yielded 4 recurrent peptide sequences. Analyses of peptides showed that peptide CL154C reacted with antibody CL15 and inhibited binding of CL15 to cardiolipin, indicating that peptide CL154C may be a peptide mimetic for the CL15 aCL. Initial studies with plasma samples revealed that CL154C-reactive IgG was present (positivity defined as the mean + 3 SD optical density of the 25 normal controls) in 15 of 21 APS patients and 1 of 12 SLE patients. CONCLUSION These findings suggest that it is feasible to develop a specific enzyme-linked immunosorbent assay for each immunologically and functionally distinct disease-associated aCL. Additional testing of CL154C with a larger number of APS patients and SLE patients, as well as identification of peptide mimetics for each distinct aCL, will reveal the diagnostic potential of CL154C and other mimetics in identifying patients with aCL who are at risk of developing life-threatening thrombosis.
Collapse
Affiliation(s)
- Sudha Visvanathan
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Jamie K. Scott
- Jamie K. Scott, MD, PhD: Institute of Molecular Biology & Biochemistry, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kwan-Ki Hwang
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Michelle Banares
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Jennifer M. Grossman
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Joan T. Merrill
- Joan T. Merrill, MD: Oklahoma Medical Research Foundation, Oklahoma City
| | - John FitzGerald
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Reginald U. Chukwuocha
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Betty P. Tsao
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Bevra H. Hahn
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| | - Pojen P. Chen
- Sudha Visvanathan, PhD, Kwan-Ki Hwang, PhD, Michelle Banares, Jennifer M. Grossman, MD, John FitzGerald, MD, Reginald U. Chukwuocha, PhD, Betty P. Tsao, PhD, Bevra H. Hahn, MD, Pojen P. Chen, PhD: University of California at Los Angeles
| |
Collapse
|
11
|
Chen WH, Kao YF, Lan MY, Chang YY, Liu JS. A perturbation of antithrombin-III and protein C coupling associates with an increase of anti-beta2-glycoprotein I antibody in non-antiphospholipid antibody syndrome cerebral ischemia. Blood Coagul Fibrinolysis 2002; 13:703-9. [PMID: 12441909 DOI: 10.1097/00001721-200212000-00006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Anti-beta -glycoprotein I antibody (abetaGPI) has been recognized in raising the risk of cerebral ischemia in patients with antiphospholipid antibody syndrome (APS), especially by protein C (PC) axis perturbation. Although a high potential is also seen in non-APS patients, the mechanism is substantially unknown. In the present study, we examined the effect of abetaGPI on PC and antithrombin-III (AT-III) activity in non-APS patients with non-cardiac cerebral ischemia (NCCI). A total of 111 NCCI patients and 30 healthy controls were enrolled. They were free of APS manifestation, and their anticardiolipin antibody and lupus anticoagulant tests were within normal range. There were 14.4% patients found to have an abnormal increase of blood abetaGPI. The PC, AT-III, albumin, aminotransferases, creatinine, prothrombin time and activated partial thromboplastin time did not differ between our patients and controls, or patients with or without increased abetaGPI. However, a marked decrease of the PC/AT-III ratio was found in patients with increased abetaGPI. The correlation between PC and AT-III activity was highly significant in patients with an increase of abetaGPI (P = 0.001), only marginal in controls (P = 0.042), and was insignificant in patients with a normal abetaGPI (P = 0.277). The abetaGPI did not correlate to PC or AT-III activity in either patients or controls. These findings suggest that high PC/AT-III coupling may relate to NCCI in non-APS patients associated with an increase of abetaGPI. This coupling effect seems not to be caused by abetaGPI directly.
Collapse
Affiliation(s)
- W H Chen
- Stroke Biology Research Laboratory, Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | | | | | | | | |
Collapse
|
12
|
Arvieux J. Immuno-analyse et biologie spécialisée. Biologie du syndrome des antiphospholipides. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s0923-2532(02)01172-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
13
|
Hwang KK, Grossman JM, Visvanathan S, Chukwuocha RU, Woods VL, Le DT, Hahn BH, Chen PP. Identification of anti-thrombin antibodies in the antiphospholipid syndrome that interfere with the inactivation of thrombin by antithrombin. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2001; 167:7192-8. [PMID: 11739542 DOI: 10.4049/jimmunol.167.12.7192] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The combined presence of anti-phospholipid (PL) Ab, including lupus anticoagulants (LAC) and/or anticardiolipin Ab (aCL), and thrombosis is recognized as the antiphospholipid syndrome (APS). LAC are detected as an inhibitory effect on PL-restricted in vitro blood coagulation tests, and are comprised mainly of Ab against beta(2) glycoprotein I and prothrombin (PT). Recently, anti-PT Ab (aPT) were found to be associated with thrombosis by some investigators, although this is not confirmed by others. Considering that aPT are heterogeneous in patients and that PT is converted into thrombin, we hypothesize that certain aPT in patients may bind to thrombin, and that some of such anti-thrombin Ab may interfere with thrombin-antithrombin (AT) interaction and thus reduce the AT inactivation of thrombin. To test this hypothesis, we searched for anti-thrombin Ab in APS patients and then studied those found for their effects on the AT inactivation of thrombin. The results revealed that most, but not all, aPT-positive patient plasma samples contained anti-thrombin Ab. To study the functional significance of these Ab, we identified six patient-derived mAb that bound to both PT and thrombin. Of these mAb, three could reduce the AT inactivation of thrombin, whereas others had minimal effect. These findings indicate that some aPT in patients react with thrombin, and that some of such anti-thrombin Ab could inhibit feedback regulation of thrombin. Because the latter anti-thrombin Ab are likely to promote clotting, it will be important to develop specific assays for such Ab and study their roles in thrombosis in APS patients.
Collapse
Affiliation(s)
- K K Hwang
- Division of Rheumatology, Department of Medicine, University of California, Los Angeles, CA 90095, USA.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Lieby P, Soley A, Levallois H, Hugel B, Freyssinet JM, Cerutti M, Pasquali JL, Martin T. The clonal analysis of anticardiolipin antibodies in a single patient with primary antiphospholipid syndrome reveals an extreme antibody heterogeneity. Blood 2001; 97:3820-8. [PMID: 11389022 DOI: 10.1182/blood.v97.12.3820] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The mechanism underlying the prothrombotic state that characterizes the primary antiphospholipid syndrome proves to be difficult to define mainly because of the variety of the phospholipid and protein targets of antiphospholipid antibodies that have been described. Much of the debate is related to the use of polyclonal antibodies during the different antiphospholipid assays. To better describe the antiphospholipid antibodies, a strategy was designed to analyze the reactivity of each one antibody making up the polyclonal anticardiolipin activity, breaking down this reactivity at the clonal level. This was performed in a single patient with primary antiphospholipid syndrome by combining (1) the antigen-specific selection of single cells sorted by flow cytometry using structurally bilayered labeled anionic phospholipids and (2) the cloning of immunoglobulin (Ig) variable (V) region genes originating from individual IgG anticardiolipin-specific B cells by a single-cell polymerase chain reaction technique. The corresponding V regions were cloned in order to express human recombinant antibodies in insect cells by a baculovirus expression system. The molecular analysis, the fine specificity, and the protein cofactor dependency of the first 5 monoclonal IgG anticardiolipins are reported here. This clonal analysis reveals the extreme heterogeneity of these antibodies, which could account for the difficulties in the previous attempts to define the pathogenic antiphospholipid response. This approach should help to unravel the complex antiphospholipid immune response and the mechanism of the prothrombotic state associated with these antibodies, but it could also shed some light on their possible origins. (Blood. 2001;97:3820-3828)
Collapse
Affiliation(s)
- P Lieby
- Laboratoire d'Immunopathologie and Laboratoire d'Hématologie, Institut d'Hématologie et d'Immunologie, Hôpital Civil, Faculté de Médecine de Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg Cedex, France
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Gruel Y. Antiphospholipid syndrome and heparin-induced thrombocytopenia: update on similarities and differences. J Autoimmun 2000; 15:265-8. [PMID: 10968922 DOI: 10.1006/jaut.2000.0424] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Y Gruel
- Service d'Hématologie-Hémostase, Centre Hospitalier Universitaire de Tours, Hôpital Trousseau, Tours, France.
| |
Collapse
|
16
|
Regnault V, De Maistre E, Wahl D, Lecompte T. Monovalent binding of autoantibodies to beta2-glycoprotein I, detected using surface plasmon resonance at low antigen density. Br J Haematol 2000; 109:187-94. [PMID: 10848799 DOI: 10.1046/j.1365-2141.2000.01976.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The precise mechanism of interaction between autoantibodies and beta2-glycoprotein I (beta2GPI) and the experimental conditions to be used for their detection are still under debate. Until now, these interactions have been studied under static conditions. We have investigated the interactions of purified IgG from 25 lupus anticoagulant-positive patients with immobilized beta2GPI under flow conditions by real-time analysis based on surface plasmon resonance technology. Sensor chips were coated with purified human beta2GPI coupled to dextran via amino groups at low densities (1.4, 1.8 or 2. 4 ng beta2GPI/mm2). Four patients' IgG displayed efficient binding and had the highest so-called antiphospholipid IgG levels by enzyme-linked immunosorbent assay (ELISA) and the highest absorbance values in an anti- beta2GPI ELISA at a beta2GPI density reported to be around 12 ng/mm2. Binding of antibodies to the beta2GPI sensor chips proved to be dependent upon the IgG concentration and beta2GPI density and was inhibited by a rabbit antibody against beta2GPI. Similar association and dissociation profiles were observed for the four efficient binders. The fast rate of dissociation limited the binding of autoantibodies to beta2GPI and was highly suggestive of a monovalent association, confirmed by binding of Fab fragments under similar experimental conditions. In conclusion, monovalent binding of low-affinity antibodies to beta2GPI immobilized at a density as low as 1.8 ng/mm2 could be detected using surface plasmon resonance.
Collapse
Affiliation(s)
- V Regnault
- UMR CNRS 7563, Laboratoire d'Hématologie, Faculté de Médecine, Hémostase-Hématologie et Service de Médecine H du CHU, Nancy, France
| | | | | | | |
Collapse
|