High avidity anti-β2-glycoprotein I antibodies in patients with antiphospholipid syndrome
- 1University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
- 2Jožef Stefan Institute, Department of Biochemistry and Molecular Biology, Ljubljana
- 3Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana
- Correspondence to:
Assistant Professor B Božič
University Medical Centre, Department of Rheumatology, Vodnikova 62, SI-1000 Ljubljana;
- Accepted 18 January 2004
Objective: To evaluate avidity of IgG anti-β2-glycoprotein I antibodies (anti-β2-GPI) in patients with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) in relation to thrombosis, and to demonstrate a possible affinity maturation of IgG anti-β2-GPI during the disease course.
Methods: 64 sera from 32 patients (18 with primary or secondary APS, 14 with SLE without APS) and their respective IgG fractions or affinity purified anti-β2-GPI were studied by anticardiolipin (aCL) and anti-β2-GPI enzyme linked immunosorbent assay and by chaotropic assay.
Results: Six, 12, and 14 patients had high, low, and heterogeneous avidity IgG anti-β2-GPI, respectively. In 12 patients an increase in antibody avidity was observed over a period of between four and 12 years. More patients with APS were in the high avidity than in the low avidity anti-β2-GPI group, while the opposite was observed for SLE alone (both p<0.05). The most common clinical feature among patients with high avidity anti-β2-GPI was thrombosis, mainly venous thrombosis (p<0.05 and p<0.02, respectively, v the low avidity anti-β2-GPI group).
Conclusions: Patients with APS with or without SLE may have anti-β2-GPI of high, low, or heterogeneous avidity. High avidity anti-β2-GPI appear to be associated with thrombosis and APS, while in pure SLE low avidity anti-β2-GPI may prevail. Monitoring of avidity may help elucidate the role of anti-β2-GPI affinity maturation in the pathogenesis of APS.
- aCL, anticardiolipin antibodies
- anti-β2-GPI, anti-β2-glycoprotein I antibody
- APS, antiphospholipid syndrome
- SLE, systemic lupus erythematosus