Thromb Haemost 2000; 83(04): 583-588
DOI: 10.1055/s-0037-1613867
Commentary
Schattauer GmbH

Analysis of Prothrombotic Effects of two Human Monoclonal IgG Antiphospholipid Antibodies of Apparently Similar Specificity

Karl J. Lackner
1   From the Institute for Clinical Chemistry and Laboratory Medicine, University of Regensburg, Germany
,
Christine von Landenberg
1   From the Institute for Clinical Chemistry and Laboratory Medicine, University of Regensburg, Germany
,
Stefan Barlage
1   From the Institute for Clinical Chemistry and Laboratory Medicine, University of Regensburg, Germany
,
Gerd Schmitz
1   From the Institute for Clinical Chemistry and Laboratory Medicine, University of Regensburg, Germany
› Author Affiliations
Further Information

Publication History

Received 18 June 1999

Accepted after resubmission 29 November 1999

Publication Date:
08 December 2017 (online)

Summary

Two human monoclonal antiphospholipid antibodies (APA) of the IgG type, HL-5B and RR-7F have been generated from a patient with primary antiphospholipid syndrome and recurrent cerebral microemboli (H.L.) and from a patient with SLE without evidence of recurrent thrombosis (R.R.). Both monoclonal APA have similar characteristics in ELISA tests. To further analyse the prothrombotic potential, their effect on human monocytes and platelets, and bovine aortic endothelial cells (BAEC) was investigated. Monocytes were isolated from buffy coats by standard techniques. They were incubated either with the respective monoclonal APA in different concentrations, or a control monoclonal IgG of the same subtype, or plasma of the patients, from whom the antibodies were isolated. Incubation with LPS served as positive control. BAEC were grown to confluence, and then incubated with the appropriate agonists. Procoagulant activity (PCA) was determined by a single stage clotting assay. PCA expression after incubation is given as the ratio of the coagulation times observed with media only divided by that observed with the agonist. A PCA ratio >1 indicates the induction of PCA by the agonist. At 1 µg/ml HL-5B yielded a PCA ratio of 1.63 ± 0.16 while RR-7F induced no significant rise to 1.06 ± 0.18. Dose response curves showed that RR-7F can induce PCA at higher concentrations. However, its effect is approx. 1/50 of HL-5B based on equimolar antibody concentration. Further analysis indicates that the majority of the PCA induced by monoclonal APA can be inhibited by a specific tissue factor antibody. Neither monoclonal antibody induced PCA in BAEC. Sera from both patients were able to induce PCA in monocytes. However, the PCA ratio of serum from H.L. was higher (1.78) than that of R.R. (1.44). Neither monoclonal APA had an effect on platelets as determined by flow cytometric analysis of CD62P, CD41, CD42b expression and fibrinogen binding with and without previous activation with 5 µM ADP or 15 µM TRAP-6. Similarly, there were no differences in platelet aggregation to different stimuli including submaximal activation. In summary, these data provide further evidence that induction of tissue factor in monocytes is one of the procoagulant effects of APA. Furthermore, the binding specificity of APA is perhaps not suited to predict the biological effects of the antibodies.

 
  • References

  • 1 Harris EN, Gharavi AE, Boey ML, Patel BM, Mackworth-Young CG, Loizou S, Hughes GRV. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983; 02: 1211-4.
  • 2 Hughes GRV. The antiphospholipid syndrome – Ten years on. Lancet 1993; 342: 341-4.
  • 3 Shapiro SS. The lupus anticoagulant/antiphospholipid syndrome. Ann Rev Med 1996; 47: 533-53.
  • 4 Galli M, Comfurius P, Maassen C, Hemker HC, De Baets MH, van Breda PJVriesman, Barbui T, Zwaal RF, Bevers M. Anticardiolipin antibodies are directed not to cardiolipin but to a plasma protein cofactor. Lancet 1990; 335: 1544-7.
  • 5 McNeil HP, Simpson RJ, Chesterman CN, Krilis SA. 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: 4120-4.
  • 6 Inanc M, Radway-Bright EL, Isenberg DA. β2-glycoprotein I and anti-β2glycoprotein I antibodies: where are we now?. Br J Rheumatol 1997; 36: 1247-57.
  • 7 Bevers EM, Galli M, Barbiu T, Comfurius P, Zwaal RF. Lupus anticoagulant IgG’s (LA) are not directed to phospholipids only, but to a complex of lipid-bound human prothrombin. Thromb Haemost 1991; 66: 629-32.
  • 8 Sammaritano LR, Gharavi AE, Soberano C, Levy RA, Lockshin MA. Phospholipid binding of antiphospholipid antibodies and placental anticoagulant protein. J Clin Immunol 1992; 12: 27-35.
  • 9 Roubey RAS. Autoantibodies to phospholipid binding plasma proteins: a new view of lupus anticoagulant and other “antiphospholipid” autoantibodies. Blood 1994; 84: 2854-67.
  • 10 Kandiah DA, Sheng YH, Krilis SA. 132-glycoprotein I: Target antigen for autoantibodies in the “antiphospholipid syndrome”. Lupus 1996; 05: 381-5.
  • 11 Esmon NL, Smirnov MD, Esmon CT. Thrombogenic mechanisms of antiphospholipid antibodies. Thromb Haemost 1997; 78: 79-82.
  • 12 Roubey RAS, Hoffman M. From antiphospholipid syndrome to antibodymediated thrombosis. Lancet 1997; 350: 1491-3.
  • 13 Greaves M. Antiphospholipid antibodies and thrombosis. Lancet 1999; 353: 1348-53.
  • 14 Machin SJ. Platelets and antiphospholipid antibodies. Lupus 1996; 05: 386-7.
  • 15 Meroni PL, Del Papa N, Beltrami P, Tincani A, Balestrieri G, Krilis SA. Modulation of endothelial cell function by antiphospholipid antibodies. Lupus 1996; 05: 448-50.
  • 16 Lindsey NJ, Henderson FI, Malia R, Milford-Ward MA, Greaves M, Hughes P. Inhibition of prostacyclin release by endothelial binding anticardiolipin antibodies in thrombosis-prone patients with systemic lupus erythematosus and the antiphospholipid syndrome. Br J Rheumatol 1994; 33: 20-6.
  • 17 Keeling DM, Campbell SM, Mackie IL, Machin SJ, Isenberg DA. The fibrinolytic response to venous occlusion and the natural anticoagulants in patients with antiphospholipid antibodies both with and without systemic lupus erythematosus. Br J Haematol 1991; 77: 354-9.
  • 18 Oosting JD, Derksen RHWM, Bobbing IWG, Hackeng TM, Bouma BN, deGroot PG. Antiphospholipid antibodies directed against a combination of phospholipids with prothrombin, protein C or protein S: an explanation for their pathogenic mechanisms?. Blood 1993; 81: 2618-25.
  • 19 Osterud B. Tissue factor: a complex biological role. Thromb Haemost 1997; 78: 755-8.
  • 20 Mackman N. Regulation of the tissue factor gene. Thromb Haemost 1997; 78: 747-54.
  • 21 Broze Jr BJ. Tissue factor pathway inhibitor and the revised theory of coagulation. Annu Rev Med 1995; 46: 103-12.
  • 22 Kornberg A, Blank M, Kaufman S, Shoenfeld Y. Induction of tissue factorlike activity in monocytes by anticardiolipin antibodies. J Immunol 1994; 153: 1328-32.
  • 23 Amengual A, Atsumi T, Khamashta MA, Hughes GRV. The role of the tissue factor pathway in the hypercoagulable state in patients with the antiphospholipid syndrome. Thromb Haemost 1998; 79: 276-81.
  • 24 Cuadrado MJ, López-Pedrera C, Khamashta MA, Camps MT, Tinabones F, Torres A, Hughes GRV, Velasco F. Thrombosis in primary antiphospholipid syndrome: a pivotal role for monocyte tissue factor expression. Arthritis Rheum 1997; 40: 834-41.
  • 25 von Landenberg C, Lackner KJ, von Landenberg P, Lang B, Schmitz G. Isolation and characterization of two human monoclonal antiphospholipid IgG from patients with autoimmune disease. J Autoimmun 1999; 13: 215-23.
  • 26 Reinhold RB, Fine J. A technique for quantitative measurement of endotoxin in human plasma. Proc Soc Exp Biol Med 1971; 137: 334-40.
  • 27 Wittig K, Rothe G, Schmitz G. Inhibition of fibrinogen binding and surface recruitment of GpIIb/IIIa as dose-dependent effects of the RGD-mimetic MK-852. Thromb Haemost 1998; 79: 625-30.
  • 28 Campbell AL, Pierangeli SS, Wellhausen S, Harris EN. Comparison of the effects of anticardiolipin antibodies from patients with the antiphospholipid syndrome and with syphilis on platelet activation and aggregation. Thromb Haemost 1995; 73: 529-34.
  • 29 Robbins DL, Leung S, Miller-Blair DJ, Ziboh V. Effect of anticardiolipin/β2-glycoprotein I complexes on production of thromboxane A2 by platelets from patients with the antiphospholipid syndrome. J Rheumatol 1998; 25: 51-60.
  • 30 Fanelli A, Bergamini C, Rapi S, Caldini A, Spinelli A, Buggiani A, Emmi L. Flow cytometric detection of circulating activated platelets in primary antiphospholipid syndrome. Correlation with thrombocytopenia and anticardiolipin antibodies. Lupus 1997; 06: 261-7.
  • 31 Joseph JE, Donohoe S, Harrison P, Mackie IJ, Machin SJ. Platelet activation and turnover in the primary antiphospholipid syndrome. Lupus 1998; 07: 333-40.
  • 32 Martinuzzo ME, Maclouf J, Carreras LO, Lévy-Toledano S. Antiphospholipid antibodies enhance thrombin-induced platelet activation and thromboxane formation. Thromb Haemost 1993; 70: 667-71.
  • 33 Shi W, Chong BH, Chesterman CN. 132-glycoprotein I is a requirement for anticardiolipin antibodies binding to activated platelets: differences with lupus anticoagulants. Blood 1993; 81: 1255-62.
  • 34 Vázquez-Mellado J, Llorente L, Richaud-Patin Y, Alarcón-Segovia D. Exposure of anionic phospholipids upon platelet activation permits binding of β2 glycoprotein I and through it that of IgG antiphospholipid antibodies. Studies in platelets from patients with antiphospholipid syndrome and normal subjects. J Autoimmun 1994; 07: 335-48.
  • 35 Robbins DL, Leung S, Miller-Blair DJ, Ziboh V. Effect of anticardiolipin/β2-glycoprotein I complexes on production of thromboxane A2 by platelets from patients with the antiphospholipid syndrome. J Rheumatol 1998; 25: 51-6.
  • 36 Arnout J. The pathogenesis of the antiphospholipid syndrome: a hypothesis based on parallelisms with heparin-induced thrombocytopenia. Thromb Haemost 1996; 75: 536-41.
  • 37 Pierangeli SS, Colden-Stanfield M, Liu X, Barker JH, Anderson GL, Harris N. Antiphospholipid antibodies from antiphospholipid syndrome patients activate endothelial cells in vitro and in vivo. Circulation 1999; 99: 1997-2002.
  • 38 Ikematsu W, Luan FL, LaRosa L, Beltrami B, Nicoletti F, Buyon JP, Meroni PL, Balestrieri G, Casali P. Human anticardiolipin monoclonal autoantibodies cause placental necrosis and fetal loss in BALB/c mice. Arthritis Rheum 1998; 41: 1026-39.
  • 39 Olee T, Pierangeli SS, Handley HH, Le DT, Wie X, Lai CJ, En J, Novotny W, Harris EN, Woods VL, Chen PP. A monoclonal IgG anticardiolipin antibody from a patient with the antiphospholipid syndrome is thrombogenic in mice. Proc Natl Acad Sci USA 1996; 93: 8606-11.
  • 40 Menon S, Rahman MAA, Ravirajan CT, Kandiah D, Longhurst CM, McNally T, Williams WM, Latchman DS, Isenberg DA. The production, binding characteristics and sequence analysis of four human IgG monoclonal antiphospholipid antibodies. J Autoimmunity 1997; 10: 43-57.
  • 41 Kupferwasser LI, Hafner G, Mohr-Kahaly S, Erbel R, Meyer J, Darius H. The presence of infection-related antiphospholipid antibodies in infective endocarditis determines a major risk factor for embolic events. J Am Coll Cardiol 1999; 33: 1365-71.