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. 2004 Nov;63(11):1478–1482. doi: 10.1136/ard.2003.017939

High avidity anti-ß2-glycoprotein I antibodies in patients with antiphospholipid syndrome

S Cucnik 1, T Kveder 1, I Krizaj 1, B Rozman 1, B Bozic 1
PMCID: PMC1754811  PMID: 15479898

Abstract

Objective: To evaluate avidity of IgG anti-ß2-glycoprotein I antibodies (anti-ß2-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-ß2-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-ß2-GPI were studied by anticardiolipin (aCL) and anti-ß2-GPI enzyme linked immunosorbent assay and by chaotropic assay.

Results: Six, 12, and 14 patients had high, low, and heterogeneous avidity IgG anti-ß2-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-ß2-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-ß2-GPI was thrombosis, mainly venous thrombosis (p<0.05 and p<0.02, respectively, v the low avidity anti-ß2-GPI group).

Conclusions: Patients with APS with or without SLE may have anti-ß2-GPI of high, low, or heterogeneous avidity. High avidity anti-ß2-GPI appear to be associated with thrombosis and APS, while in pure SLE low avidity anti-ß2-GPI may prevail. Monitoring of avidity may help elucidate the role of anti-ß2-GPI affinity maturation in the pathogenesis of APS.

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Figure 1.

Figure 1

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 The example of high, heterogeneous, and low avidity anti-ß2-glycoprotein I antibodies.

Figure 2.

Figure 2

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 Avidity determination of anti-ß2-glycoprotein I antibodies in diluted serum. mOD: absorbance x1000.

Figure 3.

Figure 3

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 Effect of matrix on the detection of high avidity anti-ß2-glycoprotein I antibodies. mOD: absorbance x1000.

Figure 4.

Figure 4

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 The example of an affinity maturation of anti-ß2-glycoprotein I antibodies in paired samples from the same patient but different blood collections.

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