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Anti-ß2-glycoprotein I and anti-prothrombin antibodies in patients with the ‘antiphospholipid’ syndrome: Immunological specificity and clotting profiles

S A Krilis

Department of Immunology, Allergy and Infectious Disease, and Department of Medicine, University of New South Wales, St George Hospital, Kogarah, New South Wales, Australia

Lupus anticoagulant (LA) antibodies have been shown to be directed to protein-phospholipid complexes. In this study, we report on LA antibodies from patients with the ‘antiphospholipid’ syndrome (APS), that are directed to prothrombin and b2-glycoprotein I, but not to the complexes of these plasma proteins to anionic phospholipids. The anti-prothrombin antibodies studied had different reactivities in two clotting assays: the dilute Russell's viper venom time (dRVVT) and the dilute kaolin clotting time (dKCT). Anti-prothrombin and anti-b2-glycoprotein I (anti-b2GPI) antibodies, affinity-purified from one patient with APS were not cross-reactive and had different effects in the dRVVT and dKCT clotting tests. Polyclonal anti-prothrombin antibodies, affinity-purified on a prothrombin column, from two patients with prothrombin reactivity in their plasma, have affinity constants to prothrombin of 104 and 192 nM. The patient with affinity-purified antibodies to prothrombin and b2GPI, had affinity constants to prothrombin and b2GPI, respectively, of 192 nM and 3030 nM, respectively. LA antibodies are a heterogenous population of antibodies that have different immunological specificities and clotting test reactivities in different patients.

Key Words: ‘antiphospholipid’ syndrome • ß2-glycoprotein • prothrombin • autoantibodies

Lupus, Vol. 7, No. 5, 323-332 (1998)
DOI: 10.1191/096120398678920253


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