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.
Keywords
Antiphospholipid antibodies - tissue factor - monocytes - endothelial cells - platelets