@article {3559, title = {A non-complement-fixing antibody to β2 glycoprotein I as a novel therapy for antiphospholipid syndrome.}, journal = {Blood}, volume = {123}, year = {2014}, month = {2014 May 29}, pages = {3478-87}, abstract = {

A single-chain fragment variable (scFv) recognizing β2-glycoprotein 1 (β2GPI) from humans and other species was isolated from a human phage display library and engineered to contain an IgG1 hinge-CH2-CH3 domain. The scFv-Fc directed against β2GPI domain I-induced thrombosis and fetal loss, thus mimicking the effect of antibodies from patients with antiphospholipid syndrome (APS). Complement is involved in the biological effect of anti-β2GPI scFv-Fc, as demonstrated by its ability to promote in vitro and in vivo complement deposition and the failure to induce vascular thrombosis in C6-deficient rats and fetal loss in C5-depleted mice. A critical role for complement was also supported by the inability of the CH2-deleted scFv-Fc to cause vessel occlusion and pregnancy failure. This antibody prevented the pathological effects of anti-β2GPI antibodies from APS patients and displaced β2GPI-bound patient antibodies. The CH2-deleted antibody represents an innovative approach potentially useful to treat APS patients refractory to standard therapy.

}, keywords = {Abortion, Spontaneous, Animals, Antibodies, Monoclonal, Antiphospholipid Syndrome, Autoantigens, beta 2-Glycoprotein I, Complement Activation, Complement System Proteins, Human Umbilical Vein Endothelial Cells, Humans, Immunoglobulin G, Male, Mice, Protein Binding, Rats, Recombinant Proteins, Single-Chain Antibodies, Thrombosis, Trophoblasts}, issn = {1528-0020}, doi = {10.1182/blood-2013-11-537704}, author = {Agostinis, Chiara and Durigutto, Paolo and Sblattero, Daniele and Borghi, Maria O and Grossi, Claudia and Guida, Filomena and Bulla, Roberta and Macor, Paolo and Pregnolato, Francesca and Meroni, Pier Luigi and Tedesco, Francesco} } @article {1781, title = {In vivo distribution of β2 glycoprotein I under various pathophysiologic conditions.}, journal = {Blood}, volume = {118}, year = {2011}, month = {2011 Oct 13}, pages = {4231-8}, abstract = {

In vitro studies have documented β2 glycoprotein I (β2GPI) binding to endothelial cells (ECs) and trophoblast using antiphospholipid antibodies. The in vivo binding of β2GPI to these cells and the conditions that favor their interaction have not been investigated. We analyzed the in vivo distribution of cyanine 5.5-labeled β2GPI in mice and evaluated the effect of pregnancy and circulating antibodies on its tissue localization. The signal was detected in the liver by whole body scan and ex vivo analysis. The β2GPI failed to bind to the vascular endothelium and reacted only with the ECs of uterine vessels. In pregnant mice the protein was localized on ECs and trophoblast at the embryo implantation sites. Immunized mice showed a similar β2GPI biodistribution to naive mice but the immunized pregnant animals exhibited a significant increase in fetal loss associated with C3 and C9 deposition at the implantation sites. Treatment of mice with LPS after β2GPI-Cy5.5 injection promoted protein localization on gut and brain ECs associated with IgG, C1q, and C9 deposition in immunized mice. These findings indicate that β2GPI binding to EC requires priming with pro-inflammatory factors which is not needed for uterine and placental localization probably dependent on hormonal changes.

}, keywords = {Animals, beta 2-Glycoprotein I, Complement C1q, Complement C3, Complement C9, Endothelial Cells, Endothelium, Vascular, Female, Fetal Death, Humans, Mice, Mice, Inbred BALB C, Pregnancy, Trophoblasts, Uterus}, issn = {1528-0020}, doi = {10.1182/blood-2011-01-333617}, author = {Agostinis, Chiara and Biffi, Stefania and Garrovo, Chiara and Durigutto, Paolo and Lorenzon, Andrea and Bek, Alpan and Bulla, Roberta and Grossi, Claudia and Borghi, Maria O and Meroni, Pierluigi and Tedesco, Francesco} }