Abstract

The molecular structure of antibodies associated with autoimmune thrombosis is beginning to be understood. We describe the binding specificities and sequence analysis of anti-β 2-glycoprotein-I (anti-β 2GP-I) or anti-prothrombin (anti-PT) antibody fragments generated by phage display from a patient with primary antiphospholipid syndrome (APS). We obtained 39 positive clones, two that had the correct size reacted with β 2GP-I (Beta 1 and Beta 2). Ten clones with the same restrictive pattern recognized PT (Prot 1) and cross-reacted with β 2GP-I. All three clones recognized anionic and zwitterionic phospholipids. The V H regions of both anti-β 2GP-I clones are members of the VH4 family. Prot 1 has a V H segment of the VH3 family. The Beta 1 J H segments are J H5b and J H4b for Beta 2 and Prot 1. V L genes are V λ1, 3 and 1, respectively. No J L was identified for Beta 1, while Beta 2 and Prot 1 carry J λ3b genes. Beta 1 and Beta 2 carry highly conserved germ-line V H and V L genes. Mutations of the Prot 1 gene appear to be antigen-dependent, most are hotspot mutations located in the CDR 1 and 2 regions. Our work suggests that some anti-β 2GP-I from patients with primary APS are natural autoantibodies. Our work may also help to explain the frequent coexistence of anti-β 2GP-I and anti-PT in the same patient.

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