title: Pathogenic role of anti-beta 2-glycoprotein I antibodies in antiphospholipid associated fetal loss: characterisation of beta 2-glycoprotein I binding to trophoblast cells and functional effects of anti-beta 2-glycoprotein I antibodies in vitro.
abstract: BACKGROUND
  Antiphospholipid antibodies reacting with beta2-glycoprotein I (beta 2GPI) have been associated with recurrent fetal loss and pregnancy complications.
  
  
  OBJECTIVE
  To investigate whether specific mutations in the phospholipid binding site of beta 2GPI might affect its binding to trophoblast and in turn the anti-beta 2GPI antibody induced functional effects.
  
  
  METHODS
  beta 2GPI adhesion to trophoblast was evaluated as human monoclonal IgM or polyclonal IgG anti-beta 2GPI antibody binding to trophoblast monolayers cultured (1) in complete medium; (2) in serum-free medium; (3) after serum starvation in the presence of purified human beta 2GPI; or (4) in the presence of beta 2GPI with single or multiple mutations in the amino acid loop Cys(281)-Lys-Asn-Lys-Glu-Lys-Lys-Cys(288). The effect of anti-beta 2GPI binding to trophoblast was evaluated as chorionic gonadotropin (hCG) mRNA expression, and protein release by RT-PCR and radioimmunoassay, respectively.
  
  
  RESULTS
  beta 2GPI adhesion to trophoblast and its consequent recognition by the specific antibodies were inversely proportional to the mutation number in the phospholipid binding site. Anti-beta 2GPI antibodies reduced gonadotropin release, hormone dependent hCG mRNA expression, and protein synthesis in the presence of beta 2GPI, while the addition of the mutants or the absence of beta 2GPI had no effect.
  
  
  CONCLUSIONS
  beta 2GPI binds to trophoblast in vitro through its fifth domain, as reported for endothelial cells, and can be recognised by anti-beta 2GPI antibodies; the antibody binding downregulates trophoblast hCG synthesis and secretion. Such a mechanism might contribute to defective placentation in women with fetal loss associated with the antiphospholipid syndrome.
authors.affiliation: Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Di Simone
authors.forename: E
authors.initials: E
authors.lastname: Raschi
authors.forename: C
authors.initials: C
authors.lastname: Testoni
authors.forename: R
authors.initials: R
authors.lastname: Castellani
authors.forename: M
authors.initials: M
authors.lastname: D'Asta
authors.forename: T
authors.initials: T
authors.lastname: Shi
authors.forename: S A
authors.initials: SA
authors.lastname: Krilis
authors.forename: A
authors.initials: A
authors.lastname: Caruso
authors.forename: P L
authors.initials: PL
authors.lastname: Meroni
mesh_terms: D016736:Antiphospholipid Syndrome / Q000276:immunology*; D001323:Autoantibodies / Q000502:physiology*; D001665:Binding Sites / Q000235:genetics; D002448:Cell Adhesion / Q000276:immunology; D002478:Cells, Cultured; D006063:Chorionic Gonadotropin / Q000096:biosynthesis / Q000235:genetics; D003470:Culture Media; D016895:Culture Media, Serum-Free; D005260:Female; D005313:Fetal Death / Q000276:immunology*; D005786:Gene Expression Regulation; D006023:Glycoproteins / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D016297:Mutagenesis, Site-Directed; D010743:Phospholipids / Q000378:metabolism; D012333:RNA, Messenger / Q000235:genetics; D014327:Trophoblasts / Q000378:metabolism*; D053482:beta 2-Glycoprotein I
chemical_list: D001323:Autoantibodies; D006063:Chorionic Gonadotropin; D003470:Culture Media; D016895:Culture Media, Serum-Free; D006023:Glycoproteins; D010743:Phospholipids; D012333:RNA, Messenger; D053482:beta 2-Glycoprotein I