Rheumatology

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Effects of anti-cardiolipin antibodies and IVIg on annexin A5 binding to endothelial cells: implications for cardiovascular disease
Scandinavian Journal of Rheumatology , 09/28/09

Frostegard AG et al. – Decreased ANXA5 binding to endothelium, mediated by aPL, is a novel mechanism of atherothrombosis that can be countered by IVIg in vitro. IVIg per se could, to a lesser degree, cause decreased ANXA5 binding in NHS, which raises the possibility that some antibodies in IVIg can be involved in a side-effect reported in IVIg treatment, namely atherothrombosis and CVD. Increasing ANXA5 binding, either by addition of ANXA5 or by use of neutralizing antibodies in IVIg, represents a possible therapeutic strategy .

• ANXA5 binding to human umbilical venous endothelial cells (HUVECs) determined by flow cytometry
• Cells cultured in serum from APS patients with high aPL titre (aPL-S)

• Binding of ANXA5 to HUVECs reduced
• Monoclonal immunoglobulin (Ig)G aPL against cardiolipin (mAb-CL) dose-dependently reduced ANXA5 binding to endothelium
• Preincubation of IV Ig at therapeutically relevant doses with aPL-S and mAb-aCL restored ANXA5 binding to comparable levels when NHS used
• IVIg had the capacity to reduce ANXA5 binding to endothelium when added to NHS

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