beta(2)-glycoprotein I: Target antigen for autoantibodies in the 'antiphospholipid syndrome'

'Antiphospholipid' (aPL) antibodies are of important clinical significance because of their association with thrombosis both arterial and venous, recurrent foetal loss, specific neurological sequelae like seizures and chorea, cardiac valvular abnormalities and thrombocytopenia.(1) Traditionally these autoantibodies have been assayed using phospholipid (PL) dependent tests and are classified as lupus anticoagulants (LA) and anticardiolipin (aCL) antibodies based on the method of detection(2). The antibodies thus, had been thought to bind PLs but it has now become clear that the true antigens are PL-binding proteins. The major protein consistently found as the target antigen for these autoantibodies is beta(2)-glycoprotein I (beta(2)-GPI)(3). Other candidate PL-binding proteins have also been investigated including prothrombin, protein C and protein S-4 but thus far appear to play less important roles in the binding of these antibodies.