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Blood, 15 February 2005, Vol. 105, No. 4, pp. 1552-1557.
Prepublished online as a Blood First Edition Paper on October 14, 2004; DOI 10.1182/blood-2004-08-3145.


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Submitted August 13, 2004
Accepted October 6, 2004

Binding of {beta}2-Glycoprotein I to anionic phospholipids facilitates processing and presentation of a cryptic epitope that activates pathogenic autoreactive T cells

Masataka Kuwana*, Eiji Matsuura, Kazuko Kobayashi, Yuka Okazaki, Junichi Kaburaki, Yasuo Ikeda, and Yutaka Kawakami

Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan
Department of Cell Chemistry, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
Department of Internal Medicine, Tokyo Electric Power Company Hospital, Tokyo, Japan
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

* Corresponding author; email: kuwanam{at}sc.itc.keio.ac.jp.

Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder in association with autoantibodies to phospholipid (PL)-binding plasma proteins, such as {beta}2-glycoprotein I ({beta}2GPI). We have recently found that autoreactive CD4+ T cells to {beta}2GPI in APS patients preferentially recognize a cryptic peptide encompassing amino acid residues 276-290 (p276-290), which contains the major PL-binding site, in the context of DR53. However, it is not clear how previously cryptic p276-290 become visible to the immune system and elicit a pathogenic autoimmune response to {beta}2GPI. Here we show that presentation of a disease-relevant cryptic T-cell determinant in {beta}2GPI is induced as a direct consequence of antigen-processing from {beta}2GPI bound to anionic PL. Dendritic cells or macrophages pulsed with PL-bound {beta}2GPI induced a response of p276-290-specific CD4+ T cell-lines generated from the patients in HLA-DR-restricted and antigen-processing-dependent manners, but those with {beta}2GPI or PL alone did not. In addition, the p276-290-reactive T-cell response was primed by stimulating peripheral blood T cells from DR53-carrying healthy individuals with dendritic cells bearing PL-bound {beta}2GPI in vitro. Our finding is the first demonstration of an in vitro mechanism eliciting pathogenic autoreactive T-cell responses to {beta}2GPI, and should be useful in clarifying the pathogenesis of APS.


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