Significance of aPL IgG subclasses

Human immunoglobulin G (IgG) is comprised of four subclasses with distinct structural and biologic properties. Patients with autoimmune disease, in general, show an overall increase in serum IgG as well as skewing in subclass distribution for particular autoantibodies. Antinuclear antibodies and anti-double stranded DNA antibodies, for example, are primarily IgG1 and IgG3. In contrast, anticardiolipin antibodies show a skewing towards presence of IgG2 presence is associated with arterial and venous thrombotic complications. Selective absorption of IgG2 from high titer sera abrogates aCL ELISA binding. Pathogenicity of aCL may be related to IgG2 in an important way. The precise mechanism of action and nature of the inducing stimulus are not yet clear.