C5a receptor-deficient mice are protected from thrombophilia and endothelial cell activation induced by some antiphospholipid antibodies

Recent findings indicate that complement activation - involving specifically C3 and C5 - contributes to antiphospholipid (aPL)-mediated thrombosis. Two complement effector pathways are initiated by the cleavage of C5, C5a and C5b, which leads to the formation of the C5b-9 membrane attack complex. To delineate and distinguish the role of C5a from the C5b-9 membrane attack complex seeded by C5b, we examined the in vivo effects (thrombosis) of aPL on C5a receptor-deficient (C5aR^-/-) mice. C5aR^-/- and C5aR^+/+ mice were injected with IgM or with IgG from two different patients with APS (IgM-APS or IgG-APS) or with control IgM or IgG (IgM-NHS or IgG-NHS) twice. Complement fixing activity of the Ig fractions and anticardiolipin activity in the sera of the mice were determined by enzyme-linked immunosorbent assay. Surgical procedures to study thrombus dynamics were performed. IgM-APS but not IgG-APS fixed C1q to cardiolipin-coated plates. IgM-APS significantly enhanced thrombus size in C5aR^+/+ mice compared to C5aR^+/+ mice treated with IgMNHS (3198 ± 2361 μm² versus 585 ± 460 μm²). C5aR^-/- mice treated with IgM-APS showed a significant reduction in thrombi size as compared with C5aR^+/+ mice (676 ± 690 μm² versus 3198 ± 2361 μm²; P = 0.001). IgG-APS enhanced thrombus formation significantly in C5aR^+/+ when compared to IgG-NHS-treated mice (3507 ± 965 μm² versus 1321 ± 798 μm ²), and these effects were not altered in C5aR^-/- mice (3400 ± 1681 μm²). The data indicate that C5aR ^-/- mice are protected from the thrombogenic effects of some aPL antibodies.