Quantitation of anti-RNP and anti-Sm antibodies in MCTD and SLE patients by immunoblotting.

A quantitative immunoblotting assay (QIBA) for the determination of specific antibody titres in human autoimmune sera is described. In this assay, a total HeLa nuclear protein fraction, immobilized on nitrocellulose blot strips, was used as source of antigens and immunoreactive species of autoantibodies were quantitated by an enzyme linked second antibody procedure. Besides being more discriminative, QIBA appeared to be up to 500 times more sensitive than immunodiffusion or immunoelectrophoresis. In this study we used 21 sera from patients with SLE or MCTD for a quantitative analysis of their specific autoantibody content. Within this group, a very diverse spectrum of antibody populations was observed; anti-RNP sera appeared to contain, among others, high tired antibody versus 70K and 31K polypeptides while all (n = 6) anti-Sm sera recognized a 25kD protein doublet. In a follow-up study of two MCTD patients significant flares in specific antibody content could be observed.     

Antibodies against polypeptides of purified Epstein-Barr virus in sera from patients with connective tissue diseases.

Antibodies to Epstein-Barr virus (EBV) were investigated in patients with systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) by immunoblotting using purified virus. Compared with sera from Epstein-Barr virus seropositive healthy individuals who served as control, sera from patients less frequently recognized several polypeptides. In particular, a 100 kDa envelope polypeptide was recognized by 92% of healthy subjects and only 11% of patients (P less than 0.001). On the other hand, 62% of the patient sera had antibodies to the 42 kDa envelope polypeptide, whereas these antibodies were only present in 4% of the sera from the control subjects (P less than 0.001). These results could reflect either perturbations of the immune response associated with connective tissue disorders or a possible pathogenic role of EBV.     

The effect of sera from patients with connective tissue diseases on red cell binding and phagocytosis by monocytes.

The uptake by human blood monocytes of sheep erythrocytes treated with rabbit anti-sheep antibody with or without mouse complement was assessed by a radioactive method to discover whether immune complexes would inhibit this reaction. It was found that sera from SLE patients inhibited uptake whereas normal sera enhanced. Some rheumatoid sera and rheumatoid joint fluids inhibited uptake whereas sera from juvenile rheumatoid patients did not.     

Clinical significance of IgG subclasses of anti-Sm and U1 ribonucleoprotein antibodies in patients with systemic lupus erythematosus and mixed connective tissue disease

IgG subclasses of anti-Sm and anti-U1 ribonucleoprotein (U1 RNP) antibodies were determined using a new clone of the anti-IgG2 antibody (HG2-56F). Although the predominance of IgG1 coincided with previous reports, IgG2 anti-Sm and U1 RNP antibodies were detected in numerous patients. IgG3 anti-Sm antibody significantly correlates with joint involvement and a high titer of anti-DNA antibody. On the other hand, IgG4 anti-U1 RNP antibody significantly correlated with esophageal dilation and muscular involvement. These results may suggest that some IgG subclasses are related to a specific clinical feature or manifestation.     

Serum antibodies in rickettsia patients as determined by immunoblotting technique.

The Western-blot technique (WB) was used to determine which polypeptides of Israeli spotted fever (ISF) isolates and other spotted fever group rickettssia (SFGR) reference isolates (G212, S484, A828) and two reference strains. R. Rickettsii (Sheila Smith strain) and R. conorii (Boutonneuse fever), were used as antigen sources for the WB. Immunoperoxidase assay (IPA) seropositive (titer greater than 80) and seronegative (titer less than) sera were examined with the separated polypeptides of the above strains. WB analysis of the rickettsial polypeptide-serum reactions showed that R. conorii and the three isolates of ISF reacted identically with the sera, except that in the three ISF strains a 175 kD protein was present. It was also observed that all of the IPA seropositive sera examined reacted with the following polypeptides: 18kD, 20kD, 22kD (28kD to 37 kD LPS group), while each seropositive and seronegative serum reacted differently with polypeptides 23kD, 42kD, 45kD, 46kD, 52kD, 55kD, 70kD, 82kD, 105kD, 125kD, 155kD and 175kD. Using this technique, no heat labile polypeptides (preelectrophoretic treatment: 100 degrees C for 2 min vs 37 degrees C for 20 min) were observed in SFGR strains used in this study. Our results indicate that the immunoblot technique shows no difference between R. conorii and ISF antigens except the existence of 175kD protein antigen in the latter.     

Pattern of antinuclear autoantibodies in diseases with systemic connective tissue lesions

Several types of antinuclear antibodies (ANA) were discovered by the fluorescent antibody method in diseases accompanied by systemic lesions of connective tissue and also in certain other diseases and in clinically healthy blood donors, depending on the character of fluorescence in the nuclei. Diffuse fluorescence of nuclei, diffuse fluorescence without fluorescence of the nucleoli, annular fluorescence, fluorescence in the form of granules, selective fluorescence of nucleoli, and fluorescnece in the form of long, thin, interweaving bands with simultaneous fluorescence in the region of the nuclear membrane were distinguished. The last type of ANA was observed only in various forms of lupus erythematosus, and the character of fluorescence in the nuclei differed from the reticular and filamentous types of fluorescence described previously.Department of Pathological Anatomy and Department of Skin Diseases, N. I. Pirogov Second Moscow Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR A. P. Avtsyn.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 84, No. 7, pp. 75–78, July, 1977.     

T-cell subpopulations in the peripheral blood of patients with connective tissue diseases as determined by flow cytometry using monoclonal antibodies

We studied by flow cytometry using monoclonal antibodies the T3, T4, and T8 subpopulations of T cells in the peripheral blood of 109 patients with various connective tissue diseases who were not receiving any treatment. Comparison of the results was made with those obtained with normal controls matched for age and sex with each connective tissue disease group. When compared as disease groups, patients with systemic lupus erythematosus (n = 41) had decreased T8 cells, but patients with active disease (n = 17) had all three T-cell subpopulations lower than their controls, whereas those with inactive disease (n = 24) showed no differences. Patients with rheumatoid arthritis (n = 23) had decreased T3 and T8 cells, whereas patients with scleroderma (n = 22) only had decreased T3 cells, and patients with primary Sj?gren's syndrome (n = 15) had lower proportions of all three T-cell subpopulations than their matched controls. Patients with mixed connective tissue disease (n = 8) had proportions of all three T-cell subpopulations akin to those of their matched controls, but showed a tendency to have decreased T8 cells that reached statistical significance when compared to the entire control group. Although our findings tend to support the notion that the abnormalities in immunoregulatory T-cell circuits leading to autoimmunity are different in each connective tissue disease, the great variability found in both patients and controls seems to preclude the use of these determinations in individual patients for clinical purposes.     

Heterogeneity of ribosomal autoantibodies from human, murine and canine connective tissue diseases

Antiribosomal auto-antibodies (anti-Rib.Ab) have been studied in connective tissue diseases (human, dog and mouse) by immunoblotting after one-dimensional (1D) or two-dimensional (2D) gel electrophoresis of rat ribosomes. Anti-Rib.Ab could be found in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and other connective tissue diseases (progressive systemic sclerosis, PSS; Sj?gren syndrome, SjS; mixed connective tissue disease, MCTD; and dermatomyositis, DM with the frequencies 41.7%, 54.6% and 33%, respectively. Immunoblotting after 1D gel electrophoresis showed the great heterogeneity of ribosomal proteins recognized by the anti-Rib.Ab. In the SLE, however, the most frequent antibodies stained bands of the 40S subunit: 30 kDa (34% of positive sera), 19.5 kDa (24.5%) and 43 kDa (17%). In RA, the 25-kDa band of the 60S subunit was the most common (54% of positive sera). In the other human connective tissue diseases, there was no particular predominance. In the MRL/1, anti-Rib.Ab were very frequent (92.6%). The 43-kDa band of the 40S subunit was found in 100% of positive sera. Seventeen out of nineteen dogs with SLE gave positive results on immunoblot, and all of them stained the 43-kDa band of the 40S subunit. 2D gel electrophoresis gave identification of Po, L7, L5, Sb, S19, S13 and L2 proteins in SLE, S3 and SjS, L35a and L37a in RA, and L7, S6 and/or L7a in MRL/1.     

Antigens of Mycobacterium leprae identified by immunoprecipitation with sera from leprosy and tuberculosis patients.

Mycobacterial antigens which react with human B lymphocytes were investigated by immunoprecipitation of radiolabelled sonicates of Mycobacterium leprae and M. bovis (BCG) with sera from patients with leprosy and tuberculosis in the presence of Staphylococcus aureus. SDS-PAGE analysis of the immunoprecipitates demonstrated that dense bands of Mr 12,000 (12K), 15K, 27K, 32-33K, 36K and 48K were the major antigens of M. leprae recognized by antibodies in lepromatous leprosy sera. Of these, only the 15-16K band reacted significantly with sera from patients with tuberculoid leprosy and tuberculosis. Other antigens including the T cell immunogens of Mr 18K and 70K reacted with some of the BL/LL sera tested. There were differences in the pattern of antigens precipitated from BCG sonicate by leprosy sera with the 65K antigen and a high molecular weight band (greater than 94K) being readily detected. These results differ in part to these obtained by probing immunoblots of M. leprae sonicate with leprosy sera. Factors contributing to these differences are discussed.     

Microflora in patients with systemic connective tissue diseases

The study of microflora of skin, mucous tunic of nose and mouth, and the quantitative and qualitative structure of the intestinal and urinal microflora in cases of systemic connective tissues diseases, are reproduced. The decrease of the dominant state of typical representatives, and the increase of the role of pseudopathogenic bacteria in various biotypes, were observed. The frequency of S. aureus detection increased in skin, mucous tunic of nose and mouth. Pseudopathogenic microbes acquired greater significance in the forming of microbiocenosis of intestine, while the number of E. coli, Bifidobacterium and Lactobacterium decreased. The frequency of detection of microbes in urine decreased. The comparative analyses of the microflora in patients with systemic lupus erythromatosis and progressive systemic sclerosis demonstrated the common peculiarities for microflora character change.     

Antinuclear antibodies in Thai patients with connective tissue diseases

A study of antinuclear antibodies (ANA) among Thai patients with various connective tissue diseases revealed that the prevalence of ANA was similar to that in other countries, but that the ANA patterns showed interesting contrasts in most diseases. Rather than the predominant homogeneous pattern seen elsewhere in systemic lupus erythematosus and rheumatoid arthritis, the speckled pattern was commonest among Thai patients with these two diseases (67.9% and 76.9% respectively). Patients with scleroderma exhibited a much lower percentage of the nucleolar pattern (17%) than reported elsewhere. The discrepancy between our findings and those from other studies may reflect differences in genetics, the environment or the severity of disease.     

Detection of anti-early endosome antigen 1 antibody in sera showing cytoplasmic vesicular staining,taken from patients with connective tissue diseases

An early endosome antigen previously reported by F.T. Mu could be stained on cytoplasmic vesicles of HEp-2 cells. Here, we have investigated autoantibodies against cytoplasmic vesicular antigens, especially against early endosome antigen 1. Twelve sera were selected on the basis of cytoplasmic vesicular staining patterns of HEp-2 cells. Protein-immunoprecipitation using 35S-methionine labeled HeLa lysates, and RNA immunoprecipitation using 32P-labeled HeLa lysates were conducted to characterize the cognate antigens. Nine of 12 sera reacted with proteins in the range of 162-180 kDa, three of which were found to react specifically with the 162 kDa 35S methionine labeled recombinant early endosome antigen 1. These proteins were not associated with common RNA. Although complete clinical information was not available, some of the patients had rheumatoid arthritis(RA). In addition, the RNA-IPP results suggest that other patients included one each with SLE, SSc, polymyositis, and Sj?gren's syndrome. Anti-early endosome antigen 1 antibody was found in 25%(3 of 12) of sera known to stain cytoplasmic vesicles. The reactive sera came mostly from patients with RA. The sera was from one case each of clinical-confirmed RA, SLE and Sj?gren's syndrome.     

Reduced zinc in peripheral blood cells from patients with inflammatory connective tissue diseases

By the use of the nuclear microprobe technique, the concentrations of zinc in isolated erythrocytes, platelets, and granulocytes were measured in patients with rheumatoid arthritis, other inflammatory arthritides, and scleroderma. Markedly reduced cellular zinc values were found compared to those measured in healthy subjects. No relation was found to inflammatory activity or disease duration. Plasma zinc was reduced in the majority of the patients and was negatively correlated to the inflammatory activity estimated by ESR and serum orosomucoid. No relation was found between total zinc values in plasma or cells or disease duration. Corticosteroid therapy was instituted in a number of the patients with inflammatory arthritides and induced a significant elevation of total zinc in all cell types, although normalization was not acheived. Plasma zinc values remained unchanged during the treatment.Supported by grants from the Swedish Medical Research Council, the Swedish Natural Science Research Council, and Pharmacia A. B.     

SS-B/La antigen purification, and ELISA detection of anti-SS-B/La antibodies in sera from patients with inflammatory connective tissue diseases

SS-B/La antigen was purified by immunoadsorbent columns with immunoglobulin from a patient with primary Sjögren's syndrome. Monitoring of the purification was facilitated by the fused rocket-immunoelectrophoresis technique. Technical ELISA variables for the detection of serum antibodies against the SS-B/La antigen were evaluated, and a recommended procedure is described. Prospective investigation of anti-SS-B/La antibodies in 103 blood donors and 131 patients with chronic inflammatory connective tissue diseases, including 43 patients with primary Sjögren's syndrome was performed. Anti-SS-B/La antibody concentrations were above normal in 65% of the patients with primary Sjögren's syndrome (verified by the strictly objective Copenhagen criteria for keratoconjunctivitis sicca and xerostomia) and 9% of patients with other chronic connective tissue diseases. The predictive value for primary Sjögren's syndrome among patients with increased levels of the anti-SS-B/La antibodies attending a rheumatology clinic was 78%.     

Antinuclear matrix antibody. Hidden antinuclear antibody in patients with connective tissue diseases

A total of 435 serum samples from patients with different rheumatic diseases were screened for the presence of autoantibody to nuclear matrix components by indirect immunofluorescence on 0.1 mol/L HCl extracted HEp-2 cell and WiL2 cell substrates. A total of 28 specimens were positive in this assay. Eighteen of them were from patients with systemic lupus erythematosus (18 of 250), 2 from patients with rheumatoid arthritis (2 of 115), and 8 from patients with mixed connective tissue disease (8 of 10). Antigenic material for this antibody is resistant to DNase, partially sensitive to RNase, and sensitive to trypsin. This indicates that the antigen is composed of protein and possibly RNA. In immunoblot analysis, sera positive for this antibody in indirect immunofluorescence assay recognized different peptides. This suggests that protein peptides are the major antigenic material.