Interplay of four Idiotypes and Interaction with Autoantibodies in Lupus Patients, their Relatives and their Spouses

Our aim was to investigate links between systemic lupus erythematosus (SLE)-associated autoantibodies, idiotypes (Id) and genetic predisposition to their development. We studied four public Ids (16/6, WRI 176β, RT72 and RT84), identified the Km and Gm phenotypes and sought six selected autoantibodies in 32 SLE patients, 174 of their relatives and 15 spouses. Though anti-double-stranded DNA antibody was uncommon in the relatives (9%), the range of antinuclear reactivities was as broad in the relatives as in the probands. Antibodies to the synthetic peptide U1-RNP-A 35–38 were found in 56% of the patients, 28% of their relatives and 20% of the spouses, whereas antibodies to the Golgi apparatus was present in 7% of the patients, 26% of their relatives and 33% of the spouses. However, most of these family members were unaffected. RT84 Id was positively associated with antibodies to Sm-D peptide 1–20 and to Ro/SSA 60 kD peptide 304–324, but negatively associated with anti-dsDNA activity. The median of age was significantly lower in the RT84 Id-positive than in the RT84 Id-negative individuals. These data suggest that genetic as well as environmental factors are involved in the aetiology of SLE. In addition, RT84-carrying immunoglobulins (Ab2) might be directed to one of many cross-reactive Ids of dsDNA-binding antibodies (Ab1), perhaps down-regulating their production.     

Drug induced impairment of polymorphonuclear cell bactericidal ability in rheumatoid arthritis.

Thirty three patients with rheumatoid arthritis (RA) treated only with non-steroidal anti-inflammatory drugs were divided into two groups according to the drug received (group A: diclofenac, group B: indomethacin or ketoprofen), and their polymorphonuclear (PMN) cell functions were investigated. We found that bactericidal ability was the only function significantly impaired in group A as compared with group B patients and normal controls. This modification correlated well with the reduction of control PMN bactericidal ability when this test was carried out in patient plasma. These differences between drug effects might explain some of the discrepancies between reports of PMN cell functions in RA.     

The antibody repertoire of early human B cells. II: Expression of anti-DNA-related idiotypes

Cord blood B cells were immortalized in vitro with Epstein-Barr virus (EBV). Supernatants containing greater than 500 ng/ml IgM from clones/lines were tested for expression of anti-DNA-associated 16/6 and PR4 idiotypes (id) by ELISA. Four of 70 lines, but no clones, were positive for 16/6 id and none expressed the PR4 id. The presence of 16/6 id on four cell lines was associated with specificity for ssDNA, cardiolipin and Fc of IgG. No association was seen with binding to the K30 polysaccharide of Klebsiella. One clone binding this antigen also had anti-ssDNA, anti-Fc and anti-cardiolipin activity but did not express 16/6 id. Our data support the germ-line nature of the 16/6 id and are consistent with the notion that IgM autoantibody-producing B cells use VH genes which are part of the normal B cell repertoire.     

Salivary lactoferrin in primary Sj?gren's syndrome

Parotid salivary lactoferrin (LF) levels were measured in 26 patients with Sj?gren's syndrome (SS), 19 patients with keratoconjunctivitis sicca (KCS) and 32 normal controls, by using a radial-immunodiffusion technique. The levels of LF were higher in SS than in KCS patients (23 +/- 21, 10 +/- 10, p less than 0.03) and in SS patients than in normals (7 +/- 6 micrograms/ml, p less than 0.001). There was some relationship of the LF level to the labial salivary gland histopathology grade.     

Survey of monoclonal gammopathy in western France: incidence and unexpected high frequency of IgM

The class distribution of 4193 monoclonal gammopathies (MG), detected over approximately 10 years in western France (WF), was compared to that established by a compilation of twenty-seven series from the literature. Several points emerged from this study: the incidence of the light chain MG (4.8%) was slightly lower than commonly observed (6.0%), the number of double MG higher (4.2%) than elsewhere (1-3%) and the IgM-MG much more frequent (33.0%) than anywhere else (16.2%).     

Mediastinal lymph node metastases from bronchogenic carcinoma: detection with MR imaging and CT

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in a prospective study of 48 patients for the detection of metastatic mediastinal lymphadenopathy from bronchogenic carcinoma. The images were interpreted by three experienced radiologists using a five-point rating scale, enabling receiver operating characteristic (ROC) analysis. Imaging results were evaluated against "truth" data based on analysis of surgical specimens from mediastinoscopy and thoracotomy. All MR images were cardiac gated to reduce cardiac motion artifacts in the mediastinum. MR and CT both performed well, as indicated by similar areas under the ROC curves of 0.779 +/- 0.039 for MR imaging and 0.781 +/- 0.038 for CT scanning. No strong correlation between nodal size and metastatic involvement could be found for either MR or CT results. As long as nodal size remains the sole criterion in the detection of metastatic mediastinal lymphadenopathy, MR imaging is unlikely to enable better interpretations than CT scanning.