Renal histology and clinical course of systemic lupus erythematosus

Thirty women with systemic lupus erythematosus were categorized into groups with and without significant renal involvement on the basis of renal biopsy and subsequently followed for an average of 9.4 years. At this time 53% of the patients with renal disease and 70% of the “nonrenal” patients had died. While 80% of the deaths in the “renal” group were due to renal disease, none of the nonrenal patients died of this complication. Major central nervous system involvement was eventually noted in 100% of the nonrenal group. After 8.3 years, mortality in the nonrenal patients exceeded that in the renal group, mainly because of the emergence of central nervous system disease.     

A sensitive solid phase microradioimmunoassay for anti-double stranded DNA antibodies

A sensitive solid phase microradioimmu-noassay has been developed for measurement of antidouble stranded DNA (dsDNA) antibodies. In this procedure, advantage has been taken of the capacity of poly-L-lysine (PLL) to facilitate the binding of pure dsDNA to plastic surfaces. In the absence of PLL, binding did not occur. Diluted sera were incubated in PLL-treated dsDNA-coated microtitration trays and anti-dsDNA Ig was measured using affinity purified¹²⁵I-anti-Ig of high specific activity. The synthetic DNA, poly dA-dT, was used as a model for dsDNA. In initial experiments, specific anti-DNA binding could not be demonstrated because of high background binding of patient Ig to PLL-treated surfaces. This was reduced by diluting test sera and anti-Ig in buffer containing 2% BGG and 1% BSA. Specificity of the assay for DNA was demonstrated by absorbing the anti-DNA activity on DNA-coated plastic. The binding of systemic lupus erythema-tosus (SLE) patient serum Ig to poly dA-dT coated trays did not diminish after digestion with nuclease S¹, suggesting that the synthetic polymer is an appropriate model for dsDNA. Patient and normal sera were screened for anti-dsDNA activity using poly dA-dT as antigen. None of the 38 normal sera, 23 of 35 active SLE sera, 1 of 25 treated SLE, 4 of 35 rheumatoid arthritis, 3 of 35 scleroderma, and 1 of 13 polymyositis sera demonstrated positive anti-dsDNA activity. The anti-dsDNA values obtained in the radioimmunoassay correlated significantly with those obtained in the Crithidia luciliae assay.     

Gold-induced changes in the morphology and functional capabilities of human monocytes

The capacity of gold compounds to induce morphologic changes and alterations in the functional activity of human mononuclear phagocytes (MΦ) in vitro was examined. Human peripheral blood mononuclear cells were incubated with gold sodium thiomalate (25 μg/ml) for 96 hours. As a result, MΦ developed electron dense precipitates within phagolysosomes, as well as marked dilatation of these organelles. Gold incubation also altered a number of MΦ functions. While viability and adherence were unaffected, the capacity to spread on surfaces was diminished. Pinocytosis of soluble proteins and phagocytosis of opsonized sheep erythrocytes were impaired, but Fc mediated particle binding was not. These data indicate that gold can alter certain functional activities of MΦ and support the idea that the major action of gold in rheumatoid arthritis results from its capacity to alter MΦ function.     

Lymphokines in the rheumatoid joint

Joint fluids and culture supernatants of synovial tissue were examined for the presence of two lymphokines. Migration inhibitory activity was found in 16 of 22 rheumatoid fluids (73%), in 3 of 15 osteoarthritis fluids (20%), and in 3 of 11 fluids from patients with various inflammatory arthritides (27%). Blastogenic activity was present in 14 of 15 rheumatoid fluids and in 1 of 7 nonrheumatoid effusions. The active materials eluted with the third peak from Sephadex G-200 and were therefore smaller than immunoglobulin or immune complexes. These findings suggest that lymphokine-like substances were present in effusions and synovial tissue of most patients with rheumatoid arthritis and some patients with other forms of chronic synovitis.