Wands J R, LaMont J T, Mann E, Isselbacher K J
N Engl J Med. 1976 Jan 15;294(3):121-4. doi: 10.1056/NEJM197601152940301.
Five patients were studied after intestinal-bypass operations for morbid obesity to determine if the arthritis observed in three of these patients was associated with circulating cryoproteins. Only serum from the three patients with acute arthritis contained cryoprotein complexes. The complexes comprised IgG, IgM, IgA, complement components C3, C4, C5 and IgG antibody against Escherichia coli and Bacillus fragilis. The C3-activator fragment of the properdin complex was identified in fresh serum samples obtained from two of the three patients with circulating cryoprotein complexes and arthritis. These observations suggest that systemically absorbed intestinal bacterial antigens may lead to (or contribute to) the formation of circulating cryoprotein complexes. Circulating cryoprotein complexes activated both the classical and alternate complement pathways and may be important in the pathogenesis of the arthritis associated with the intestinal-bypass procedure for morbid obesity.
对5例因病态肥胖接受肠道旁路手术的患者进行了研究，以确定其中3例患者所观察到的关节炎是否与循环冷球蛋白有关。只有3例患急性关节炎患者的血清含有冷球蛋白复合物。这些复合物包含IgG、IgM、IgA、补体成分C3、C4、C5以及抗大肠杆菌和脆弱拟杆菌的IgG抗体。在3例有循环冷球蛋白复合物和关节炎患者中的2例所获取的新鲜血清样本中，鉴定出备解素复合物的C3激活片段。这些观察结果表明，全身吸收的肠道细菌抗原可能导致（或促成）循环冷球蛋白复合物的形成。循环冷球蛋白复合物激活了经典和替代补体途径，并且在与病态肥胖肠道旁路手术相关的关节炎发病机制中可能起重要作用。
