Rossi F, Jayne D R, Lockwood C M, Kazatchkine M D
INSERM U28, Hôpital Broussais, Paris, France.
Clin Exp Immunol. 1991 Feb;83(2):298-303. doi: 10.1111/j.1365-2249.1991.tb05631.x.
Anti-neutrophil cytoplasmic antigen (ANCA) activity was inhibited in 15 out of 21 sera from patients with acute systemic vasculitis following incubation with normal polyspecific IgG for therapeutic use (IVIg). ANCA antibodies reacted with IVIg through idiotypic-anti-idiotypic interactions, as shown in competitive binding assays using F(ab')2 fragments from IVIg and affinity chromatography of ANCA IgG on Sepharose-bound F(ab')2 fragments from IVIg. Co-incubation of sera from patients with acute systemic vasculitis with paired autologous remission stage sera also resulted in inhibition of ANCA activity in acute sera. Remission sera contain IgM and IgG capable of interacting with beta and or alpha idiotypes of ANCA IgG from acute sera. Anti-idiotypic IgM may account for the lack of expression of ANCA activity in whole serum from patients in remission from systemic vasculitis, which were found to contain high titres of ANCA IgG. These observations suggest that remission of systemic vasculitis is associated with the generation of anti-idiotypes against autoantibodies rather than the suppression of production of ANCA autoantibodies. IVIg may modulate the activity of systemic vasculitis in vivo.
在21例急性系统性血管炎患者的血清中，有15例在与治疗用正常多特异性IgG（静脉注射免疫球蛋白，IVIg）孵育后，抗中性粒细胞胞浆抗原（ANCA）活性受到抑制。ANCA抗体通过独特型 - 抗独特型相互作用与IVIg反应，如使用IVIg的F(ab')2片段进行的竞争性结合试验以及ANCA IgG在与IVIg的Sepharose结合的F(ab')2片段上的亲和层析所示。将急性系统性血管炎患者的血清与配对的自身缓解期血清共同孵育，也导致急性血清中ANCA活性受到抑制。缓解期血清含有能够与急性血清中ANCA IgG的β和/或α独特型相互作用的IgM和IgG。抗独特型IgM可能解释了系统性血管炎缓解期患者全血清中ANCA活性缺乏表达的现象，这些患者的血清中发现含有高滴度的ANCA IgG。这些观察结果表明，系统性血管炎的缓解与针对自身抗体的抗独特型的产生有关，而不是ANCA自身抗体产生的抑制。IVIg可能在体内调节系统性血管炎的活性。
