Robbins D L, Skilling J, Benisek W F, Wistar R
Arthritis Rheum. 1986 Jun;29(6):722-9. doi: 10.1002/art.1780290604.
19S IgM rheumatoid factors (RF) may play an important role in sustaining inflammation in rheumatoid arthritis (RA). As yet, no unique antigenic specificity for RF in RA has been identified. Because the synovium is central to the pathogenic changes in RA, RF produced therein might be pathogenically more important than serum RF. Therefore, we examined the reactivity and relative avidity of 19S IgM-RF in serum and rheumatoid synovial cells (RSC) from 20 patients with seropositive RA. Reactivities were determined by competitive inhibition of serum RF hemolytic activity and RSC RF-plaque-forming cells (PFC) by added soluble antigen, i.e., monomeric human IgG subclasses. Estimation of relative avidities of RSC RF for human IgG subclasses was done by calculation of fractional RF expression in the RSC RF-PFC assay following inhibition by IgG subclasses. RSC RF had greatest reactivity with IgG3 and IgG1, some reactivity with IgG2, and the least reactivity with IgG4. Serum RF reacted most with IgG1 and IgG2, reacted some with IgG4, but reacted poorly with IgG3. The antigenic determinants with which RSC RF reacted were common to many IgG3 molecules. The highest relative avidity of RSC RF was for IgG3. These observations indicate a selective deficiency of serum RF compared with RSC RF and suggest an important pathogenic role for these qualitatively different RSC RF molecules for in situ RF immune complex-mediated inflammation in RA synovial tissue.
19S IgM类风湿因子(RF)可能在类风湿关节炎(RA)的炎症持续中发挥重要作用。迄今为止,尚未确定RA中RF的独特抗原特异性。由于滑膜是RA致病变化的核心,滑膜中产生的RF在致病性方面可能比血清RF更重要。因此,我们检测了20例血清阳性RA患者血清和类风湿滑膜细胞(RSC)中19S IgM-RF的反应性和相对亲和力。通过添加可溶性抗原(即单体人IgG亚类)竞争性抑制血清RF溶血活性和RSC RF空斑形成细胞(PFC)来确定反应性。通过计算IgG亚类抑制后RSC RF-PFC试验中的分数RF表达来估计RSC RF对人IgG亚类的相对亲和力。RSC RF与IgG3和IgG1反应性最强,与IgG2有一些反应性,与IgG4反应性最弱。血清RF与IgG1和IgG2反应最强,与IgG4有一些反应,但与IgG3反应较弱。RSC RF反应的抗原决定簇在许多IgG3分子中是常见的。RSC RF对IgG3的相对亲和力最高。这些观察结果表明,与RSC RF相比,血清RF存在选择性缺陷,并提示这些性质不同的RSC RF分子在RA滑膜组织中原位RF免疫复合物介导的炎症中起重要的致病作用。