Gripenberg M, Teppo A M, Kurki P, Gripenberg G, Helve T
Fourth Department of Medicine, Helsinki University Central Hospital, Finland.
Scand J Rheumatol. 1988;17(4):249-54. doi: 10.3109/03009748809098793.
A total of 218 samples obtained during a follow-up study of 36 patients with systemic lupus erythematosus (SLE) were tested for the presence of cryoglobulins. Cold-insoluble precipitates were found in 81% for the patients (29 patients, 114 samples). The protein concentration of the cryoglobulins correlated significantly with the disease activity. Autoantibody activity was determined in the dissolved cryoglobulins and in corresponding serum samples by enzyme-linked immunosorbent assays (ELISA). IgM-RF could be demonstrated more often in the cryoglobulins than in the sera (75% vs. 14%), whereas IgA-RF were seen in 28% of both cryoglobulins and sera. Anti-ssDNA and anti-poly(A) antibodies of both IgG and IgM classes were found more often in the sera than in the corresponding cryoprecipitates. In 7 samples from 5 patients an increase in the IgG-anti-ssDNA activity was seen after DNase digestion of the cryoglobulins. Patients with Raynaud's syndrome had a significantly higher level of cryoprecipitating IgM class rheumatoid factors than other patients. There was also an association between the IgG-anti-poly(A) antibody levels in the cryoglobulins and the activity of the disease. There was no difference with regard to the composition of the cryoglobulins, between patients with nephritis and those without an overt renal disease. Thus, the presence of cryoglobulins in SLE indicates active disease, but not necessarily renal involvement. IgM rheumatoid factors may play a role in the pathogenesis of Raynaud's syndrome of SLE patients.
在一项对36例系统性红斑狼疮（SLE）患者的随访研究中，共检测了218份样本中的冷球蛋白。81%的患者（29例患者，114份样本）发现有冷不溶性沉淀物。冷球蛋白的蛋白质浓度与疾病活动度显著相关。通过酶联免疫吸附测定（ELISA）在溶解的冷球蛋白和相应血清样本中测定自身抗体活性。在冷球蛋白中比在血清中更常检测到IgM类风湿因子（RF）（75%对14%），而在冷球蛋白和血清中均有28%检测到IgA-RF。IgG和IgM类的抗单链DNA（ssDNA）和抗多聚（A）抗体在血清中比在相应的冷沉淀物中更常被检测到。在5例患者的7份样本中，冷球蛋白经DNA酶消化后，IgG抗ssDNA活性增加。患有雷诺综合征的患者其冷沉淀IgM类类风湿因子水平显著高于其他患者。冷球蛋白中的IgG抗多聚（A）抗体水平与疾病活动度之间也存在关联。肾炎患者和无明显肾脏疾病的患者在冷球蛋白组成方面没有差异。因此，SLE患者中冷球蛋白的存在表明疾病处于活动期，但不一定意味着肾脏受累。IgM类风湿因子可能在SLE患者雷诺综合征的发病机制中起作用。
