Pennebaker J B, Gilliam J N, Ziff M
J Clin Invest. 1977 Dec;60(6):1331-8. doi: 10.1172/JCI108892.
36 systemic lupus erythematosus patients with native DNA binding activity (nDNA-BA) in the serum and subepidermal immunoglobulin deposits were studied to determine the relationship of the immunoglobulin (Ig) class distribution of serum nDNA-BA to the clinical characteristics of their disease and to the Ig class present at the dermal-epidermal junction (DEJ). The patients with predominantly (86-98%) IgM nDNA-BA in the serum had less active disease, mild or no renal involvement, and longer survival than those with predominantly (51-95%) IgG nDNA-BA in the serum. Renal biopsies in eight patients with predominantly IgM nDNA-BA in the serum showed relatively benign histologic changes in the kidney. In contrast, renal tissue from 23 patients with predominantly IgG nDNA-BA showed more severe histologic changes. All patients had multiple skin biopsies. Patients with predominantly IgM nDNA-BA consistently had only IgM at the DEJ. Patients with predominantly IgG nDNA-BA had IgG, usually in association with IgM, at the DEJ. The findings demonstrate that a minority of systemic lupus erythematosus patients may exhibit a limited anti-nDNA response characterized by the presence of chiefly IgM nDNA-BA in the serum and that this is reflected by the presence of mild disease and IgM alone at the DEJ. The development of IgG nDNA-BA is associated with more severe and active disease.
对36例血清中具有天然DNA结合活性（nDNA-BA）且存在表皮下免疫球蛋白沉积的系统性红斑狼疮患者进行了研究，以确定血清nDNA-BA的免疫球蛋白（Ig）类别分布与其疾病临床特征以及真皮-表皮交界处（DEJ）存在的Ig类别之间的关系。血清中主要为（86-98%）IgM nDNA-BA的患者，与血清中主要为（51-95%）IgG nDNA-BA的患者相比，疾病活动度较低，肾脏受累较轻或无肾脏受累，生存期更长。对8例血清中主要为IgM nDNA-BA的患者进行肾活检，结果显示肾脏组织学改变相对良性。相比之下，23例血清中主要为IgG nDNA-BA的患者的肾组织显示出更严重的组织学改变。所有患者均进行了多次皮肤活检。血清中主要为IgM nDNA-BA的患者在DEJ始终仅存在IgM。血清中主要为IgG nDNA-BA的患者在DEJ存在IgG，通常与IgM同时存在。这些发现表明，少数系统性红斑狼疮患者可能表现出有限的抗nDNA反应，其特征是血清中主要存在IgM nDNA-BA，并且这反映在疾病较轻以及DEJ仅存在IgM上。IgG nDNA-BA的出现与更严重和活跃的疾病相关。
