Gale R, Bertouch J V, Bradley J, Roberts-Thomson P J
Ann Rheum Dis. 1983 Apr;42(2):158-62. doi: 10.1136/ard.42.2.158.
The majority of paired sera and synovial fluids from 21 patients with rheumatoid arthritis produced a rapid chemiluminescent response when incubated with human neutrophils. Synovial fluid gave considerably higher responses than the paired serum specimen. In contrast little or no response was found with paired sera and joint fluid taken from patients with gout, psoriasis, and osteoarthritis and with sera from healthy donors. A similar chemiluminescent response was observed when neutrophils were preincubated with large aggregates of heated human gammaglobulin (HAGG), which were used as a model of immune complexes. Smaller nonreactive aggregates of gammaglobulin became reactive after preincubation with a purified monoclonal rheumatoid factor (mRF) which had a high avidity for aggregated IgG. The addition of this monoclonal rheumatoid factor also caused enhancement of chemiluminescence by rheumatoid sera. Further evidence suggesting that the active material found in these rheumatoid specimens contained complexed immunoglobulin was obtained by indirect immunofluorescence. Neutrophils developed intracellular immunoglobulin inclusions after preincubation in reactive rheumatoid sera but not with nonreactive or normal sera. However, activation of neutrophil chemiluminescence by rheumatoid specimens did not correlate significantly with levels of rheumatoid factor or immune complexes suggesting that the activating complexes were of a particular type. In conclusion we have shown the direct activation of neutrophil chemiluminescence by rheumatoid sera synovial fluid and suggest that the activation is caused by large IgG-containing immune complexes. It is possible that this activation may have important implications in the immunopathogenesis of the rheumatoid inflammatory process.
21例类风湿性关节炎患者的大多数配对血清和滑液在与人中性粒细胞孵育时会产生快速化学发光反应。滑液产生的反应比配对血清标本高得多。相比之下，痛风、银屑病和骨关节炎患者的配对血清和关节液以及健康供体的血清几乎没有反应或没有反应。当中性粒细胞与加热的人γ球蛋白（HAGG）大聚集体预孵育时，观察到类似的化学发光反应，HAGG用作免疫复合物的模型。γ球蛋白较小的无反应聚集体在与对聚集IgG具有高亲和力的纯化单克隆类风湿因子（mRF）预孵育后变得有反应。添加这种单克隆类风湿因子也会导致类风湿血清增强化学发光。通过间接免疫荧光获得了进一步的证据，表明这些类风湿标本中发现的活性物质含有复合免疫球蛋白。中性粒细胞在反应性类风湿血清中预孵育后会形成细胞内免疫球蛋白包涵体，但在无反应或正常血清中则不会。然而，类风湿标本对中性粒细胞化学发光的激活与类风湿因子或免疫复合物的水平没有显著相关性，这表明激活复合物是特定类型的。总之，我们已经证明类风湿血清和滑液可直接激活中性粒细胞化学发光，并表明这种激活是由含大量IgG的免疫复合物引起的。这种激活可能在类风湿炎症过程的免疫发病机制中具有重要意义。
