Williams R W, Malone C C, Silvestris F
Department of Medicine, College of Medicine, University of Florida, Gainesville 32610, USA.
J Lab Clin Med. 1995 Jul;126(1):44-56.
Patients with active systemic lupus erythematosus (SLE) with disease worsening or severe flares frequently show very low levels of serum immunoglobulin G (IgG) anti-F(ab')2 antibody. Anti-F(ab')2 antibody probably represents a polyclonal collection of generic anti-idiotypic antibodies involved in immune homeostasis. We synthesized the entire variable regions of the heavy and light chains (VH and VL) of two monoclonal anti-DNA antibodies, V88 and 2A4, as overlapping 7-mers on small polypropylene pins and tested these linear segments of anti-DNA V-regions for reactivity against serum samples from 10 normal subjects with high serum IgG anti-F(ab')2, 11 normal subjects with low anti-F(ab')2, 5 patients with SLE with active uncontrolled disease, 3 patients with SLE in remission, and 8 unaffected normal first-degree SLE relatives. VH and VL regions of a human monoclonal IgG anti-rabies antibody were also tested as a control. Concordant IgG antibody reacting with the same complementarity-determining regions (CDRs) was arbitrarily scored as indicative of the presence of anti-idiotypic antibody in test serum samples. Among normal subjects with either high or low serum anti-F(ab')2 levels, 10% to 21% showed strong concordant anti-CDR reactions with either the monoclonal anti-DNA or the control monoclonal anti-rabies V-region sequences. However, all patients with active SLE showed no detectable anti-CDR-reactive antibody. Patients with SLE in remission often showed return of strong concordant anti-CDR antibody. Normal unaffected SLE relatives also showed high levels of anti-CDR reactivity for both monoclonal anti-DNA and anti-rabies antibody sequences.
患有活动性系统性红斑狼疮（SLE）且病情恶化或严重发作的患者，其血清免疫球蛋白G（IgG）抗F(ab')2抗体水平通常非常低。抗F(ab')2抗体可能代表参与免疫稳态的通用抗独特型抗体的多克隆集合。我们在小聚丙烯针上合成了两种单克隆抗DNA抗体V88和2A4重链和轻链的整个可变区（VH和VL），作为重叠7聚体，并测试了这些抗DNA V区的线性片段与10名血清IgG抗F(ab')2水平高的正常受试者、11名抗F(ab')2水平低的正常受试者、5名患有活动性未控制疾病的SLE患者、3名处于缓解期的SLE患者以及8名未受影响的正常SLE一级亲属的血清样本的反应性。还测试了人单克隆IgG抗狂犬病抗体的VH和VL区作为对照。与相同互补决定区（CDR）反应的一致IgG抗体被任意评分，以表明测试血清样本中存在抗独特型抗体。在血清抗F(ab')2水平高或低的正常受试者中，10%至21%表现出与单克隆抗DNA或对照单克隆抗狂犬病V区序列强烈的一致抗CDR反应。然而，所有活动性SLE患者均未检测到抗CDR反应性抗体。处于缓解期的SLE患者通常表现出强烈的一致抗CDR抗体恢复。未受影响的正常SLE亲属对单克隆抗DNA和抗狂犬病抗体序列也表现出高水平的抗CDR反应性。
