Mitchell L A, Décarie D, Shukin R, Tingle A J, Ford D K, Lacroix M, Zrein M
Department of Pathology, University of British Columbia, Vancouver, Canada.
Ann Rheum Dis. 1993 Aug;52(8):590-4. doi: 10.1136/ard.52.8.590.
Immune recognition of the major structural proteins of rubella virus by peripheral blood mononuclear cells and synovial inflammatory infiltrates of a patient with documented chronic rubella associated arthritis was compared with responses of normal healthy rubella virus immunoreactive subjects to establish if there were unusual response patterns associated with rubella associated arthritis in this subject.
Synthetic peptides (16-33 amino acids in length) representing selected amino acid sequences of the rubella virus envelope (E1 and E2) and capsid (C) proteins were used in lymphocyte stimulation assays with peripheral blood mononuclear cells or synovial inflammatory infiltrates to determine T lymphocyte recognition of antigenic sites within the synthetic peptides. A rubella virus specific polymerase chain reaction was used to determine the persistence of rubella virus in the patient's cells.
The patient's peripheral blood mononuclear cells showed abnormally increased lymphoproliferative responses to three E1 synthetic peptides encompassing residues 219-234, 389-411, and 462-481, and one E2 synthetic peptide containing the sequence 50-72, of which the last three were predicted to contain T cell antigenic sites. Although the patient's peripheral blood mononuclear cells showed positive proliferative responses to C synthetic peptides, these were not unusual. The number of synthetic peptides within the E1, E2, and C panels recognised by the patient's peripheral blood mononuclear cells was greater than was previously observed in normal healthy subjects. The recognition of synthetic peptides by synovial inflammatory infiltrates was similar to peripheral blood mononuclear cells but the responses measured were lower. The polymerase chain reaction was negative for rubella virus detection in peripheral blood mononuclear cells and synovial inflammatory infiltrates.
Abnormally increased T cell recognition of antigenic sites within rubella virus E1 and E2 proteins observed in this patient with rubella associated arthritis suggests chronic antigenaemia due to persistent rubella virus in tissue sites other than peripheral blood mononuclear cells or synovial inflammatory infiltrates.
将一名确诊为慢性风疹相关性关节炎患者的外周血单核细胞和滑膜炎性浸润物对风疹病毒主要结构蛋白的免疫识别，与正常健康的风疹病毒免疫反应性受试者的反应进行比较，以确定该患者是否存在与风疹相关性关节炎相关的异常反应模式。
使用代表风疹病毒包膜（E1和E2）和衣壳（C）蛋白选定氨基酸序列的合成肽（长度为16 - 33个氨基酸），对外周血单核细胞或滑膜炎性浸润物进行淋巴细胞刺激试验，以确定T淋巴细胞对合成肽内抗原位点的识别。采用风疹病毒特异性聚合酶链反应来确定风疹病毒在患者细胞中的持续性。
患者的外周血单核细胞对三种E1合成肽（包含残基219 - 234、389 - 411和462 - 481）以及一种包含序列50 - 72的E2合成肽显示出异常增加的淋巴细胞增殖反应，其中后三种合成肽预计含有T细胞抗原位点。虽然患者的外周血单核细胞对C合成肽显示出阳性增殖反应，但这些反应并无异常。患者外周血单核细胞识别的E1、E2和C组合成肽数量比之前在正常健康受试者中观察到的更多。滑膜炎性浸润物对合成肽的识别与外周血单核细胞相似，但所测反应较低。外周血单核细胞和滑膜炎性浸润物的聚合酶链反应风疹病毒检测均为阴性。
在该风疹相关性关节炎患者中观察到的对风疹病毒E1和E2蛋白内抗原位点的T细胞识别异常增加，提示除外周血单核细胞或滑膜炎性浸润物外，组织部位存在持续性风疹病毒导致慢性抗原血症。
