Calvanico N J
Medical College of Wisconsin, Milwaukee.
Dermatol Clin. 1993 Jul;11(3):379-89.
Only within the last 5 years have data on variable region sequences of autoantibodies begun to accumulate. Although it is too early to draw final conclusions, certain principles are beginning to emerge. It is clear that self-recognition by the immune system is normal. This fact is supported by the anti-idiotype network and the presence of natural autoantibody in normal sera. Furthermore, there appears to be a connection between these phenomena because the former may serve to keep the latter in check. Natural autoantibody appears to be primarily IgM polyreactive antibody of low affinity, quite different from the monospecific high-affinity IgG antibody usually associated with autoimmune disease. Natural autoantibodies also exhibit a high degree of cross-reactive idiotypes and are the products of CD5+ B cells, whereas IgG autoantibody is not. This is only a generalization, however, and it must be kept in mind that IgG autoantibody polyreactive with several autoantigens has been reported for normal sera of mice and humans. In Balb/c sera, a significant proportion of natural autoantibody is IgG, but it is apparently masked by inhibitory polyreactive IgM antibody that has affinity for IgG autoantibody, thereby exhibiting a regulatory role. A human CD5+ B-cell clone that secretes a high-affinity IgM anti-idiotype-specific antibody has been reported. Another generalization that is beginning to emerge is that natural autoantibodies are the products of unmutated germline genes, whereas autoantibody associated with autoimmune disease has highly mutated VH and VL segments. Mutations exhibited by pathogenic autoantibody increase the antibody's affinity for autoantigen and therefore represent an antigen-selected or affinity maturation, resulting in more restricted heterogeneity. In contrast to this, polyreactive natural antibodies have variable regions that are essentially identical to germline gene V segments with few amino acid changes. However, it is important to note that pathologic autoantibodies arise from the same fetal genes that give rise to natural autoantibodies and antibodies against foreign antigens. There does not appear to be a set of genes specific for autoantibodies. The key question then becomes whether or not natural autoantibodies are precursors of pathogenic autoantibodies. If not, what is the function of natural autoantibodies and how do pathogenic autoantibodies arise? The answers to these questions are not yet clear and many theories have been offered, but sufficient data are not yet available to reach conclusions. One of the problems in reaching a definitive conclusion is the ability to identify pathogenic antibody.(ABSTRACT TRUNCATED AT 400 WORDS)
仅在过去5年里,自身抗体可变区序列的数据才开始积累。虽然现在得出最终结论还为时过早,但某些原则已开始显现。很明显,免疫系统的自我识别是正常的。抗独特型网络以及正常血清中天然自身抗体的存在支持了这一事实。此外,这些现象之间似乎存在联系,因为前者可能起到控制后者的作用。天然自身抗体似乎主要是低亲和力的IgM多反应性抗体,与通常与自身免疫性疾病相关的单特异性高亲和力IgG抗体有很大不同。天然自身抗体还表现出高度的交叉反应独特型,是CD5+B细胞的产物,而IgG自身抗体则不是。然而,这只是一个普遍情况,必须记住,已报道小鼠和人类正常血清中存在与多种自身抗原发生多反应的IgG自身抗体。在Balb/c血清中,相当一部分天然自身抗体是IgG,但它显然被对IgG自身抗体有亲和力的抑制性多反应性IgM抗体所掩盖,从而发挥调节作用。已报道一个分泌高亲和力IgM抗独特型特异性抗体的人类CD5+B细胞克隆。另一个开始出现的普遍情况是,天然自身抗体是未突变的种系基因的产物,而与自身免疫性疾病相关的自身抗体具有高度突变的VH和VL区段。致病性自身抗体所表现出的突变增加了抗体对自身抗原的亲和力,因此代表了一种抗原选择或亲和力成熟,导致异质性更受限。与此相反,多反应性天然抗体的可变区与种系基因V区段基本相同,只有很少的氨基酸变化。然而,需要注意的是,病理性自身抗体与产生天然自身抗体和抗外来抗原抗体的胎儿基因相同。似乎不存在一组特定的自身抗体基因。那么关键问题就变成了天然自身抗体是否是致病性自身抗体的前体。如果不是,天然自身抗体的功能是什么,致病性自身抗体又是如何产生的?这些问题的答案尚不清楚,已经提出了许多理论,但目前还没有足够的数据得出结论。得出明确结论的一个问题是识别致病性抗体的能力。(摘要截选至400字)