Immunologic models used for the study of rheumatoid arthritis.
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Biomedical subjects
Publications and source records attributed to J D Smiley.
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The secondary immune response to tetanus toxoid in 14 patients with rheumatoid arthritis (RA) has been studied in suspension cultures of peripheral blood lymphocytes (PBL) and synovial membrane obtained at synovectomy. Sequential cultures of PBL from three normal subjects established the optimal time of antibody response at 5 days. At this time, the antitetanus antibody produced was predominantly IgG, comprising half of this immunoglobulin fraction. Rheumatoid synovium synthesized 5-9 times more IgG than PBL, expressed as per cent of total protein synthesis, but only negligible amounts of tetanus antibody. The same results were observed in synovial cultures following repeated immunization and after the additional intra-articular injection of tetanus antigen. This marked limitation of the synovium to respond to exogenous antigen in spite of its large immunoglobulin production was considered consistent with a prior commitment of the synovial lymphoid infiltrate to other antigen.
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A technique for the in vitro culture of rheumatoid synovial tissue with (14)C-amino acids and isolation and quantitation of the newly synthesized immunoglobulins has been developed. This technique has been used to compare immunoglobulin synthesis of 12 rheumatoid synovia with that of synovia from nonarthritic patients and with that of normal human lymph nodes and spleen. In addition, the spleen of a patient with Felty's syndrome has also been examined. Immunoglobulin synthesis in rheumatoid synovia has been shown to be quantitatively and qualitatively similar to that of normal human spleen and lymph nodes although somewhat less active than the Felty's syndrome spleen examined. 79% of the immunoglobulin produced in rheumatoid synovia was of the IgG type, whereas IgM comprised 10% and IgA, 11% of the total. Less than 10% of the IgM synthesized was found to be rheumatoid factor. A fraction containing approximately 90% of its radioactivity in the form of IgG has been obtained for further studies.
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Horseradish peroxidase (HRPO) conjugated with goat antihuman IgG, goat antihuman IgM, and aggregated human IgG has been used as a enzymatic marker to stain IgG, IgM, and rheumatoid factor in rheumatoid cartilage. When Hrpo-anti IgG and HRPO-anti IgM were used, immunoglobulin deposits were not observed in nonrheumatoid cartilage. However 7 of 8 rheumatoid cartilage specimens stained with HRPO-anti IgG showed electron-dense deposits. Three rheumatoid specimens stained with HRPO-anti IgM showed similar findings. Both of 2 rheumatoid specimens also stained positively with HRPO conjugated with aggregated IgG, a finding indicating that rheumatoid factor was present. The deposits were seen between the collagen fibers of the superficial layer of the cartilage to a maximal depth of 22 mu from the surface (average: 7 mu). The amorphous fibrinous material on the surface of the cartilage was also stained. The demonstration of IgG, IgM, and rheumatoid factor in the superficial zone of rheumatoid cartilage suggests that immune complexes are deposited in the cartilage in this disease.