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V L Esnault

Publications and source records attributed to V L Esnault.

40 records · Page 3Linked to original sources

Autoantibodies to myeloperoxidase in brown Norway rats treated with mercuric chloride.

BACKGROUND: Mercuric chloride (HgCl2) induces an autoimmune syndrome in Brown Norway (BN) rats characterized by the presence of a number of autoantibodies, including antibodies to glomerular basement membrane. Tissue injury has previously been reported to be rare in this model, but in the accompanying paper we describe changes in a number of organs including a necrotizing leucocytoclastic vasculitis in the gut. Myeloperoxidase (MPO) is one of the target antigens for anti-neutrophil cytoplasm antibodies, that are present in the majority of patients with the human autoimmune disease systemic vasculitis and have been implicated in pathogenesis. There is at present, no animal model for anti-neutrophil cytoplasm antibody positive systemic vasculitis. EXPERIMENTAL DESIGN: Ten BN rats were given five injections of HgCl2, each of 1 mg/kg, over 10 days. Sequential serum samples were tested for autoantibodies to MPO using solid phase assays, indirect immunofluorescence on normal rat neutrophils, and Western blot analysis. The specificity of these antibodies in the solid phase assay was confirmed by inhibition studies with purified antigen, and by testing binding to uncoated plates. Sera from control animals treated with saline were also tested. RESULTS: BN rats given HgCl2 developed antibodies to MPO, which in Western blots bound to similar determinants to those bound by human anti-MPO antibodies. The anti-MPO antibodies resolved spontaneously, with a time course similar to that of the anti-glomerular basement membrane antibodies, but there was no correlation between the two antibody responses in individual animals. There was no anti-MPO activity in sera taken before HgCl2 was given, nor in sera from saline-treated controls. CONCLUSIONS: BN rats treated with HgCl2 develop anti-MPO antibodies. Together with the description in the accompanying paper of necrotizing vasculitis in these animals, these observations suggest that HgCl2-induced autoimmunity in the BN rat may provide a useful model of anti-neutrophil cytoplasm antibody positive systemic vasculitis.

Animals↗

Captopril but not acebutolol, prazosin or indomethacin decreases postexercise proteinuria.

Strenuous physical exercise causes transient proteinuria and renal hemodynamic changes: decrease of renal blood flow and to a lesser extent of the glomerular filtration rate, and an increase of the filtration fraction. However, the mechanisms of these modifications are still poorly understood. In order to elucidate them we performed maximal exercise tests on 8 untrained healthy volunteers after inhibition of the renin-angiotensin system (RAS) by captopril, the sympathetic nervous system by a beta-blocking drug (acebutolol) or an alpha-blocking drug (prazosin) and the prostaglandin system by indomethacin. Urinary albumin excretion was measured in every subject first at rest (AB) and then after exercise (AA) performed successively without and with blockade by each of theses drugs. AA-AB difference in the captopril test (12.04 +/- 6.11 micrograms/min) compared to that in the control test (68.91 +/- 25.18 micrograms/min) was significantly reduced (p less than 0.02). This difference remained unchanged after acebutolol (59.87 +/- 21.91 micrograms/min, p = 0.62), prazosin (35.23 +/- 27.80 micrograms/min, p = 0.21) and indomethacin (55.21 +/- 28.43 micrograms/min, p = 0.35). There was a negative correlation between the lowering of AA elevation and the rise in plasma renin activity in the captopril test (r = 0.64; p less than 0.03). Only acebutolol decreased systolic blood pressure significantly. These results suggest that the RAS plays a major role in postexercise proteinuria. We hypothesize that stimulation of this system induces an increase of efferent glomerular artery constriction and consequently of glomerular transcapillary pressure and the filtration fraction. Captopril seems able to prevent these hemodynamic changes.

Acebutolol↗

IgG subclass distribution and relative functional affinity of anti-myeloperoxidase antibodies in systemic vasculitis at presentation and during follow-up.

Circulating IgG autoantibodies to myeloperoxidase (MPO) are associated with renal vasculitis and have been implicated in its pathogenesis. However, raised levels of these autoantibodies may persist during clinical remission. We tested whether this paradox could be explained by immunoglobulin subclass switching during disease evolution, since different subclasses have different immunological and biochemical properties. Sera with anti-myeloperoxidase (anti-MPO) activity from 33 patients with active disease and 20 anti-MPO positive follow-up sera were studied by an ELISA using a panel of anti-human IgG subclass monoclonal reagents previously calibrated on human myeloma proteins. Anti-MPO subclass distribution in initial sera was: IgG1, 31 (94%); IgG2, 10 (30%); IgG3, 24 (73%); and IgG4, 22 (67%). IgG3 anti-MPO decreased during follow-up (P less than 0.02), with no change in IgG1 and IgG4. Relative functional affinity of anti-MPO antibodies in purified IgG subclasses was studied by the diethylamine method. IgG3 fractions consistently had a greater affinity for MPO than the other subclasses. Sequential studies in four patients demonstrated an affinity maturation for IgG1 and IgG4 anti-MPO as IgG3 anti-MPO disappeared. We conclude that dynamic changes of subclass distribution and affinity may explain discrepancies between anti-MPO antibody titre and disease expression.

Antibody Affinity↗

Anti-neutrophil cytoplasm antibodies in patients with monoclonal gammopathies.

Anti-neutrophil cytoplasm antibodies (ANCA) are specific markers for systemic vasculitis. In view of the autoreactivity to other autoantigens reported in patients with monoclonal immunoglobulins (MIg), the reactivity of 150 sera from 125 patients with MIg was tested for ANCA by radioimmunoassay (RIA) with inhibition stage and indirect immunofluorescence (IIF). Seven were positive for IgG ANCA, all with IgG MIg and 5 were positive for IgM ANCA, 4 with IgM MIg and 1 with IgG MIg. No IgA ANCA were found. The patterns seen on IIF were identical to those seen with sera from patients with systemic vasculitis and were cytoplasmic in 6 and peri-nuclear in 6. The restriction of the ANCA activity to the MIg was studied in six sera by light chain specific RIA, and anion exchange fractionation of the sera. The ANCA activity appeared to be polyclonal in at least three sera and could be found in the monoclonal fraction in only three patients. Associated autoimmune diseases were found in some of these ANCA positive patients including Sjögren's syndrome, MacDuffie hypocomplementemic vasculitis and rheumatoid polyarthritis but the classical vasculitic features normally associated with ANCA were not observed. We conclude that ANCA is a further autoreactivity present in some sera with MIg and discuss the relation between monoclonal gammopathies and autoimmunity.

Aged↗