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In the period of 1975-1983 twenty-three patients with thromboangiitis obliterans were examined at the Surgical Clinic of the Medical Academy of Magdeburg. The diagnosis was established clinically, angiographically histologically and immunologically. In 7 out of 12 patients histology revealed inflammatory vascular alterations including lymphocyte infiltrates throughout the entire vessel wall and also in the perivascular area. Immunohistology showed in 10 out of 15 patients segmental granular fluorescence identifiable as deposits of IgM and IgG. In 6 cases a complement formation was found. The endangiitis group revealed more frequent and increased immune complexes concentrations. Circulating immune complexes were established by phase-locked radio-immunoassay. The therapy is depended on the localization of the obliteration and can be a lumbar sympathectomy or a vascular reconstruction.
Anticardiolipin antibodies of IgG/IgM class were detected in seven of 28 patients with systemic sclerosis including five of 16 patients severely affected by extensive visceral disease. This severely affected sub-group also showed significant elevations of plasma levels of von Willebrand factor antigen in 10 cases and serum C1q binding activity in seven cases respectively. This triple association raises the possibility that multiple immunological mechanisms are involved in the pathogenesis of systemic sclerosis and its vascular lesions.
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Circulating immune complexes (CIC) in the sera or ascites of hepatocellular carcinoma (HCC), chronic hepatitis patients and normal healthy persons were measured by polyethylene glycol (PEG) and C1q solid-phase microassay (C1q-SPMA). Both the PEG and C1q-SPMA methods showed the serum CIC levels of HCC patients were significantly higher than those of chronic hepatitis patients and of normal persons. The CIC levels of chronic hepatitis patients were also significantly higher than those of normal persons as detected by PEG method but not by C1q-SPMA. The ascites from HCC patients also had CIC. But the amount of CIC in ascites was significantly lower than those of the serum from the same HCC patients. These results suggest that the increase of CIC may play some pathological role in the HCC patients.
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The radial immunodiffusion assay overestimates the C1q in serum. Here we describe a convenient, accurate procedure for measuring C1q in 250 microL of dialyzed serum. This method is based on our previous findings that all C1q in serum precipitates with the euglobulin fraction and that all other serum proteins containing hydroxyproline are excluded from this fraction. Because C1q is 4.3% hydroxyproline, the concentration of C1q in serum can therefore be calculated from the hydroxyproline content of the euglobulin fraction. The procedure, all done in the same tube, consists of precipitating the euglobulin fraction, digesting it with HClO4, and converting hydroxyproline to the corresponding pyrrole, which is extracted with toluene and measured by absorbance at 560 nm.
The interaction between fibronectin and C1q was studied in the presence of normal human plasma and rheumatoid synovial fluid by solid phase binding assay. Fibronectin-C1q binding occurred in the presence of rheumatoid synovial fluid but not in the presence of normal plasma. Binding was strongest at 4 degrees C and in the presence of EDTA. Fibronectin-C1q binding could be induced in the presence of normal plasma by hypotonicity, augmentation of the concentration of solution-phase fibronectin or by the addition of heat-aggregated IgG. The C1q present in rheumatoid synovial fluid bound to both aminoterminal collagen-binding and carboxyterminal noncollagen binding fibronectin fragments although binding to the aminoterminal fragment was stronger. The interaction between fibronectin and C1q in rheumatoid synovial fluid may modulate immune-complex deposition and complement activation in the inflamed joint.
The complement subcomponent, C1q, was isolated from serum obtained from clinically normal dogs, using a rapid 2-step process involving affinity chromatography. Yield of C1q ranged from 8 to 10 mg/L of serum. Hemolytically active C1q had 3 protein bands after sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing conditions and formed a single line of identity with rabbit anti-canine C1q. The amino acid composition of canine C1q was similar to that of human C1q and contained a high percentage of glycine. Isolated canine C1q was iodinated, and the fluid-phase binding assay was used to detect circulating immune complexes in dogs with systemic lupus erythematosus and rheumatoid arthritis.
C1q-binding material was released, by limited proteolysis with trypsin, from the membranes of intact cells of the Raji lymphoblastoid cell line and the U937 monocytic cell line. The trypsin-digested C1q-binding material was purified from the supernatant of the trypsin-treated cells by affinity chromatography on C1q-Sepharose followed by gel filtration. On gel filtration in non-dissociating conditions this material behaved as a molecule of approx. Mr 65,000, while on SDS/polyacrylamide-gel electrophoresis two peptides of Mr 10,000 and Mr 15,000 were seen under both reducing and non-reducing conditions. Evidence for the synthesis of the C1q-binding material by both Raji and U937 cells was obtained by biosynthetic-labelling studies using [35S]cysteine and [35S]methionine.
A quantitative assay for C4-containing immune complexes (IC) by a solid phase anti-C4 micro ELISA is described. It is based upon the use of an affinity purified chicken anti-human C4 antibody to capture the immune complex, and protein A-alkaline phosphatase for detection. The chicken antibody was chosen as capture antibody because it does not react with rheumatoid factor, does not activate the human complement system and is not detected by anti-mammalian IgG antibodies or protein A. Increased levels of C4 containing circulating immune complexes (CIC) were detected in sera from patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and lung cancer, when compared with normal sera. Normal levels of C4 containing immune complexes were found in sera from patients with Bell's palsy.
Complement-receptor type 1, CR1, which recognizes the C3b cleavage fragment of C3, is present on the membranes of human phagocytic cells, but does not mediate phagocytosis or undergo internalization unless activated by one of a variety of stimuli. Among these stimuli low doses of phorbol esters have been shown to induce a consistently increased expression of CR1, despite apparently continuous receptor internalization. We have studied the fate of internalized receptor-ligand complexes in neutrophils activated with low concentrations of phorbol dibutyrate. In our studies, we followed CR1 with either 125I-C3b, the physiologic ligand, or with 125I-Fab fragments of a monoclonal anti-CR1 antibody. We observed rapid internalization of CR1-C3b complexes by PMN treated with 10 ng/ml (1.98 x 10(-8)M) PDBu, consistent in rate and extent with previously reported results using monoclonal antibodies. The fate of the internalized ligand was studied after elution of cell-surface C3b at 0 degrees. Intracellular ligand was externalized in a time- and temperature-dependent fashion, reaching a plateau at 10-15 min. Released C3b was totally TCA precipitable and structurally unaltered, as determined by SDS-PAGE, suggesting that recycling occurs via a prelysosomal predegradative compartment. Loading the cells with chloroquine did not affect this process. A monoclonal anti-CR1 Fab probe behaved in exactly the same manner, suggesting that the recycling of intact ligand-receptor complexes takes place. The possible physiological consequences of this finding are discussed.
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Hyperacute renal allograft rejection is described in a patient suffering from mesangio-proliferative glomerulonephritis. The transplanted kidney was HL-A identical and the direct cytotoxic cross-match between the recipient's serum and donor lymphocytes was negative. Intrarenal consumption of C 3, but not of C 1 q, C 4, total haemolytic complement, IgG or Igm was demonstrated. Immunofluorescence studies exhibited dense granular deposits of C 3, but not of IgG, IgM C 1q or C 4. These findings together with the observation of beta 1 C-beta 1A converting activity in the patient's serum, raised the possibility that the alternative pathway of complement activation induced by nephritic factor could have operated in this case. Further studies will be necessary to clarify the question whether hyperacute rejection of renal allografts is only antibody mediated or not.
A variety of benzamidine and pyridinium compounds were examined for their ability to inhibit irreversibly C1s-induced vascular leakage in guinea pig skin. Vascular leakage was compared with esterolysis of N-Z-L-Tyr-Np and catalysis of EAC42 formation by C1s. Vascular leakage correlated significantly better with esterolytic activity than with EAC42 formation. The presence of a sulfonyl fluoride moiety in the compounds is important in the inhibition of C1s-induced vascular leakage.
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A modification of the [125I]C1q binding assay was developed to allow the estimation of C1q binding activity (C1q BA) in pemphigus and bullous pemphigoid sera. The modifications include lower final concentration of PEG 6000 (1-5%) which permitted the use of sera that had been stored at -20 degrees C for extended periods of time; use of 131I instead of 125I and an [131I] C1q concentration of 5 microng/ml rather than 1 microng/ml. EDTA was used at a final concentration of 0-13 M to obviate the need for heat inactivation of sera. Sera from seventy-one patients with pemphigus and from 142 patients with bullous pemphigoid were tested for C1q BA. Of these 40% of the pemphigus and 20% of the bullous pemphigoid patients showed elevated C1q BA. A relationship between elevated C1q BA in serum and active disease was noted. Sequential samples from forty patients with pemphigus and thirty-seven patients with bullous pemphigoid demonstrated two different types of relationship between serum antibody titres to cutaneous antigens and C1a BA. In some patients serum antibody titres and C1q BA increased and decreased simultaneously; in others, increase of C1q BA followed increase of antibody titre and coincided with its decrease. The latter relationship supports the hypothesis that C1q BA may represent at least in part antigen-antibody complexes containing cutaneous antigens.