Light chain heterogeneity of 19S and 7S anti-gamma-globulins in rheumatoid arthritis and subacute bacterial endocarditis

Evidence for selection of 11 amino acid CDR3 domains in V kappa III-derived immunoglobulin light chains in Kawasaki disease

Kawasaki disease (KD) is a rheumatic disease that occurs during childhood. Although T cells have been implicated as having an important role in the pathogenesis of KD, the role of B cells is unclear. To detect preferential expression of 11 amino acid complementarity determining region (CDR)3 domains, we used two-stage PCR (polymerase chain reaction) to analyze the CDR3 lengths of VkIII-derived immunoglobulin kappa light chains expressed in peripheral blood B cells during the acute, subacute, and convalescent phase of this disease. As controls, the peripheral blood B cells of age-matched normal and children with acute febrile diseases other than KD were tested. In 5 of 7 KD patients, expression of kappa light chains containing 11 amino acid codon CDR3 intervals was increased during the acute and subacute phase of KD but decreased during the convalescent phase. Two of the 7 KD patients showed the same pattern during the subacute and convalescent phase, but not during the acute phase. Two of the 5 patients with acute febrile diseases other than KD showed increased expression of kappa chains with 11 amino acid codon CDR3 intervals, but it was not a major fraction. Three of the 5 patients with acute febrile diseases other than KD and all normal control subjects showed only 9 and 10 amino acid CDR3 domains. These results strongly suggest that B cells expressing kappa light chains with the 11 amino acid CDR3 domains might be involved in the pathogenesis of KD.

Heavy and light chain composition of serum IgA and IgA rheumatoid factor in Henoch-Schönlein purpura

OBJECTIVE

To characterize the heavy and light chain composition of serum IgA and IgA rheumatoid factor (RF) in 34 children with Henoch-Schönlein purpura (HSP).

METHODS

Serum IgA and IgA subclass concentrations were measured by radial immunodiffusion. IgA-RF and the light chain composition of serum IgA and IgA-RF were determined by enzyme immunoassay.

RESULTS

Serum IgA and IgA1 concentrations were higher in HSP patients than controls (P = 0.0001), but there was no difference in IgA2 concentrations between the two groups. IgA-RF was present in 19 of 34 HSP patients; it was composed predominantly of IgA1. The kappa:lambda ratio of serum IgA was virtually identical in patients and controls, but the kappa:lambda ratio of IgA-RF was significantly higher than that of the serum IgA from the 19 IgA-RF seropositive patients (P = 0.0003).

CONCLUSION

Serum IgA1 is preferentially increased in children with HSP, but the light chain composition of IgA is not different from that in controls. IgA-RF is common in HSP; it is composed predominantly of IgA1 and it is enriched in kappa light chains.

Immunological studies in the hyper-immunoglobulin D syndrome

Five patients with hyper-immunoglobulin D syndrome (hyper-IgD syndrome) were followed up for 3 to 8 years. In all patients studied, serum IgG3 was high. IgM decreased during the follow-up in all patients. In four of the patients serum IgA was elevated. In four patients the serum IgD kappa/lambda ratio was measured and was found to be raised in all. However, the serum total light-chain ratio and IgG, IgA, and IgM kappa/lambda ratios separately were virtually normal. In two of the patients, clinical symptoms preceded the increase in serum IgD. All patients had a history of severe reactions on immunizations in early childhood. We conclude that in hyper-IgD syndrome, other immunoglobulins may also be affected, in particular, IgA, IgM, and IgG3. The IgD light-chain ratio is also disturbed. We emphasize that clinical symptoms may herald immunological changes. This may be the result of an underlying factor causing both the clinical symptoms and, later, the increasing serum IgD levels.

Immunoglobulin G, A, and M light chain ratios in some humoral immunological disorders

The total kappa/lambda immunoglobulin light chain ratio and the kappa/lambda ratios within each of the serum immunoglobulin classes G, A, and M were measured in thirteen patients with humoral immunological disorders. Of those patients, eight had common variable immunodeficiency whereas five patients had other forms of humoral immunological deficiencies. Eleven patients had abnormal antibody response in vivo. All but three of the thirteen patients had clearly abnormal light chain ratios in one or more of the immunoglobulin classes. We conclude that humoral immunological disorders, usually characterized by abnormal heavy chain production and a disturbed antibody response, may frequently have a concomitant abnormal synthesis of the light chains resulting in an abnormal kappa/lambda light chain ratio.

Immunoglobulin G, A and M light chain ratio in children

Values for the kappa/lambda light chain ratio in immunoglobulins G, A and M and the total kappa/lambda ratio, measured by enzyme linked immunosorbent assay, were evaluated in serum samples from different age groups (114 children, aged from 1 month to 15 years, and 20 adults). The IgG kappa/lambda ratio decreased in the first 6 months and subsequently increased slowly during childhood towards the adult value of 2.0. The IgM kappa/lambda ratio increased at a greater rate than IgG kappa/lambda ratio in the first years of life and thereafter rose slightly throughout childhood to reach an adult value of 1.7. A decreasing IgA kappa/lambda ratio was found from 1 month of age onwards to an adult value of 1.1. The pattern of total kappa/lambda ratio was similar to the IgG kappa/lambda ratio with an adult value of 2.0.

Variable-constant segment genotype of immunoglobulin kappa is associated with increased risk for rheumatoid arthritis

OBJECTIVE

To further investigate the association of rheumatoid arthritis (RA) with a particular genotype identified by a restriction site polymorphism near the constant segment of immunoglobulin kappa (C kappa).

METHODS

The frequencies of genomic DNA polymorphisms detected within or near C kappa (the most C kappa-proximal variable segment [V kappa] B3 and a T lymphocyte marker [CD8A]) were determined by Southern blotting and hybridization. The frequencies of coding-region polymorphisms of C kappa (Km allotypes) were determined by amplification by polymerase chain reaction followed by restriction enzyme digestion.

RESULTS

Although the frequencies of B3, Km, and CD8A genotypes were not different between RA and normal control populations, more individuals were homozygous for both C kappa and B3 in the RA group (relative risk 2.2, P less than 0.01), especially in the DR4-negative RA subgroup (relative risk 3.9, P less than 0.001).

CONCLUSION

The homozygous genotype of an approximately 30,000-base region including the C kappa segment confers an elevated risk for RA, particularly in the DR4-negative subgroup.

In vitro secretion of human IgM rheumatoid factor. Evidence for distinct rheumatoid factor populations in health and disease

The production of antibodies that react with the Fc fragment of IgG, i.e., rheumatoid factors (RF), is now regarded as a normal host immune response. It is not clear, however, if such putative physiologic RF are different from their counterparts which characterize pathologic states like rheumatoid arthritis (RA). Using Staphylococcus aureus Cowan I as an in vitro stimulant of RF production, we now report that the IgM-RF secreted by blood mononuclear cells obtained from healthy newborn infants and healthy adults can be distinguished not only from classic monoclonal RF and polyclonal RA serum RF, but also from the RF secreted by blood mononuclear cells obtained from RA patients. Whereas the Fc-binding activity of all RF secreted in vitro was easily inhibited by aggregated human IgG, only the RF produced by the normal umbilical cord cells and the normal adult cells were inhibited by monomeric Fc(IgG). The normal RF were also selectively inhibited by monomeric rabbit and guinea pig (Fc(IgG). The RF secreted by umbilical cord blood cells utilized lambda and kappa light chains, with a disproportionate use of lambda light chains relative to the total IgM secreted. Together, these data provide evidence for distinct subsets of RF in health and in disease.

Immunoglobulin kappa genotype confers risk of rheumatoid arthritis among HLA-DR4 negative individuals

Because DNA polymorphisms of immunoglobulin kappa confer risk for rheumatoid arthritis (RA) and not all persons with RA have the HLA-DR4 marker, genomic polymorphisms of immunoglobulin kappa and HLA-DR beta were determined in white patients with RA. Compared with control subjects matched for DR beta genotype, the homozygous genotype of the constant segment of immunoglobulin kappa (C kappa) was more frequent in the subgroups of RA patients without the DR beta genotype corresponding to HLA-DR4 (relative risk 6.2, P less than 0.01) and patients without DR4 or DR1 (relative risk 6.7, P = 0.013), but not in the DR4+ RA subgroup. Therefore, RA may be a genetically heterogeneous disease, with HLA-DR4 marking one genetic subset and the homozygous C kappa genotype marking another.

DNA polymorphism of immunoglobulin kappa confers risk of rheumatoid arthritis

To examine the hypothesis that a hereditary factor linked to the immunoglobulin kappa constant segment (C kappa) contributes to risk of rheumatoid arthritis (RA), white persons with RA were examined for Sac I restriction site polymorphisms. RA patients were more likely to have the 5/5-kb C kappa genotype than white control subjects (relative risk 2.8, P less than 0.02). A subgroup of RA patients who were positive for serum rheumatoid factor had a relative risk of 2.4 (P less than 0.05). The subgroup without serum rheumatoid factor had an even higher relative risk of 9.7 (P less than 0.05). The results suggest that immunoglobulin kappa is an important component in the genetic predisposition toward RA.

The immunoglobulin class, the subclass and the ratio of kappa:lambda light chain of autoantibodies to human insulin in insulin autoimmune syndrome

The immunoglobulin class, subclass and the k:lambda light chain ratio of insulin autoantibodies were determined in the sera of twenty-four patients with insulin autoimmune syndrome. All sera proved to be of the IgG immunoglobulin class but exhibited various IgG1:IgG2:IgG3:IgG4 ratios. The ratio of k:lambda light chain ranged from 1:0.13 to 1:0.75 with the exceptions of two sera that were characterized as IgG1(k) and IgG1(lambda).

Amino acid sequence of a light chain variable region of a human rheumatoid factor of the Wa idiotypic group, in part predicted by its reactivity with antipeptide antibodies

Antipeptide antisera were raised to the second and third complementarity-determining regions of the light chain derived from a human monoclonal IgM (Sie) which had antigammaglobulin activity and belonged to the Wa cross-reactive idiotypic group of human rheumatoid factors, two of whose members (Sie, Wo1) had been previously sequenced in our laboratory (Andrews and Capra, Biochemistry 20, 5816-5822, 1981). These antisera were found to react with the light chain of another human monoclonal IgM (Go1) that shared the Wa idiotype while antipeptide antisera made to the third CDR of the Sie heavy chain failed to react. The amino acid sequence of the variable region of the Go1 light chain was found to be highly homologous to the light chain of Sie from which the synthetic peptides were derived, particularly in the framework regions and the second and third CDR. This study illustrates that antipeptide antisera are valuable and specific probes for determining the relationship between molecules which exhibit similar antigen binding or idiotypic specificities and, furthermore, such antisera are able to predict amino acid sequences with surprising precision.

Enzyme-linked immunosorbent assay (ELISA) screening test for detection of rheumatoid factor

A new enzyme-linked immunosorbent assay (ELISA) screening test for total rheumatoid factor (RF) activity is described. Rabbit IgG was used as antigen and enzyme-conjugated monoclonal anti-kappa antibody as third layer. Of 183 samples measured for RF isotype levels, 60 were found to have one or more raised. In terms of raised isotypes the ELISA screening test had a sensitivity of 97% (58/60) while the Rheumaton had a sensitivity of only 75% (45/60). Nearly all discordant false-negative samples had only one RF isotype raised. The ELISA test gave 29% (53/183) and the Rheumaton 34% (63/183) false-positive results. Thus the ELISA test was more specific and sensitive for the detection of raised single RF isotypes than the Rheumaton and Rose-Waaler tests. Moreover, approximately 30% of RA patients were seronegative according to the conventional RF tests but only 8% in the new ELISA system.

Subclass restriction and polyclonality of the systemic lupus erythematosus marker antibody anti-Sm

Anti-Sm antibodies are highly specific markers for the diagnosis of systemic lupus erythematosus (SLE). This specificity suggests that the immunoregulation of these autoantibodies would reflect fundamental immune abnormalities in this disorder. As a clue to this immunoregulation, we have investigated the isotype distribution of anti-Sm antibodies by enzyme-linked immunosorbent assays. We have found that the anti-Sm response is markedly restricted to the IgG1 heavy chain isotype. On the other hand, the light chain distribution reflects that in normal serum, while isoelectric focusing analysis fails to show an oligoclonal pattern. The related specificity, anti-ribonucleoprotein, is also restricted to IgG1, while the SLE-specific antibody anti-double-stranded DNA is mostly IgG1 with a lesser contribution by IgG3. These results suggest that antinuclear antibodies that are strongly associated with SLE are produced by a T cell-dependent response, probably driven by antigen. The immunoregulation of the response to several autoantigens may be quite similar.

A common idiotope on human rheumatoid factors identified by a hybridoma antibody

Human monoclonal and polyclonal anti-IgG autoantibodies [rheumatoid factors (RFs)] are composed primarily of kappa light chains, and may display cross-reactive idiotypes. However, the nature of the shared idiotope(s) has remained unclear. We have prepared a murine hybridoma antibody (17-109) that recognizes an idiotope present on 30% (3/10) of human IgM-RF paraproteins, and absent on immunoglobulins without RF activity. The idiotope was measurable on isolated, intact kappa light chains, but not on light-chain tryptic peptides, nor on isolated heavy chains. A comparison of the binding to 17-109 of five IgM-RF paraproteins, with known kappa chain amino acid sequences, suggested a relationship between the idiotope recognized by the hybridoma and the complementarity-determining regions. The serum of patients with rheumatoid arthritis contained idiotope positive material that bound specifically to a 17-109 immunoadsorbent column. Moreover, the 17-109 anti-idiotope antibody partially inhibited the binding to IgG of IgM-RF and IgA-RF in serum, but did not effect the binding to antigen of IgM and IgA anti-tetanus toxoid antibodies. These results suggest that a significant proportion of IgM-RF paraproteins share an idiotope located at or near the complementarity-determining regions of the kappa light chain. Human serum RFs include a kappa light chain family that is idiotopically related to the kappa chains on IgM-RF paraproteins.

A highly conserved determinant on human rheumatoid factor idiotypes defined by a mouse monoclonal antibody

Different human IgM rheumatoid factor (IgM RF) idiotypes have been described defined by polyclonal rabbit anti-idiotypic antibodies. These antisera do not allow clear genetic analysis of the idiotypic determinants, be they cross-reactive or private. Therefore, we tried to obtain a set of monoclonal anti-idiotypic antibodies directed against RF idiotypes. Purified IgM RF serum from a patient with classical rheumatoid arthritis was used to immunize BALB/c mice. The spleen cells were fused with Sp 2/0 Ag 14, a nonsecreting mouse myeloma cell line, and a hybrid producing monoclonal anti-idiotypic antibody was selected. The mouse antibody, an IgG1 kappa, reacts with an identical or similar determinant located on (or close to) the binding site of all tested monoclonal or polyclonal IgM RF from totally unrelated patients with Waldenströms's macroglobulinemias or rheumatoid arthritis. The monoclonal antibody also reacts with 2 rheumatoid arthritis patients' IgG RF and with a low proportion of normal polyclonal IgM without detectable RF activity. An hypothesis is proposed to explain the existence of a such highly conserved determinant on RF idiotypes.

Circular dichroism of immune complexes, IgG and Fab gamma with unique antigenic determinants from rheumatoid serum

IgG-IgG and IgG-IgM complexes were isolated from one rheumatoid arthritis (RA) serum by affinity chromatography to immobilized F(ag')2 gamma of specific antibodies against unique determinants in the complexes. Both IgG nd IgM, when isolated from these complexes, contained the unique determinants. The circular dichroism (CD) spectrum of IgG differed from that of normal IgG at neutral pH. At pH 3 both IgG and IgM displayed normal CD spectra, and only one third of the molecules now had affinity for the immobilized ligand. The molecules with affinity at pH 3 exhibited an abnormal CD spectrum at pH 3, and a normal CD spectrum was obtained only of those components that lacked affinity. One-third of the Fab gamma isolated from the IgG and IgG complexes with the unique determinants contained the unique determinants that were lacking in the rest of the same principal the Fc gamma fragments. The CD of the two Fab gamma preparations showed the same principal differences as the CD of the molecules with and without affinity to the ligand at acidic pH.

IgM-rheumatoid factors cross-reactive with IgG and a cell nuclear antigen: immunopathological implications?

The cross-reaction of IgM-rheumatoid factors (IgM-RF) with a cell nuclear antigen has been further investigated by immunofluorescence procedures. This reaction appears to be optimal at pH 8-9, and fails to occur at pH 6.5. No evidence was obtained by immunofluorescence that IgM-RF bound to the cell nuclear antigen fixes complement. It would appear that the nuclear reactivity of IgM-RF may be of limited immunopathological significance, though this reaction is of note in understanding the behavioural nature of rheumatoid factors.

IgG rheumatoid factor. Relationship to seropositive rheumatoid arthritis and absence in seronegative disorders

IgG rheumatoid factor was detected in the sera of the majority of patients with seropositive rheumatoid arthritis. Values suggestive of IgG rheumatoid factor were noted in one-quarter of patients with seronegative inflammatory arthropathies. These determinations were always low and correlated with elevated IgG concentrations, suggesting nonspecific adherence of IgG rather than a true antigen-antibody reaction. In support of this conclusion, nonrheumatoid factor IgG was capable of concentration-dependent nonspecific adsorption to the solid phase. IgG, but not IgM, rheumatoid factor corresponded with disease activity in patients with seropositive rheumatoid arthritis, suggesting that IgG rheumatoid factor may be important in the pathogenesis.

IgM-rheumatoid factors cross-reactive with IgG and a cell nuclear antigen: apparent 'masking' in original serum

Fourteen out of fifteen IgM-rheumatoid factor (IgM-RF) preparations isolated from high-titred seropositive rheumatoid sera by affinity chromatography on immobilized human IgG have been shown to cross-react with a cell nuclear antigen, as manifest by positive immunofluorescent anti-nuclear antibody (ANA) staining on rat liver and kidney tissue sections. The cross-reacting ANA activity within isolated IgM-RF preparations was inhibitable by both human and rabbit IgG, as well as by isolated rat liver chromatin, and could be isolated from seropositive ANA-negative sera. It would appear that this cross-reacting ANA activity can be masked in the original seropositive serum and may often require purification of RF from serum for its manifestation.