Rheumatoid factors from patients with rheumatoid arthritis react with tryptophan 60 and 95, lysine 58, and arginine 97, on human beta 2-microglobulin

beta(2)-microglobulin: from physiology to amyloidosis

beta(2)-microglobulin (beta(2)m) is capable of forming amyloid in osteoarticular structures in kidney failure patients that undergo chronic hemodialysis treatment. Although sophisticated analytical methods have yielded comprehensive data about the conformation of the native protein both as a monomer and as the light chain of the type I major histocompatibility complex, the cause and mechanisms leading to the transformation of beta(2)m into amyloid deposits in patients with dialysis-related amyloidosis are unsettled. The impact on conformational stability of various truncations, cleavages, amino acid substitutions, and divalent cations, especially Cu(2+), however, are highly relevant for understanding beta(2)m unfolding pathways leading to amyloid formation. This review describes the current knowledge about such conformationally destabilizing and amyloidogenic factors and links these to the structure and function of beta(2)m in normal physiology and pathology. Tables listing modifications of beta(2)m found in amyloid from patients and a systematic overview of laboratory conditions conducive to beta(2)m-fibrillogenesis are also included.

Recognition of IgG-derived peptides by a human IgM with an unusual combining site

A monoclonal immunoglobulin (Ig)M cryoglobulin (Mez) with interesting binding behaviour was isolated from a Waldenström's macroglobulinemia (WM) patient. It demonstrated very strong binding to peptides derived from the sequences of human IgG. However, when tested for binding to intact IgG, this antibody (Ab) did not show any rheumatoid factor (RF) activity. We propose several nonexclusive structural interpretations of the Mez-binding propensities, based on the orientations and solvent accessibilities of ligand residues and the nature of the Ab-binding site. To further characterize the structural features of Mez-peptide binding, IgG-derived octapeptides were docked into the Mez fragment variable (Fv)-binding site, revealing additional reasons for Mez-binding selectivity based on the interactions of the docked peptides with the Mez Fv. The problem was also approached from an immunological perspective. Comparisons of Mez variable region of the light chain (VL)/variable region of the heavy chain (VH) sequences with those of human germlines and known IgM RFs allowed us to provide a possible outline tracing the structural and functional origins of the Mez IgM. Coupled with examinations of interactions in docked complexes, this analysis led us to propose that the potential for RF activity, demonstrated through Mez binding to IgG-derived peptides, was owing to the inherent sequence and structure of the Mez IgM, rather than to somatic mutations. Thus, Mez IgM may occupy an intermediate niche between IgMs with and without RF activity.

Interference of rheumatoid factor activity by aspartame, a dipeptide methyl ester

Circulating autoimmune complexes of IgM rheumatoid factors (RF) bound to the Fc portions of normal, polyclonal IgG antibodies are frequently present in humans with rheumatoid arthritis (RA). The sweet tasting methyl ester of L-Asp-L-Phe (aspartame or APM) was found to relieve pain and improve joint mobility in subjects with osteo- and mixed osteo/rheumatoid arthritis [Edmundson, A. B. and Manion, C. V. (1998). Clin. Pharmac. Ther. 63, 580-593]. These clinical observations prompted the testing of the inhibition by APM of the binding interactions of human IgM RFs with IgG Fc regions. The propensity of APM to inhibit IgM RF binding was assessed by competitive enzyme immunoassays with solid-phase human IgG. Ten RA serum samples and three purified monoclonal cryoglobulins, all of which had RF activity, were tested in this system. We found that the presence of APM significantly reduced the binding of IgM RFs. The inhibitory propensity of APM with monoclonal RF cryoglobulins was increased by the addition of CaCl(2) to the binding buffer. Similar inhibition of the binding of RA derived RFs to IgG was observed for Asp-Phe and its amidated derivative, indicating that the methyl ester is not required for APM's interaction with IgM antibodies. A human (Mez) IgM known to bind octameric peptides derived from the Fc portion of a human IgG(1) antibody was tested for binding of dipeptides by the Pepscan method of combinatorial chemistry. The relative binding constants of Asp-Phe and Phe-Asp were ranked among the highest values for 400 possible combinations of the 20 most common amino acids. Possible blocking interactions of APM were explored by computer-assisted docking studies with the model of a complex of an RF Fab with the Fc of a human IgG(4) antibody. Modeling of ternary immune complexes revealed a few key residues, which could act as molecular recognition sites for APM. A structural hypothesis is presented to explain the observed interference with RF reactivity by APM. Extrapolations of the current results suggest that APM may inhibit the binding of IgG in a substantial proportion of IgM RFs. Interference of RF reactivity, especially in RA patients, may alleviate the pain and immobility resulting from chronic inflammation of the joints.

Antigenic determinants reacting with rheumatoid factor: epitopes with different primary sequences share similar conformation

Polyclonal or monoclonal human IgM rheumatoid factors (RF) react with eight antigenic sites on the CH3 IgG domain, four sites on CH2 and two on human beta 2-microglobulin. All 14 of these RF-reactive epitopes are linear 7-11 amino acid peptides with different primary sequence. We questioned whether RF reactivity with such a variety of epitopes showing no obvious sequence homology might result from conformational similarities shared by various RF-reactive regions. Strong support for this concept was obtained using rabbit antisera as well as mouse mAbs to individual CH3, CH2 or beta 2m RF-reactive peptides. Major cross-reactivity was demonstrated between most of the 14 different CH3, CH2, or beta 2m RF-reactive peptides using individual anti-epitope antibodies. Molecular modelling studies of these peptides showed striking similarities in three-dimensional shape among many RF-reactive peptides. Main-chain atoms rather than side chains seemed to contribute most directly to conformational similarity. Molecular simulation studies on control peptides showed no conformational similarities with RF-reactive peptides. Our studies indicate that autoantibodies such as RF recognize main-chain conformations of reactive epitopes and react with a number of antigenic determinants of quite different primary sequence but similar main chain conformations.

Autoimmune mechanisms involved in the pathogenesis of rheumatoid arthritis

Rheumatoid arthritis (RA) was one of the first systemic disorders to be considered an autoimmune disease. Two major aspects of RA suggest a fundamental immune-mediated derangement in the disease: (1) presence of often massive lymphocytic infiltrates and activated CD4(+) T cells within the inflamed hypertrophied synovium, and (2) production of large amounts of rheumatoid factor (RF) by B-cells and plasma cells in the involved synovium itself. The actual tissue damage to joints and extra-articular structures affected by the disease comes from the rheumatoid inflammatory pannus or granulomatous collections of cells called rheumatoid nodules. RF production has long been studied as a prime example of apparent autoantibody production in association with the basic underlying disease process. RA patients who belong to subtype HLA DR4, Dw4 (DR B1 or 0401, Dw14 (0404/0408), or Dw15 (0405/0410) are most likely to be seropositive for RF and to have severe progressive disease. RFs are felt to represent an autoantibody associated with RA, since they show principal specificity for structures on the C gamma 3 and C gamma 2 (Fc) domains of IgG. Recent work by our group has defined a number of solvent-exposed linear RF-reactive epitopes on C gamma 3 and C gamma 2 using a strategy of overlapping 7-mers of primary sequence. RFs also have been demonstrated to react with two different regions, SKDWSFY and LSQPKIVKWDR, on beta 2-microglobulin (beta 2m). Many of the RF-reactive sites on C gamma 2 and C gamma 3 as well as on beta 2m show common immunodominant valines, leucines, tryptophanes, arginines, lysines, and glutamines, thus comprising common reactive residues. In the future, this approach may provide more direct insight into the specificities of other autoantibodies.

Immunity in the connective tissue diseases. The humoral side of the coin

Clinicians who care for patients with various connective tissue diseases frequently employ measurements of autoantibodies such as rheumatoid factors (RFs), anti-Sm antibodies, or anti-neutrophil cytoplasmic antibodies (cANCA) as a method to follow patients. Although the primary specificity of RFs appears to be directed against the Fc portion (C gamma 3 and C gamma 2 domains) of IgG, epitope mapping studies have now also demonstrated that many RFs also react with linear regions on beta 2-microglobulin and Class I HLA molecules. Cross reacting regions of IgG, beta 2m, and HLA Class I frequently show immunodominant tyrosines, trytophanes, valines, leucines, glutamic acids, aspartic acids, and threonines. Immunodominant linear epitopes on Sm antigen may be limited to regions expressing the PPPGMRPP or PPPGIRGP motifs. A number of linear regions of Proteinase 3 reacting with IgG antibodies in the sera of patients with Wegener's granulomatosis have now been identified. However, affinity purified rabbit antibodies to two of these major PR3 antigenic sties (ATVQLPQ and RVGAHDP) linked to Sepharose to form affinity columns, absorbed equal amounts of a mixture of many serum proteins from both Wegener's patients and normal controls. Continued study of this interface between autoantibody production, disease, and normal immune modulation is necessary.

Molecular localization of human IgG anti-F(ab')2 reactivity with variable- and constant-region lambda light-chain epitopes

Human IgG antibodies reacting with antigenic determinants on F(ab')2 fragments represent generic antiidiotypic antibodies present in the serum of normal individuals. Additionally, the titers of these antibodies in the sera of patients with systemic lupus erythematosus (SLE) are inversely related to disease activity. Because these autoantibodies recognize predominantly light chain-related epitopes, especially lambda type, we synthesized constant (C)lambda- and variable (V)lambda-related overlapping 7-mer peptides on polypropylene pins to determine anti-F(ab')2-reactive epitopes on human lambda light chains. ELISA reactivity of affinity-purified anti-F(ab')2 antibodies obtained from normal individuals and from patients with SLE, as well as murine anti-human light-chain monoclonal antibodies specific for C lambda and V lambda subgroup-related determinants, was tested using the overlapping 7-mers of human lambda light-chain sequence. The patterns of reactivity against C lambda-related peptides were similar in both normal and SLE-derived anti-F(ab')2 antibodies. However, reactivity profiles against V lambda-related peptides were distinctively different between the normal and the SLE-associated anti-F(ab')2 autoantibodies. A decrease in reactivity among the SLE IgG anti-F(ab')2 antibodies was noted for particular amino acid V lambda complementarity-determining region (CDR) residues, including glycine at positions 27 and 54, alanine at 16 and 37, and tyrosine at 28 and 91. This different pattern of reactivity from normal may indicate that in SLE there is a failure of antiidiotypic control mechanisms, as reflected by a defect in production of antibody to immunodominant V lambda CDR residues.

Fv structure of monoclonal antibody II-481 against herpes simplex virus Fc gamma-binding glycoprotein gE contains immunodominant complementarity determining region epitopes that react with human immunoglobulin M rheumatoid factors

Human immunoglobulin M (IgM) rheumatoid factors (RFs) show primary direct enzyme-linked immunosorbent assay (ELISA) reactivity with Fab rather than Fc fragments of monoclonal antibody (mAb) II-481 directed against the Fc gamma-binding site of herpes simplex virus glycoprotein gE. This preferential anti-Fab specificity suggests that RFs react with antigen-binding portions of mAb II-481 as anti-idiotypic antibodies directed at the combining site regions of mAb reacting with the Fc gamma-binding region of gE. Analysis of this idiotype-anti-idiotype reaction employed polymerase chain reaction amplification and sequencing of the variable heavy and light (VH and VL) regions of mAb II-481. When VH and VL regions of mAb II-481 were synthesized as overlapping 7-mer peptides on polypropylene pins, a panel of 10 polyclonal and 6 monoclonal human IgM RFs reacted primarily with epitopes within the three solvent-exposed mAb II-481 complementarity determining regions (CDRs). Preincubation of single CDR heptamer peptides with IgM RFs in free solution, resulted in 63-100% inhibition of RF binding to mAb II-481 on the ELISA plate, confirming the antigenic importance of linear CDR regions for RF reactivity. Combinations of two or three CDR peptides frequently produced 94-100% inhibition of RF binding to whole mAb II-481. Control peptides, singly or in combination, showed no inhibition. Computer modeling suggested that the RF-reactive mAb II-481 Fv region and a previously demonstrated RF-reactive CH3 epitope displayed considerable three-dimensional similarities in conformation. These studies may provide insight into limited shape homologies possibly involved in an RF anti-idiotypic reaction.

Rheumatoid-factor-reactive sites on CH2 established by analysis of overlapping peptides of primary sequence

Polyclonal IgM rheumatoid factors (RF) from ten patients with rheumatoid arthritis (RA) isolated on IgG affinity columns were studied for their reactivity with overlapping 7-mer peptides representative of solvent accessible regions of the CH2 domains of IgG using a pin-ELISA assay. A panel of nine monoclonal RF from RA patients' B cells were studied in parallel. Four peptides SVFLFPP (239-245), KFNWYVD (274-280), NSTYRVVSV (297-305) and VLTVLHQNWL (305-314) reacted with most RF. Glycine substitution showed that tryptophanes at 277 and 313, tyrosine at 278, valines at 279 and 305, and leucine 314 represented important residues for RF reactivity. Assays using monoclonal IgM RF produced from RA synovial B cells or peripheral blood B cells frequently showed a restricted spectrum of reactivity for CH2 epitopes, which often were identical to those binding to polyclonal IgM RF. Combinations of synthetic 7-mer peptides representing RF-reactive CH2 or CH3 epitopes produced as much as 60-90% inhibition of RF binding to IgG when peptides were preincubated with RF in free solution before completion of the reaction of RF with IgG on the ELISA plate.

Monoclonal IgM rheumatoid factors generated from synovial B cells of rheumatoid arthritis patients react with beta 2-microglobulin. Monoclonal RF react with beta 2m

Four of 15 monoclonal human IgM rheumatoid factors (RF) derived from synovial B cells of patients with rheumatoid arthritis showed positive ELISA reactions with human beta 2-microglobulin. These findings were different from those previously noted using IgM RF derived from monoclonal Waldenstrom's paraproteins or the IgM components of mixed cryoglobulins, and resembled the anti-beta 2 microglobulin specificity of polyclonal IgM RF from patients with rheumatoid arthritis. Reactions of monoclonal IgM synovial RF with overlapping 7-mers of beta 2m sequence indicated major regions of positive reactivity at positions 57-64 and 89-95 which were maintained in the presence of high salt (300 mM NaCl) conditions. Glycine substitution of each residue within RF-reactive beta 2m regions indicated that tryptophanes at position 60 and 95, lysine at 58, phenylalanine at 62, valine at 93 and arginine at 97 constituted important single amino acids for the reactive epitopes. These findings indicate that clonally restricted human IgM RF derived from diseased tissues of patients with RA show anti-beta 2m reactivity similar to polyclonal RF from the same patients. This particular fine specificity is not present in monoclonal RF derived from patients with Waldenstrom's or mixed cryoglobulins showing anti-gamma-globulin activity.