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López-Medina C, Calvo-Gutiérrez J, Ábalos-Aguilera MC, Cepas F, Plasencia-Rodríguez C, Martínez-Feito A, Balsa A, Faré-García R, Juan-Mas A, Ruiz-Esquide V, Sainz L, Díaz-Torné C, Godoy-Navarrete FJ, Añón-Oñate I, Mena-Vázquez N, Manrique-Arija S, Moreno-García MS, Ortega-Castro R, Escudero-Contreras A. Exploring the influence of baseline rheumatoid factor levels on TNF inhibitor retention rate in patients with rheumatoid arthritis: a multicentre and retrospective study. RMD Open 2024; 10:e003975. [PMID: 38395455 PMCID: PMC10895218 DOI: 10.1136/rmdopen-2023-003975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVE To assess whether the retention rate of certolizumab pegol (CZP) was longer than that of other tumour necrosis factor inhibitors (TNFi) based on baseline rheumatoid factor (RF) levels. METHODS Longitudinal, retrospective and multicentre study including patients with RA who were treated with any TNFi (monoclonal antibodies (mAB), etanercept (ETA) or CZP). Log-rank test and Cox regressions were conducted to evaluate the retention rate in the three groups according to the level of RF, with the third quartile of the baseline levels used as cut-off: <200 ( RESULTS A total of 638 individuals and 752 treatments (132 CZP, 439 mAB and 181 ETA) were included. In non-naïve patients with ≥200 IU/mL of RF, those treated with CZP showed a significantly longer retention rate in comparison with mAB and ETA. After matching using the propensity score, patients with ≥200 IU/mL RF levels exhibited longer retention rates with CZP than with mAB (HR 2.3 (95% CI 1.2 to 4.3), or ETA (HR 2.8 (95% CI 1.5 to 5.2). No differences were found between groups in patients with <200 UI/mL. CONCLUSIONS CZP showed a longer retention rate than mAB and ETA in patients with very high RF levels (≥200 IU/mL), while these differences were absent in patients with <200 IU/mL levels. The results suggest the potential effect of RF on binding the fragment crystallisable portion of certain TNFi.
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Affiliation(s)
- Clementina López-Medina
- Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Jerusalem Calvo-Gutiérrez
- Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - M Carmen Ábalos-Aguilera
- GC05, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Francisco Cepas
- Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | | | - Ana Martínez-Feito
- Rheumatology, La Paz University Hospital, Madrid, Spain
- IdiPAZ, Madrid, Spain
| | - Alejandro Balsa
- Rheumatology, La Paz University Hospital, Madrid, Spain
- IdiPAZ, Madrid, Spain
| | | | - Antoni Juan-Mas
- Rheumatology, Son Llatzer University Hospital, Palma de Mallorca, Spain
| | | | - Luis Sainz
- Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - César Díaz-Torné
- Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Natalia Mena-Vázquez
- Rheumatology, Hospital Regional Universitario de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Sara Manrique-Arija
- Rheumatology, Hospital Regional Universitario de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Medicina, Univeristy of Málaga, Málaga, Spain
| | | | - Rafaela Ortega-Castro
- Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
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Trier NH, Houen G. Anti-citrullinated protein antibodies as biomarkers in rheumatoid arthritis. Expert Rev Mol Diagn 2023; 23:895-911. [PMID: 37578277 DOI: 10.1080/14737159.2023.2247986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/15/2023] [Accepted: 08/10/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION The serological biomarker anti-citrullinated protein antibodies (ACPAs) may have several functions but is especially important for the diagnosis of rheumatoid arthritis (RA) along with clinical symptoms. AREAS COVERED This review provides an overview of ACPAs, which are useful in RA diagnostics and may improve our understanding of disease etiology. PubMed was searched with combinations of words related to antibodies recognizing epitopes containing the post-translationally modified amino acid citrulline in combination with rheumatoid arthritis; cyclic citrullinated peptide, CCP, anti-CCP, anti-citrullinated protein antibodies, ACPA, citrullination, peptide/protein arginine deiminase, PAD, filaggrin, vimentin, keratin, collagen, perinuclear factor, EBNA1, EBNA2, and others. From this search, we made a qualitative extract of publications relevant to the discovery, characterization, and clinical use of these antibodies in relation to RA. We highlight significant findings and identify areas for improvement. EXPERT OPINION ACPAs have high diagnostic sensitivity and specificity for RA and recognize citrullinated epitopes from several proteins. The best-performing single epitope originates from Epstein-Barr Virus nuclear antigen 2 and contains a central Cit-Gly motif, which is recognized by ACPAS when located in a flexible peptide structure. In addition, ACPAs may also have prognostic value, especially in relation to early treatment, although ACPAs' main function is to aid in the diagnosis of RA.
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Affiliation(s)
| | - Gunnar Houen
- Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense M, Denmark
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Nicolò A, Amendt T, El Ayoubi O, Young M, Finzel S, Senel M, Voll RE, Jumaa H. Rheumatoid factor IgM autoantibodies control IgG homeostasis. Front Immunol 2022; 13:1016263. [PMID: 36341420 PMCID: PMC9634112 DOI: 10.3389/fimmu.2022.1016263] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/05/2022] [Indexed: 01/17/2023] Open
Abstract
Rheumatoid arthritis is an autoimmune disease characterized by joint inflammation due to autoantibodies targeting multiple self-proteins. Most patients with poor prognosis show elevated titers of IgM antibodies specifically binding to IgG. Such autoreactive antibodies are referred to as rheumatoid factor (RF). However, their biological function and contribution to disease progression remains elusive. We have recently shown that autoreactive antibodies are present in healthy individuals and play an important role in regulating physiological processes. This regulatory mechanism is determined by the class and affinity of the autoreactive antibody, as low-affinity autoreactive IgM neutralizes the recognized autoantigen while high-affinity IgM protects its autoantigen from degradation. Here, we show that RFs possessing a high affinity and mono-specificity to IgG have a stabilizing effect on IgG, whereas low-affinity polyreactive RFs neutralize IgG in vivo. These results suggest that autoreactive IgM antibodies recognizing IgG play a crucial role in regulating IgG homeostasis and that a disbalance between IgM-mediated IgG degradation and stabilization might affect the onset and progression of autoimmune diseases. Consequently, restoring this balance using low-affinity anti-IgG IgM might be a promising therapeutic approach for autoimmune diseases involving autoreactive IgG.
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Affiliation(s)
- Antonella Nicolò
- Institute of Immunology, Ulm University Medical Center, Ulm, Germany
| | - Timm Amendt
- Institute of Immunology, Ulm University Medical Center, Ulm, Germany
| | - Omar El Ayoubi
- Institute of Immunology, Ulm University Medical Center, Ulm, Germany
| | - Marc Young
- Institute of Immunology, Ulm University Medical Center, Ulm, Germany
| | - Stephanie Finzel
- Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, Freiburg, Germany
| | - Makbule Senel
- Department of Neurology, Ulm University Medical Center, Ulm, Germany
| | - Reinhard E. Voll
- Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, Freiburg, Germany
| | - Hassan Jumaa
- Institute of Immunology, Ulm University Medical Center, Ulm, Germany,*Correspondence: Hassan Jumaa,
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Song T, Shi R, Vijayalakshmi A, Lei B. Protective effect of lupeol on arthritis induced by type II collagen via the suppression of P13K/AKT signaling pathway in Sprague dawley rats. ENVIRONMENTAL TOXICOLOGY 2022; 37:1814-1822. [PMID: 35446470 DOI: 10.1002/tox.23529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/14/2022] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
To explore the therapeutic value of lupeol on collagen-induced arthritis (CIA) in rats, a rheumatoid arthritis model. Lupeol is well known pentacyclic triterpene found in various plant sources, which possess anti-inflammatory and antioxidant actions. The current study was assessed the anti-arthritic potential of lupeol and its molecular mechanisms as compared with indomethacin (Indo) in collagen-induced arthritis CIA rats. The rats were randomly alienated into five groups: Control, CIA alone, CIA + lupeol (10 mg/kg bw), CIA + Indomethacin (3 mg/kg bw), and lupeol (10 mg/kg bw) alone. The paw volume, biochemical, hematological parameters, inflammatory enzymes, and cytokines were measured. As well protein expression of apoptotic proteins, and histopathological of ankle joint were examined. Inflammatory markers, cytokines, histological changes, paw volume, and inflammation were intensely reduced and enhanced apoptosis by lupeol. Alterations in hematological parameters, rheumatoid factor, C-reactive protein, and ceruloplasmin in arthritis were reverted by lupeol. Protein expressions of Bcl-2, and P13K/Akt signaling were declined, whereas the Bax, caspssae-3, and caspase-9 were elevated. These results highlighted that lupeol suppresses P13K/Akt signaling and has a promising anti-arthritic potential for collagen-induced rheumatic arthritis treatment. Hence lupeol would be suggested as an alternative natural source with potent anti-inflammatory and apoptotic actions for chronic inflammatory disorders.
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Affiliation(s)
- Tiebing Song
- Department of Orthopaedic Trauma Joint Ward 1, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, China
| | - Renhong Shi
- Department of Surgery, People's Liberation Army, Xi'an, China
| | - Annamalai Vijayalakshmi
- Department of Biochemistry, Rabiammal Ahamed Maideen College for Women, Thiruvarur, Tamil Nadu, India
| | - Bin Lei
- Department of Second Bone Injury, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, China
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Regueiro C, Rodriguez-Rodriguez L, Lopez-Mejias R, Nuño L, Triguero-Martinez A, Perez-Pampin E, Corrales A, Villalba A, Lopez-Golan Y, Abasolo L, Remuzgo-Martínez S, Ortiz AM, Herranz E, Martínez-Feito A, Conde C, Mera-Varela A, Balsa A, Gonzalez-Alvaro I, González-Gay MÁ, Fernandez-Gutierrez B, Gonzalez A. A predominant involvement of the triple seropositive patients and others with rheumatoid factor in the association of smoking with rheumatoid arthritis. Sci Rep 2020; 10:3355. [PMID: 32098994 PMCID: PMC7042270 DOI: 10.1038/s41598-020-60305-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 02/07/2020] [Indexed: 01/16/2023] Open
Abstract
The major environmental risk factor for rheumatoid arthritis (RA) is smoking, which according to a widely accepted model induces protein citrullination in the lungs, triggering the production of anti-citrullinated protein antibodies (ACPA) and RA development. Nevertheless, some research findings do not fit this model. Therefore, we obtained six independent cohorts with 2253 RA patients for a detailed analysis of the association between smoking and RA autoantibodies. Our results showed a predominant association of smoking with the concurrent presence of the three antibodies: rheumatoid factor (RF), ACPA and anti-carbamylated protein antibodies (ACarPA) (3 Ab vs. 0 Ab: OR = 1.99, p = 2.5 × 10–8). Meta-analysis with previous data (4491 patients) confirmed the predominant association with the concurrent presence of the three antibodies (3 Ab vs. 0 Ab: OR = 2.00, p = 4.4 ×10–16) and revealed that smoking was exclusively associated with the presence of RF in patients with one or two antibodies (RF+1+2vs. RF−0+1+2: OR = 1.32, p = 0.0002). In contrast, no specific association with ACPA or ACarPA was found. Therefore, these results showed the need to understand how smoking favors the concordance of RA specific antibodies and RF triggering, perhaps involving smoking-induced epitope spreading and other hypothesized mechanisms.
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Affiliation(s)
- Cristina Regueiro
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Luis Rodriguez-Rodriguez
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Raquel Lopez-Mejias
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Laura Nuño
- Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Ana Triguero-Martinez
- Rheumatology Department, Instituto de Investigación Sanitaria la Princesa, Hospital Universitario de la Princesa (IIS-lP), Madrid, Spain
| | - Eva Perez-Pampin
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Alfonso Corrales
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Alejandro Villalba
- Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Yolanda Lopez-Golan
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Lydia Abasolo
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Sara Remuzgo-Martínez
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Ana M Ortiz
- Rheumatology Department, Instituto de Investigación Sanitaria la Princesa, Hospital Universitario de la Princesa (IIS-lP), Madrid, Spain
| | - Eva Herranz
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Ana Martínez-Feito
- Immuno-Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Carmen Conde
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Antonio Mera-Varela
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain.,Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alejandro Balsa
- Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Isidoro Gonzalez-Alvaro
- Rheumatology Department, Instituto de Investigación Sanitaria la Princesa, Hospital Universitario de la Princesa (IIS-lP), Madrid, Spain
| | - Miguel Ángel González-Gay
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Benjamín Fernandez-Gutierrez
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Antonio Gonzalez
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain.
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Sidorov A, Beduleva L, Menshikov I, Terentiev A, Cherepanov I. Physicochemical characteristics of human IgG Fc fragments that expose regulatory rheumatoid factor neoepitopes and may show promise as antirheumatic agents. Biotechnol Appl Biochem 2020; 67:287-293. [DOI: 10.1002/bab.1849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/05/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Alexandr Sidorov
- Udmurt Federal Research Center UB RAS Izhevsk Russian Federation
- Department of Immunology and Cell BiologyUdmurt State University Izhevsk Russian Federation
| | - Liubov Beduleva
- Udmurt Federal Research Center UB RAS Izhevsk Russian Federation
- Department of Immunology and Cell BiologyUdmurt State University Izhevsk Russian Federation
- Novye Vakciny Ltd. Izhevsk Russian Federation
| | - Igor Menshikov
- Udmurt Federal Research Center UB RAS Izhevsk Russian Federation
- Department of Immunology and Cell BiologyUdmurt State University Izhevsk Russian Federation
- Novye Vakciny Ltd. Izhevsk Russian Federation
| | - Alexey Terentiev
- Udmurt Federal Research Center UB RAS Izhevsk Russian Federation
- Department of Immunology and Cell BiologyUdmurt State University Izhevsk Russian Federation
| | - Igor Cherepanov
- Department of Fundamental ChemistryUdmurt State University Izhevsk Russian Federation
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Emerging role of innate B1 cells in the pathophysiology of autoimmune and neuroimmune diseases: Association with inflammation, oxidative and nitrosative stress and autoimmune responses. Pharmacol Res 2019; 148:104408. [DOI: 10.1016/j.phrs.2019.104408] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/16/2022]
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Maibom-Thomsen SL, Trier NH, Holm BE, Hansen KB, Rasmussen MI, Chailyan A, Marcatili P, Højrup P, Houen G. Immunoglobulin G structure and rheumatoid factor epitopes. PLoS One 2019; 14:e0217624. [PMID: 31199818 PMCID: PMC6568389 DOI: 10.1371/journal.pone.0217624] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 05/15/2019] [Indexed: 12/14/2022] Open
Abstract
Antibodies are important for immunity and exist in several classes (IgM, IgD, IgA, IgG, IgE). They are composed of symmetric dimeric molecules with two antigen binding regions (Fab) and a constant part (Fc), usually depicted as Y-shaped molecules. Rheumatoid factors found in patients with rheumatoid arthritis are autoantibodies binding to IgG and paradoxically appear to circulate in blood alongside with their antigen (IgG) without reacting with it. Here, it is shown that rheumatoid factors do not react with native IgG in solution, and that their epitopes only become accessible upon certain physico-chemical treatments (e.g. heat treatment at 57 °C), by physical adsorption on a hydrophobic surface or by antigen binding. Moreover, chemical cross-linking in combination with mass spectrometry showed that the native state of IgG is a compact (closed) form and that the Fab parts of IgG shield the Fc region and thereby control access of rheumatoid factors and presumably also some effector functions. It can be inferred that antibody binding to pathogen surfaces induces a conformational change, which exposes the Fc part with its effector sites and rheumatoid factor epitopes. This has strong implications for understanding antibody structure and physiology and necessitates a conceptual reformulation of IgG models.
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Affiliation(s)
| | - Nicole Hartwig Trier
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
- Department of Autoimmunology, Statens Serum Institut, Copenhagen, Denmark
| | - Bettina Eide Holm
- Department of Autoimmunology, Statens Serum Institut, Copenhagen, Denmark
| | - Kirsten Beth Hansen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
- Department of Autoimmunology, Statens Serum Institut, Copenhagen, Denmark
| | - Morten Ib Rasmussen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Anna Chailyan
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Paolo Marcatili
- Department of Bioinformatics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Peter Højrup
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Gunnar Houen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
- Department of Autoimmunology, Statens Serum Institut, Copenhagen, Denmark
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Abstract
Inflammatory arthritis encompasses a set of common diseases characterized by immune-mediated attack on joint tissues. Most but not all affected patients manifest circulating autoantibodies. Decades of study in human and animal arthritis have identified key roles for autoantibodies in immune complexes and through direct modulation of articular biology. However, joint inflammation can arise because of pathogenic T cells and other pathways that are antibody-independent. Here we review the evidence for these parallel tracks, in animal models and in humans, to explore the range of mechanisms engaged in the pathophysiology of arthritis and to highlight opportunities for targeted therapeutic intervention.
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Affiliation(s)
- Margaret H. Chang
- Department of Medicine, Division of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter A. Nigrovic
- Department of Medicine, Division of Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Abstract
IgM and IgA autoantibodies binding to IgG are called rheumatoid factors (RFs) and occur with high frequency in rheumatoid arthritis (RA) and with lower frequency in other autoimmune diseases. RFs have diagnostic and prognostic value in RA, but they also have a high potential to cause false positive reactions in other immunoassays, especially sandwich assays. For these reasons it is imperative to be able to measure RFs in serum samples from patients suspected of RA or other autoimmune diseases and in serum samples to be analyzed by sandwich immunoassay for various clinical parameters. Here, a simple ELISA for IgM and IgA RFs is described.
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Falkenburg WJJ, von Richthofen HJ, Rispens T. On the origin of rheumatoid factors: Insights from analyses of variable region sequences. Semin Arthritis Rheum 2018; 48:603-610. [PMID: 30032973 DOI: 10.1016/j.semarthrit.2018.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/17/2018] [Accepted: 06/01/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Rheumatoid factors (RFs) are thought to play an important role in rheumatoid arthritis (RA), but are also found in healthy donors (HDs). Previous studies examined variable region sequences of these autoantibodies at a time when knowledge of the human germline repertoire was incomplete. Here we collected and analyzed RF sequence data from the literature to elucidate how RFs develop and whether their characteristics differ between RA patients and HDs. METHODS A database was built containing nucleotide sequences of RF heavy and light chain variable domains and characteristics including affinity, isotype and specificity, all collected from published papers. Gene usage and mutation frequencies were analyzed using IMGT/HiV-QUEST. Selection strength was assessed with the BASELINe tool. RESULTS Sequences were retrieved for 183 RF clones (87 RA; 67 HDs; 29 other). No biased gene usage was observed for RA and HDs. However, there does appear to be skewed gene usage in RFs from patients with mixed cryoglobulinemia. Mutation frequency varies considerably between RFs, and isotype-switched clones have significantly more mutations. Monospecific RFs carry more mutations than polyspecific RFs; no difference was found for RA- versus HD-derived RFs. Overall, reported affinity is low (median 1 µM), with a non-significant trend toward higher affinity of RA-derived RFs. Mutation frequency and affinity did not appear to be correlated. BASELINe analysis suggests an overall lack of positive selection and less negative selection strength in RA-derived RFs. CONCLUSIONS RFs derived from RA patients have similar properties as those derived from HDs. The RF response can be characterized as a moderately matured autoantibody response, with variable levels of somatic hypermutation, but low affinity.
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Affiliation(s)
- Willem J J Falkenburg
- Amsterdam Rheumatology and Immunology Center, Reade, Doctor Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands; Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, PO Box 9892, 1006 AN Amsterdam, The Netherlands.
| | - Helen J von Richthofen
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, PO Box 9892, 1006 AN Amsterdam, The Netherlands
| | - Theo Rispens
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, PO Box 9892, 1006 AN Amsterdam, The Netherlands.
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Holm BE, Sandhu N, Tronstrøm J, Lydolph M, Trier NH, Houen G. Species cross-reactivity of rheumatoid factors and implications for immunoassays. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 75:51-63. [DOI: 10.3109/00365513.2014.965738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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13
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Song YW, Kang EH. The pathogenic role of rheumatoid factor in rheumatoid arthritis. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/ijr.10.62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Hayman MW, van Beijnen MTA, Stamp LK, Spellerberg MB, O'Donnell JL. Soluble human leukocyte antigen: A diagnostic indicator of rheumatoid arthritis? J Immunol Methods 2006; 315:19-26. [PMID: 16893550 DOI: 10.1016/j.jim.2006.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2006] [Revised: 06/14/2006] [Accepted: 06/26/2006] [Indexed: 11/22/2022]
Abstract
Early stage rheumatoid arthritis (RA) is often difficult to diagnose because initial symptoms are non-specific. To aid diagnosis, suitable serological diagnostic markers are sought. Elevated levels of soluble MHC class II (soluble human leukocyte antigen; sHLA-DR) in human serum have been associated with rheumatoid and 'rheumatoid-like' autoimmune diseases. As a result, sHLA-DR has been suggested as a specific marker of RA. However, reported levels of sHLA-DR in sera of healthy donors vary significantly and the mechanism of release of HLA-DR into serum is poorly understood. Investigations into the diagnostic potential of this molecule necessitate the development of a sensitive and specific sHLA-DR assay. We have investigated multiple ELISA setups to develop such an assay and false positive signal has been carefully removed using a combination of isotype-matched controls and immuno-depletion. sHLA-DR levels in sera of RA patients were not significantly different from those in healthy donors which suggests sHLA-DR has limited utility in the diagnosis of RA. In RA patients, we detected high levels of sHLA-DR in aspirated synovial fluid (SF), but this did not correlate with sHLA-DR levels in serum.
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Affiliation(s)
- M W Hayman
- Immunology Section, Canterbury Health Laboratories, Christchurch, New Zealand.
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15
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16
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Hata H, Sakaguchi N, Yoshitomi H, Iwakura Y, Sekikawa K, Azuma Y, Kanai C, Moriizumi E, Nomura T, Nakamura T, Sakaguchi S. Distinct contribution of IL-6, TNF-α, IL-1, and IL-10 to T cell–mediated spontaneous autoimmune arthritis in mice. J Clin Invest 2004. [DOI: 10.1172/jci200421795] [Citation(s) in RCA: 205] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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17
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Hata H, Sakaguchi N, Yoshitomi H, Iwakura Y, Sekikawa K, Azuma Y, Kanai C, Moriizumi E, Nomura T, Nakamura T, Sakaguchi S. Distinct contribution of IL-6, TNF-alpha, IL-1, and IL-10 to T cell-mediated spontaneous autoimmune arthritis in mice. J Clin Invest 2004; 114:582-8. [PMID: 15314695 PMCID: PMC503774 DOI: 10.1172/jci21795] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2004] [Accepted: 06/29/2004] [Indexed: 11/17/2022] Open
Abstract
Cytokines play key roles in spontaneous CD4(+) T cell-mediated chronic autoimmune arthritis in SKG mice, a new model of rheumatoid arthritis. Genetic deficiency in IL-6 completely suppressed the development of arthritis in SKG mice, irrespective of the persistence of circulating rheumatoid factor. Either IL-1 or TNF-alpha deficiency retarded the onset of arthritis and substantially reduced its incidence and severity. IL-10 deficiency, on the other hand, exacerbated disease, whereas IL-4 or IFN-gamma deficiency did not alter the disease course. Synovial fluid of arthritic SKG mice contained high amounts of IL-6, TNF-alpha, and IL-1, in accord with active transcription of these cytokine genes in the afflicted joints. Notably, immunohistochemistry revealed that distinct subsets of synovial cells produced different cytokines in the inflamed synovium: the superficial synovial lining cells mainly produced IL-1 and TNF-alpha, whereas scattered subsynovial cells produced IL-6. Thus, IL-6, IL-1, TNF-alpha, and IL-10 play distinct roles in the development of SKG arthritis; arthritogenic CD4(+) T cells are not required to skew to either Th1 or Th2; and the appearance of rheumatoid factor is independent of joint inflammation. The results also indicate that targeting not only each cytokine but also each cell population secreting distinct cytokines could be an effective treatment of rheumatoid arthritis.
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Affiliation(s)
- Hiroshi Hata
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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18
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Campbell IK, Roberts LJ, Wicks IP. Molecular targets in immune-mediated diseases: the case of tumour necrosis factor and rheumatoid arthritis. Immunol Cell Biol 2003; 81:354-66. [PMID: 12969323 DOI: 10.1046/j.0818-9641.2003.01185.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Rheumatoid arthritis is a common autoimmune condition in which, for unknown reasons, synovial joints become the target of a sustained immune response. For many years, rheumatoid arthritis was in the 'too hard basket' in terms of understanding disease mechanisms and providing rational therapy. This has changed dramatically over the last 10 years and rheumatoid arthritis is now at the forefront of biotechnology. In this review, we outline one of the most exciting recent developments, namely antagonists of the cytokine TNF. The preclinical evaluation of TNF in animal models of rheumatoid arthritis, and subsequent clinical trials of TNF inhibitors in patients, provides insight into the 'bench to bedside' paradigm. We therefore briefly review rheumatoid arthritis, animal models of rheumatoid arthritis, the biology of TNF, the pivotal clinical trials of TNF antagonists and the emerging data on side-effects. Tumour necrosis factor inhibitors in rheumatoid arthritis represent the first attempt to achieve sustained blockade of a single cytokine in a human disease. Whilst this approach has been even more successful than might have been predicted, we suggest it is only the beginning of what has become a new therapeutic era.
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Affiliation(s)
- Ian K Campbell
- Reid Rheumatology Laboratory, Walter and Eliza Hall Institute of Medical Research, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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19
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Van Esch WJE, Reparon-Schuijt CC, Hamstra HJ, Van Kooten C, Logtenberg T, Breedveld FC, Verweij CL. Human IgG Fc-binding phage antibodies constructed from synovial fluid CD38+ B cells of patients with rheumatoid arthritis show the imprints of an antigen-dependent process of somatic hypermutation and clonal selection. Clin Exp Immunol 2003; 131:364-76. [PMID: 12562401 PMCID: PMC1808634 DOI: 10.1046/j.1365-2249.2003.02068.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The persistent presence of rheumatoid factors (RFs) in the circulation is a characteristic phenomenon in patients with rheumatoid arthritis (RA). Recent data indicate that RFs associated with seropositive RA are derived from terminally differentiated CD20-, CD38+ plasma cells (PCs) present in synovial fluids of the inflamed joints. These cells were shown to secrete RFs actively and are thought to originate from germinal centre (GC)-like structures present in the inflamed synovium. To obtain a representative image of the structural properties of IgM and IgG RFs associated with RA, phage antibody display libraries were constructed from CD38+ PCs isolated from the inflamed joints of RF-seropositive patients with RA. Subsequently, human IgG Fc-binding monoclonal phage antibodies were selected and analysed. The data suggest that RA-associated RFs are encoded by a diverse set of VL and a more restricted set of VH regions. VH gene family usage of PC-derived IgM- and IgG-RFs was found to be restricted to the VH1 and 3 gene families, with a preference for VH3, and many different VL genes were shown to contribute to RF specificity. Clonally related VH as well as VL sequences were identified, based on the presence of identical CDR3 regions and shared somatic mutations. In this B cell selection process base-pair substitutions as well as deletions of triplets in CDR regions, leaving the transcripts in frame, were involved. Together, these data provide further evidence for an Ag-driven immune response in the terminal differentiation into RF-producing PCs in patients with RA, including expansion of clonally related B cells, selection and isotype switching, all hallmarks of a GC reaction.
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Affiliation(s)
- W J E Van Esch
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
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20
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Kurth J, Perniok A, Schmitz R, Iking-Konert C, Chiorazzi N, Thompson KM, Winkler T, Rajewsky K, Küppers R. Lack of deleterious somatic mutations in the CD95 gene of plasmablasts from systemic lupus erythematosus patients and autoantibody-producing cell lines. Eur J Immunol 2002; 32:3785-92. [PMID: 12516573 DOI: 10.1002/1521-4141(200212)32:12<3785::aid-immu3785>3.0.co;2-e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The interaction of CD95 with its ligand CD95L is important for negative selection of B cells during the germinal center (GC) reaction. Recently, mutations conferring resistance to CD95-induced apoptosis have been described for human GC B cells. Hence, as has been demonstrated for CD95-deficient mice, also GC-derived autoreactive B cells carrying somatic CD95 gene mutations may potentially service negative selection and participate in the development of autoimmune diseases. Here, single plasmablasts (PB) which are implicated in the production of autoantibodies in systemic lupus erythematosus (SLE) patients as well as ten human B cell lines producing autoantibodies were analyzed for destructive somatic CD95 gene mutations. However, inactivating CD95 gene mutations were very rare in PB and not detected in the cell lines. Sequence analysis of V gene rearrangements amplified from single PB confirmed that the cells are (post) GC B cells and additionally demonstrated massive clonal expansion of these cells in two of four SLE patients. We conclude that CD95 gene mutations play little if any role in the generation of the pool of PB in SLE patients and that mutations in the CD95 gene are rare among autoantibody-producing B cells in SLE and rheumatoid arthritis.
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Affiliation(s)
- Julia Kurth
- Institute for Genetics and Department of Internal Medicine I, University of Cologne, Cologne, Germany.
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21
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Abstract
Rheumatoid factors (RFs), autoantibodies that bind to the Fc portion of IgG, are important in the immune response. RF-committed B-cells exist in the circulating lymphocyte pool in a high frequency (approximately 1-2 %) in normal individuals and in patients with pathological conditions associated with the sustained levels of circulating RF, such as rheumatoid arthritis (RA), Sjogren's syndrome (SS), and mixed cryoglobulinemia, associated with hepatitis C virus infection. RFs are induced by many infectious entities (viruses, bacteria, parasites) as a consequence of a secondary immune response to the pathogen, but usually the response is transient. It is likely that RFs play an important role in the host's defense against infection, both at the cellular level, where the RF B-cell can be an antigen presenting cell which can promote the antipathogen response, and at the humoral level, where RFs can contribute to the mopping up of the IgG antipathogen antibodies by contributing to immune complex formation and clearance. There has been much research on RFs in chronic pathological conditions, and the literature pertaining to their origin, structure, binding specificities, and possible roles in disease are discussed. The importance of the host defense, sometimes at the expense of an autoimmune response, is a balance that needs to be considered in light of a possible outcome of health or disease.
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Affiliation(s)
- Marianna M Newkirk
- Department of Medicine, The McGill University Hospital Centre, The Montreal General Hospital, Montreal, Quebec, Canada
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22
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Semrad TJ, Kenny TP, Malyj W, Robbins DL. Mutational analysis of immunoglobulin germline derived Vlambda4A light chains in rheumatoid arthritis. Clin Immunol 2001; 99:276-82. [PMID: 11318599 DOI: 10.1006/clim.2001.5006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In order to better characterize the expression of a family of light chains previously expressed in IgM rheumatoid factors, we studied the usage and somatic mutational pattern of the Vlambda4A light chain gene in rheumatoid arthritis (RA) patients. We sequenced 11 different transcripts of Vlambda4A from the synovial tissue of three different RA patients. For comparison, we found 8 rearranged transcripts of Vlambda4A from 4 normal peripheral blood lymphocyte libraries and 1 rearranged transcript from a non-RA con-A-resistant hybridoma in GenBank. A previously undescribed polymorphism of Vlambda4A was noted. Furthermore, conserved replacement mutations in the complementary determining regions, common silent mutations around these replacement mutations, and two subsets of mutated sequences were detected in multiple RA patients. These mutation patterns also correlated with observed consistencies in the rearrangements of the Vlambda4A/Jlambda junction. These data suggest that there is clonal expansion of Vlambda4A light chains in the RA synovium in response to a RA-specific antigen or as the result of an idiotypic response in RA.
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Affiliation(s)
- T J Semrad
- Department of Internal Medicine, University of California at Davis, Davis, CA 95616, USA
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Aarvak T, Natvig JB. Cell-cell interactions in synovitis: antigen presenting cells and T cell interaction in rheumatoid arthritis. ARTHRITIS RESEARCH 2001; 3:13-7. [PMID: 11178123 PMCID: PMC128879 DOI: 10.1186/ar135] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2000] [Revised: 09/20/2000] [Accepted: 09/20/2000] [Indexed: 11/23/2022]
Abstract
The synovial tissue in rheumatoid arthritis (RA) patients is enriched with mature antigen presenting cells (APCs) and many T lymphocytes. Interactions between APCs and T cells are essential for the initiation and amplification of T-cell-dependent immune responses, and may therefore play an important role in the chronic inflammatory processes in the synovium. The nature of the antigen(s) involved in RA still remains elusive. However, interactions and signaling through the costimulatory molecules CD28-CD80/86 and CD40-CD40L are critical during APC-T cell interaction for optimal cell activation. This review discusses how such costimulatory signals can be involved in the initiation and amplification of the inflammatory reactions in the synovium. Blocking of the signaling pathways involved in APC-T cell interactions might provide a specific immuno-therapeutic approach for the treatment of RA.
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Affiliation(s)
- T Aarvak
- Institute of Immunology, Laboratory of Rheumatology Research, The National Hospital, Oslo, Norway.
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24
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Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Br J Nutr 2000; 83:207-17. [PMID: 10884708 DOI: 10.1017/s0007114500000271] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Despite the almost universal clinical observation that inflammation of the gut is frequently associated with inflammation of the joints and vice versa, the nature of this relationship remains elusive. In the present review, we provide evidence for how the interaction of dietary lectins with enterocytes and lymphocytes may facilitate the translocation of both dietary and gut-derived pathogenic antigens to peripheral tissues, which in turn causes persistent peripheral antigenic stimulation. In genetically susceptible individuals, this antigenic stimulation may ultimately result in the expression of overt rheumatoid arthritis (RA) via molecular mimicry, a process whereby foreign peptides, similar in structure to endogenous peptides, may cause antibodies or T-lymphocytes to cross-react with both foreign and endogenous peptides and thereby break immunological tolerance. By eliminating dietary elements, particularly lectins, which adversely influence both enterocyte and lymphocyte structure and function, it is proposed that the peripheral antigenic stimulus (both pathogenic and dietary) will be reduced and thereby result in a diminution of disease symptoms in certain patients with RA.
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Affiliation(s)
- L Cordain
- Department of Health and Exercise Science, Colorado State University, Fort Collins 80523, USA.
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25
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Kyburz D, Corr M, Brinson DC, Von Damm A, Tighe H, Carson DA. Human Rheumatoid Factor Production Is Dependent on CD40 Signaling and Autoantigen. THE JOURNAL OF IMMUNOLOGY 1999. [DOI: 10.4049/jimmunol.163.6.3116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
High-affinity pathologic rheumatoid factor (RF) B cells occur in autoimmune diseases such as rheumatoid arthritis, but are deleted in healthy individuals. The reasons for the survival and differentiation of these autoreactive B cells in rheumatoid arthritis are not known. Previous studies in mice transgenic for a human IgM RF have shown that peripheral encounter with soluble human IgG leads to deletion of high-affinity RF B cells; however, deletion can be prevented when concomitant T cell help is provided. This study aimed to further discern the minimal factors necessary not only for the in vivo survival of RF B cells, but also for their differentiation into Ab-secreting cells. The combination of MHC class II-reactive T cells and Ag induced the production of RF in human IgM RF transgenic mice, while either stimulus alone was ineffective. Neutralizing Abs against CD40 ligand (CD40L), but not against IL-4 or IL-15, abrogated IgM-RF production. Moreover, blockade of CD40L-CD40 allowed IgG to delete the RF precursor cells. Most importantly, activating Abs to CD40 could substitute entirely for T cell help in promoting the survival of RF precursors and in stimulating RF synthesis in T cell deficient animals. The data indicate that CD40 signaling alone can prevent deletion of RF B cells by Ag and in the presence of IgG is sufficient to trigger RF synthesis. The results suggest that selective induction of apoptosis in high-affinity RF B cells may be achieved by blockade of CD40L-CD40 interaction.
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Affiliation(s)
- Diego Kyburz
- Department of Medicine and The Sam and Rose Stein Institute for Research on Aging, University of California at San Diego, La Jolla, CA 92093
| | - Maripat Corr
- Department of Medicine and The Sam and Rose Stein Institute for Research on Aging, University of California at San Diego, La Jolla, CA 92093
| | - Diana C. Brinson
- Department of Medicine and The Sam and Rose Stein Institute for Research on Aging, University of California at San Diego, La Jolla, CA 92093
| | - Amila Von Damm
- Department of Medicine and The Sam and Rose Stein Institute for Research on Aging, University of California at San Diego, La Jolla, CA 92093
| | - Helen Tighe
- Department of Medicine and The Sam and Rose Stein Institute for Research on Aging, University of California at San Diego, La Jolla, CA 92093
| | - Dennis A. Carson
- Department of Medicine and The Sam and Rose Stein Institute for Research on Aging, University of California at San Diego, La Jolla, CA 92093
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26
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Warnatz K, Kyburz D, Brinson DC, Lee DJ, Von Damm A, Engelhart M, Corr M, Carson DA, Tighe H. Rheumatoid factor B cell tolerance via autonomous Fas/FasL-independent apoptosis. Cell Immunol 1999; 191:69-73. [PMID: 9918688 DOI: 10.1006/cimm.1998.1415] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Normal individuals do not express the high-affinity autoantibodies specific for self-IgG (rheumatoid factors, RF) that are commonly seen in rheumatoid arthritis patients. Studies of transgenic mice expressing a human IgM rheumatoid factor have shown that one mechanism by which higher affinity RF B cells are tolerized to IgG is through abortive RF B cell activation followed by deletion in the absence of T cell help. We show that RF B cell deletion occurs through an intrinsic apoptotic mechanism that is independent of the Fas/FasL pathway and does not involve active killing by T cells, as it occurs in RAG-1-deficient RF transgenic mice to the same extent as in the parental RF transgenic line.
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Affiliation(s)
- K Warnatz
- Department of Medicine and The Sam and Rose Stein Institute for Research on Aging, University of California at San Diego, La Jolla, California, 92093-0663, USA
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27
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Jefferis R, Lund J, Pound JD. IgG-Fc-mediated effector functions: molecular definition of interaction sites for effector ligands and the role of glycosylation. Immunol Rev 1998; 163:59-76. [PMID: 9700502 DOI: 10.1111/j.1600-065x.1998.tb01188.x] [Citation(s) in RCA: 239] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The Fc region of human IgG expresses interaction sites for many effector ligands. In this review the topographical distributions of ten of these sites are discussed in relation to functional requirement. It is apparent that interaction sites localised to the inter-CH2-CH3 domain region of the Fc allow for functional divalency, whereas sites localised to the hinge proximal region of the CH2 domain are functionally monovalent, with expression of the latter sites being particularly dependent on glycosylation. All x-ray crystal structures for Fc and Fc-ligand complexes report that the protein structure of the hinge proximal region of the CH2 domain is "disordered", suggesting "internal mobility". We propose a model in which such "internal mobility" results in the generation of a dynamic equilibrium between multiple conformers, certain of which express interaction sites specific to individual ligands. The emerging understanding of the influence of oligosaccharide/protein interactions on protein conformation and biological function of IgG antibodies suggests a potential to generate novel glycoforms of antibody molecules having unique profiles of effector functions.
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Affiliation(s)
- R Jefferis
- Department of Immunology, Medical School, University of Birmingham, Edgbaston, UK.
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