Structural and immunological characterization of hydroxyl radical modified human IgG: Clinical correlation in rheumatoid arthritis Moreover, the high frequency of occurrence of IgG4 AKA might result from chronic exposure to the eliciting antigen, which could be a genuine autoantigen since we demonstrated that it is also present in the stratum corneum of human epidermis. The large predominance of IgG1 AKA and the quasi-absence of IgG2 AKA suggest that the recognized antigen may be partly comprised of protein. In spite of inter-individual heterogeneity, two predominant profiles were distinguished: IgG1 (alone) and IgG(1 + 4), which together represented 18 sera (58%). IgG1,2,3, and 4 AKA were detected in 27 (87%), 6 (19%), 4 (13%) and 11 (35%) of the 31 rheumatoid sera, respectively, and were found to be independent of the clinical and biological indices of the disease. In the rheumatoid sera, the serum level of IgG1 was found to be significantly increased and the level of IgG2 significantly decreased with regard to the control sera, while the levels of IgG3 and 4 as well as total IgG were in the normal range. The serum level of IgG1,2,3 and 4 was determined by radial immunodiffusion and the subclass distribution of IgG AKA by a three-step semi-quantitative immunofluorescence assay using standard monoclonal antibodies specific for each of the four human IgG subclasses. In this study, we investigated 31 IgG AKA-positive rheumatoid sera and 21 control sera from patients with non- rheumatoid inflammatory rheumatic diseases. Serum IgG, labelling the stratum corneum of the rat oesophagus epithelium, so-called anti-keratin antibodies (AKA) constitute the most specific marker for the diagnosis of rheumatoid arthritis. Vincent, C Serre, G Basile, J P Lestra, H C Girbal, E Sebbag, M Soleilhavoup, J P Subclass distribution of IgG antibodies to the rat oesophagus stratum corneum (so-called anti-keratin antibodies) in rheumatoid arthritis. Application of the polymerase chain reaction (PCR), using probes specific for the nucleotide sequence coding for the Gm(a) tetrapeptide, to the amplification of DNA from the in In most instances, these PBMC produced IgG that behaved as Gm(a+) in sensitive ELISA. To investigate the molecular basis of the acquired Gm(a) phenotype, PBMC from five Gm(a−) patients with rheumatoid arthritis and two Gm(a−) normal subjects were cultured in vitro after activation with PWM. RF mAb 61 displayed a high affinity (Kd, 10−7 M) for IgG Fc fragment of Gm(a+) and (g+) IgG or aggregated autologous Gm(a−), (g−) IgG but did not bind to native autologous IgG. That heterocliticity and dual Gm(a), Gm(g) specificity can be features of a single antibody molecule was formally demonstrated by analysis of a monoclonal RF (IgM mAb 61) generated from a Gm(a−), (g−) rheumatoid patient. Heat aggregation (63Â☌ for 20 min) or binding to Ag (as in tetanus toxoid-antitetanus toxoid complexes) induced a “functional†Gm(a+) and/or (g+) phenotype in Gm(a−), (g−) IgG from five healthy subjects and five rheumatoid patients, as suggested by the ability of these altered IgG to function as efficient targets for six heteroclitic RF in direct binding and competitive inhibition experiments. To investigate possible mechanisms underlying the in vivo generation of heteroclitic RF, we tested the ability of non-specifically and immune-specifically aggregated Gm(a−), (g−) IgG to function as targets for RF from Gm(a−), (g−) patients with rheumatoid arthritis. All polyclonal RF we isolated from nine rheumatoid arthritis patients with circulating Gm(a−), (b+), (g−), (f+) IgG displayed dual heteroclitic activity for the Gm(a) and Gm(g) allotypes, as shown by using appropriate RBC agglutination assays and affinity columns bearing Gm(a+) or Gm(g+) IgG. Heteroclitic rheumatoid factors (RF) are specific for allotypic determinants, e.g., Gm(a) or Gm(g) on allogeneic, but not autologous IgG. HETEROCLITIC POLYCLONAL AND MONOCLONAL ANTI-Gm(a) AND ANTI-Gm(g) HUMAN RHEUMATOID FACTORS REACT WITH EPITOPES INDUCED IN Gm(a−) Gm(g−) IgG BY INTERACTION WITH ANTIGEN OR BY NONSPECIFIC AGGREGATION
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