Læknablaðið : fylgirit - 01.05.1978, Side 130

Læknablaðið : fylgirit - 01.05.1978, Side 130
IgG-RF after DTT treatment. Among the seropos. were 19 women and 17 men, mean age 51 years (20 - 72) and mean duration of disease 8.7 years (1 - 40). Among the seroneg. were 21 women 2 men, mean age 47.7 years (24 - 70) and mean duration of disease 7.6 years (1 - 25). IgG-RF was seen in sera from 44% of the seropos. and 44.57o of the seroneg. patients, and only 3.7% of the controls. The titer of IgG-RF varied between' 1:9 to 1:72. As well as the titer - 1:9 as >1:9 a statistically significant difference between the arthritis group and the controlgroup was seen (p < 0.01, 3C2 test). No difference between the seropos. and seronegative arthritis group was seen. 55 of the total 59 RA patients had clinical activity in their disease. No correllation between presence of IgG-RF and the sedimentation reaction (SR), ANA (organspecific as well as organ non- specific) or elevated gammaglobulin in the serum was found. Mean duration of the disease was 10 and 9.1 years in the seropos. resp. the seroneg. which had IgG-RF. In the patients without presence of IgG-RF the mean duration of disease was 8.5 and 5.8 years in the seropos. and the seroneg. groups respectively. Acknowledgements: This work has been supported by the Danish Association Against Rheumatism, Copenhagen. Sum m ary: An indirect immunofluorescence method was used for the detection of IgM- and IgG- Rheuma- toid Factors, (IgMRF and IgGRF) in heat inacti- vated sera. Regarding IgMRF, positive reactions were found in sera from 29/30 seropositive and 3/24 seronegative rheumatoid patients and from 1/20 blood donors. Correlation was found between positive staining and the Waaler-Rose reaction and the RA-Latex reaction. Now again sera from seropositive and seronegative rheumatoid patients and healthy blood donors were inactivated and before immunofluorescent testing treated with a solution of dithiothreitol (DTT) in phosphate buffered saline (0,154 g/100 ml), which reduce disulfid bindings, and inactivate the polymeric IgM (and IgA-) antibodies. This makes it possible to differentiate between IgM and IgG antibodies and to avoid false positive reactions for IgG-RF caused by a possible binding of normal IgG to IgMRE. After DTT treatment RA-Latex positive sera became negative. The method was shown to be specific for the Fc-fragment of the antigen- IgG used in the testsystem. By testing sera pretreated with DTT, occur- rence of IgGRF was found in 16/36 (44%) of seropositive- and 10/23 (44,9%) of seronegative patients with definite rheumatoid arthritis, and in 2/54 (3,7%) controls in a titer 1:9. IgGRF titer varied between 1:9 and 1:72. The differ- ence between sera from rheumatoid patients and controls was significant (p< 0,01,3C?-test) for IgG-RF-titerKl:9 as well as > 1:9, whereas no difference between seropositive and seronegative rheumatoid arthritics was found, regarding IgG-RF. No correllation between occurrence of IgG-RF and other laboratory parameters was found. Litt. referencer: 1. Atra E. Peltier A, et Estes D.: De'tection des Facteur Antigammaglobuliniques (Facteur Rheumatoides) Seriques par Immunofluoresce- nce: I Description de la Réaction et Resultats Cliniques Path. et Biol. 1972, 20 : 175 - 180. 2. Freedman J. Masters C.A. Newlands M. Mollison P. L. Optimal Conditions for Use of Sulphydryl Compounds in Dissociating Red Cell Antibodies. Vox. Sang. 30 : 231-239, 1976. 3. JohnsonG.D., Holborow E.J.: Immuno- fluorescent Test for Rheumatoid Factor in Serum. Lancet 2: 1142, 1963. 4. Munthe E.: Immunological Studies in Rheuma- toid Arthritis. Universitetsforlaget, 1972. Oslo. 5. Natvig J.B.: Heterogenicity of Anti-gamma- Globulin Factors Detected by Pepsin-Digested Human Ig-Globulin. Acta. path. et microbiol. scandinav, 66 : 389, 1966. 6. Lyet P., et Normansell: Low Molecular weight Rheumatoid Factors in Rheumatoid Arthritis Sera. Immunochemistry 11 : 417, 1974. 7. Panush R.S., Bianco N.E., Schur P.H.: Serum and Synovial Fluid IgG, IgA and IgM Antigammaglobulins in Rheumatoid Arthritis. Arthritis Rheum. 14 : 737, 1971. 8. Pirofsky B. , and Rosner E.R.: DTT Test: A New Method to Differentiate IgM and IgG Erythrocyte Antibody, Vox. Sang. 27 : 480- 488, 1974. 9. Ropes M.W. , Bennett G.A.Cobb S. et al. 1958: Revision of Diagnostic Criteria for Rheumatoid Arthritis. Bull. Rheum. Dis. 9: 175-176, 1958. 10. Sany J. Clot J. Alary M. F. , Serre H. Intérét Pratique de la Détection des Facteurs Antigammaglobulinique Par L'immunofluore- scence Indirecte. Rev. Rhumatisme 41: 235-240, 1974. 11. Steensgaard J. M/ller N. P.H. and Funding L.: The Effects of Overloading in Density- Gradient Centrifugation. Eur. J. Biochem. 51: 483-493 (1975) 128
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