IgA-alpha-1-antitrypsin complex in systemic lupus erythematosus: preliminary report

Abstract

To investigate the role of the complex IgA-alpha-1-antitrypsin (IgA-AT) in systemic lupus erythematosus (SLE) and in mixed connective tissue disease (MCTD), and its possible relations to either activity of the disease or a treatment, we examined a concentration of IgA-AT complex in 65 SLE and 9 MCTD sera. Complex IgA-AT was evaluated using a double antibody enzyme-linked immunoassay (ELISA).

Twenty nine patients with SLE (44.6%) and three patients with MCTD (33.3%) had increased serum IgA-AT levels. The mean values of IgA-AT complex in patients with SLE and MCTD were higher than in healthy controls. Among the SLE group, patients with current neurological manifestation were characterized by an increase in IgA-AT serum concentration (2.45 ± 2.07 U vs. 0.78 ± 0.70 U, P < 0.001).

No relation was found between this complex and ESR level, C-reactive protein (CRP) concentration, or hemoglobin level. Ten SLE patients were treated with CTX intravenously. In this group of patients, IgA-AT complex level was found to be increased compared with patients without such a treatment (1.82 ± 1.30 U vs. 0.80 ± 0.67 U, P <0.05).

The present study provides two new observations. Firstly, IgA-AT complex is increased in SLE and MCTD compared with healthy controls, and secondly, patients with CNS involvement displayed a striking increased IgA-AT level.

Keywords

IgA-AT complex neurological involvement

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References

Gladman DD et al. Cross cultural validation and reliability of 3 diseases activity indices in systemic lupus erythematosus. J Rheumatol 1992; 19: 608-611.

Isenberg DA et al. Criteria for assessing disease activity in systemic lupus erythematosus . J Rheumatol 1989; 16: 1395-1396.

Liang MH et al. Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus. Arthritis Rheum 1989; 32: 1107-1118.

Petri M. , Hellmann D. , Hochberg M. Validity and reliability of lupus activity measures in the routine clinical setting. J Rheumatol 1992; 19: 53-59.

Tanaka S. et al. Antilymphocyte antibodies against CD4+2H4+ cell populations in patients with systemic lupus erythematosus. Arthritis Rheum 1989; 32: 398-405.

Winfield JB , Cohen PL , Litvin DA Antibodies to activated T cells and their soluble products in systemic lupus erythematosus. Arthritis Rheum 1982; 25: 814-819.

Stanworth DR IgA dysfunction in rheumatoid arthritis. Immunol Today 1985; 6: 43-45.

Tomasi TH , Hauptman S. The binding of alpha 1-antitrypsin to human IgA. J Immunol 1974; 112: 2274-2277.

Davis MJ et al. The association and predictive value of the complex immunoglobulin A-alpha 1 antitrypsin in the development of erosions in early rheumatoid arthritis . Scand J Rheumatol 1991; 20: 23-27.

10.

Dawes PT et al. The relationship between the complex of immunoglobulin A and alpha-1-antitrypsin, its constituent components and the acute-phase response as measured by C-reactive protein in rheumatoid arthritis treated with gold or D-penicillamine. Br J Rheumatol 1987; 26: 351-353.

11.

Lacki JK et al. Does the serum level of IgA-alpha-1-antitrypsin complex correlate with radiological progression in early rheumatoid arthritis? A 3-year follow-up study. Rheumatol Int 1994 (in press).

12.

Davis MJ et al. Sulphasalazine therapy in ankylosing spondylitis: its effect on disease activity, immunoglobulin A and the complex immunoglobulin A alpha-1-antitrypsin . Br J Rheumatol 1989; 28: 410-413.

13.

Struthers GR , Lewin IV , Stanworth DR IgA-alpha1 antitrypsin complex in ankylosing spondylitis. Ann Rheum Dis 1989; 48: 30-34.

14.

Laurell CB et al. J chain and alpha-1-antitrypsin complex in sera with poly and monoclonal IgA. Ric Clin Lab 1976; 6 (Suppl.3.): 57-67.

15.

Stanworth DR The effect of D-penicillamine treatment on humoral immunological factors in clinical and experimental arthritis. In: Maini R , Barry H (eds). Modulation if Autoimmunito and Disease. New York: Praeper, 1981: 31-35.

16.

Tan EM et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271-1277.

17.

Arnet FC et al. The American Rheumatism Association 1987 revised criteria for classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315-324.

18.

Christian CL Systemic lupus erythematosus. Clinical manifestation and prognosis. Arthritis Rheum 1982; 25: 887-888.

19.

Harris EN et al. Mortality of Jamaican patients with systemic lupus erythematosus . Br J Rheunatol 1989; 28: 113-117.

20.

Golstein M. et al. Neurological manifestations of systemic lupus erythematosus: role of antiphospholipid antibodies. Clin Exp Rheum 1993; 11: 373-379.

21.

Munves EF , Schur PH Antibodies to Sm and RNP: prognostic factors of disease involvement. Arthritis Rheum 1983; 26: 848-853.

22.

Winfield JD , Brunner CM , Koffler D. Serologic studies in patients with systemic lupus erythematosus and central nervous system dysfunction. Arthritis Rheum 1978; 21: 289-294.

23.

Winn DM et al. Identification of clinical subset of systemic lupus erythematosus by antibodies to Sm antigen. Arthritis Rheum 1979; 22: 1334-1337.