[Antinuclear and anticytoplasmic antibodies in polymyositis and dermatomyositis].
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Biomedical subjects
Publications and source records attributed to M Nishikai.
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A 52-year-old woman developed scleroderma, primary biliary cirrhosis, and Sjögren's syndrome after cosmetic silicone injections. These conditions may possibly represent 'human adjuvant disease'.
Anticentromere (kinetochore) antibody is the marker antibody in CREST syndrome, but the precise molecular composition of the partner antigen has been poorly defined. This report describes for the first time a procedure for the successful extraction and biochemical characterisation of the centromere antigen molecule. The centromere antigen was extracted with 4M NaCl solution. The molecular weight of the partner antigen of the centromere antibody was determined to be 70 000 daltons by the SDS-PAGE and immunoblotting methods. A Sephacryl S-300 column experiment confirmed these results. Centromere antigenic activity was preserved at pHs between 3 and 11 and was resistant to three enzymes, trypsin, RNase, and DNase.
Anti-nuclear ribonucleoprotein (RNP) antibody titers were estimated serially in 19 anti-RNP antibody-positive patients, which included 10 patients with systemic lupus erythematosus (SLE), 6 patients with mixed connective tissue disease (MCTD) and 3 patients with rheumatoid arthritis (RA). Counterimmunoelectrophoresis was used for antibody detection and a calf thymus extract was utilized as an antigen. Anti-RNP antibody titers in most patients with MCTD and RA did not fluctuate significantly, whereas those in patients with SLE fluctuated by more than a four-fold serum dilution. The anti-RNP antibody titers in SLE seemed to correlate with disease activity. Previous reports have stated that anti-RNP antibody titers do not fluctuate easily throughout the disease course. The present report shows that they do fluctuate in patients with SLE. The use of high dose of steroids in SLE might be responsible for the fall in antibody titer.
Precipitating antibodies occurring in 26 "pure" polymyositis (PM) patients and 22 "pure" dermatomyositis (DM) patients were studied by double immunodiffusion using calf thymus nuclear extract and whole calf thymus extract. Seventeen of 26 (65%) PM sera and 13 of 22 (59%) DM sera showed positive reactions, and 18, 10, and 2 sera exhibited 1, 2, and 3 precipitin lines, respectively. Common specificities were established by immunodiffusion for the 11 PM and 6 DM sera with strong precipitin lines. These were classed into three groups of shared specificity and six reactions specific for individual sera. These 9 calf thymus antigens were shown to be different from the known soluble tissue antigens Sm, nuclear RNP, Ro, and La. A 600-fold purification of the most frequently appearing system designated Jo-1 was achieved and its clinical specificity for patients with PM syndromes was established.
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A passive hemagglutination method for circulating autoantibody to purified human skeletal muscle myoglobin has been developed. This antibody was detected in the sera of 22 of 31 patients with polymyositis. The incidence and the antibody titers were significantly higher than in other myopathies such as myasthenia gravis (P less than .02), Duchenne-type muscular dystrophy (P less than .001), and other conditions (P less than .001). This new antibody test is useful in diagnosing polymyositis.
Esophageal diameters were measured in the roentgenogram in 43 patients with rheumatoid arthritis and in 43 healthy subjects matched by sex and age. The incidence of esophageal dilatation in rheumatoid patients was significantly higher than that of healthy subjects (P LESS THAN 0.01). Higher incidence of esophageal dilatation was seen in groups with pulmonary fibrosis and with subcutaneous nodules (P less than 0.01, P less than 0.05 respectively). An orderly relationship between the incidence of esophageal dilatation and the grades of RA test, stage of joint x-ray, or duration of disease were shown. These results suggest the existence of "rheumatoid esophageal disease".
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Radioimmunoassay of serum myoglobin was done in 53 patients with polymyositis syndromes and other conditions. Serum myoglobin values in 33 healthy subjects ranged from 4 to 77 [mean 33.3 +/- 19.8 (SD)] ng/ml. Fifty percent of polymyositis patients had elevated serum myoglobin levels (greater than 80 ng/ml). Serum myoglobin values in polymyositis patients fluctuated more sensitively than CPK and GOT. Combined estimation of myoglobin and CPK offers advantages for the detection of muscle injury and the prediction of disease exacerbation.