Cell‐mediated immune response in systemic lupus erythematosus.

Abstract

Cell-mediated immunity in 29 patients with systemic lupus erythematosus was assayed by macrophage inhibitory test (MI-test) using native DNA as an antigen. The mean percentage migration in SLE and normal control was 77.8 and 98.1%. The percentage migration below 84.3% was considered t o be a positive MI-test. Patients with SLE possessed cellular hypersensitivity to native DNA; positive MI-tests seemed to be present more often when the disease was clinically active. Percentage migration did not correlate with the presence of ANA and anti-DNA antibody. It is of note that lymphocytes from patients with negative ANA produced migration inhibitory factor in response t o native DNA. The higher incidence of positive MI-tests in patients with nephrotic syndrome is impressive. The role of the presence of DNA-sensitized lymphocytes t o the perpetuation of renal lesion in nephrotic syndrome is discussed.Although the importance of humoral antibodies in the pathogenesis of certain forms of systemic lupus erythematosus (SLE) has been established, the role of cellular immune response in this disorder is unknown.One in uitro assay of cell-mediated immunity, the inhibition of macrophage migration, has been shown to correlate with delayed hypersensitivity in the guinea pig (1). This reaction is mediated by a soluble substance, migration inhibitory factor (MIF), which is produced by sensitized lymphocytes in response to specific antigen. This technique has been adapted to human lymphocytes (2). This paper describes studies of cell-mediated immunity using this technique in patients with SLE. MATERIALS AND METHODS PatientsTwenty nine patients, seen as both in-and outpatients at Keio University Hospital, had multiple system involvement compatible with SLE and fulfilled ARA preliminary criteria for the classification of SLE (3). The patients had been observed during both active and inactive stages. At biweekly intervals, clinical and laboratory observations were recorded regardless of clinical activity. The average period of observation was 2 H years, the extremes varying between 1 and 86 months. All patients had received corticosteroid drugs at some time, and most of them were receiving maintenance therapy.Thirteen patients with either rheumatoid arthritis or systemic sclerosis were also studied.As normal controls, 8 healthy adults were studied. Criteria of ActivityPatients were considered clinically active if two or more of the following symptoms were present: fever more than 38" C, butterfly rash, arthritis or persistent arthralgia, oral 688

In vitro nucleoside specific immune response by lymphocytes from systemic lupus erythematosus.

“…This result is consistent with studies demonstrating that SLE lymphocytes had sensitized to nuclear antigen (17,18). In other studies, SLE lymphocytes cultured with native DNA produced a macrophage migration inhibitory factor that also suggests that there are circulating DNA-sensitized lymphocytes (19).…”

In Vitro TNP‐Specific Antibody Formation by Peripheral Lymphocytes from Patients with Systemic Lupus Erythematosus

“…Separation of peripheral lymphocytes (1). Lymphocytes were separated from peripheral blood by centrifugation on a Conray-FicoU gradient.…”