Immunopathologic Study of Sural Nerves in Rheumatoid Arthritis

Immune complexes in sera and synovial fluids of patients with rheumatoid arthritis. Radioimmunoassay with monocylonal rheumatoid factor.

“…Fish, Michael, Gewurz, and Good (18) (20) found similar deposits in the walls of nutrient vessels of sural nerves of patients with rheumatoid neuropathy. Previously Pekin and Zvaifler (21,22) and Hedberg (23) had reported disproportionately low levels of hemolytic complement in the synovial fluids as compared to the sera in patients with RA.…”

Complement fixation by rheumatoid factor.

“…Patients with highest titers of RF appear to be afflicted with more severe disease (5,6), and in experimental animals RF appear to augment tissue damage (7,8). Both RF and complement have been identified in the lesions of rheumatoid arthritis (9,10). Crucial to the elucidation of the role of RF and complement in the possible pathogenesis of rheumatoid arthritis is the question of whether complement with its potential for producing inflammation and alterations in vascular permeability is activated by RF.…”

IgM rheumatoid factor and low molecular weight IgM. An association with vasculitis

“…However the correlation between the titer of IgM RF and the occurrence of vasculitis has not been constant since vasculitis has occurred in patients with relatively low serum titers of this factor (1). Nevertheless the observation of Conn et al (4) that patients with rheumatoid vasculitis have deposits of IgG and complement in their sural nerves indicates that immune complexes are deposited in the peripheral nerves in this condition. This has raised the possibility that rheumatoid factors of the IgG variety may participate in the formation of immune complexes involved in the development of vasculitis.…”