Clark M. Whitehead, Robert J. Winkfein, Marvin J. Fritzler, and J. B. Rattner 1635

The detection of autoantibodies in human sera provides important diagnostic and prognostic information. This study identifies a mitotic spindle component, the human kinesin-like-protein HsEg5, as an antigen in autoimmune disease. HsDg5 is shown to be a serologic marker for systemic lupus erythematosus that can be distinguished from the spindle-associated autoantigen NuMA by both indirect immunofluorescence and Western blotting.

Luis E. C. Andrade, Edward K. L. Chan, Carol L. Peebles, and Eng M. Tan 1643

In ANA determinations, a serum sample might show antibodies that react with the mitotic poles and spindle fibers. There are two types of staining, NuMA-1 and NuMA-2, which can be differentiated. This study shows that type 1 nuclear mitotic apparatus (NuMA-1) antibodies react with a 210-kd protein, and slightly more than 50% of patients with this antibody have Sjogren's syndrome. NuMA-2 antibodies react with a 116-kd protein, and patients with this antibody are heterogeneous, having both systemic and organ-specific manifestations.

Anders Bengtsson, Jonas Blomberg, Ola Nived, Rudiger Pipkorn, Lajos Toth, and Gunnar Sturfelt 1654

Results of the present study demonstrated that antibodies to certain human endogenous retroviruses were more common among SLE patients compared with healthy blood donors. Moreover, longitudinal analyses in 1 patient indicated that the antibody concentrations varied according to disease activity. These findings are consistent with previous findings from animal models, suggesting a possible retroviral contribution to the pathogenesis of SLE.

R. Hal Scofield, Fenchung Zhang, Biji T. Kurien, Camille J. Anderson, Morris Reichlin, John B. Harley, and Haraldine A. Stafford 1664

The initial events associated with autoantibody production in patients with SLE are rarely seen or studied. The finding that these early events resemble those for a foreign antigen suggests specific pathogenic mechanisms for the production of autoantibodies in SLE.

Carlomaurizio Montecucco, Roberto Caporali, Fabio Cobianchi, and Giuseppe Biamonti 1669

The results of this study demonstrate a new autoantibody specificity directed to the I protein of the hnRNP complex. Antibodies to hnRNP I occur in patients with SSc, while other anti-hnRNP antibodies (directed to the A/B proteins) are present in patients with RA, SLE, and MCTD, indicating distinct patterns of anti-hnRNP reactivity. These results may open new perspectives on the study of diagnostic markers for connective tissue diseases and on the study of the different biologic functions of single hnRNP proteins.

Grant W. Cannon, Scott J. Openshaw, John B. Hibbs, Jr., John R. Hoidal, Thomas P. Huecksteadt, and Marie M. Griffiths 1677

This study explores the potential role of nitric oxide in animal models of arthritis. This may increase our understanding of how this compound functions in human disease.

Kazuo Hino, Toshinaga Maeda, Kiyotoshi Sekiguchi, Kazuko Shiozawa, Hisanobu Hirano, Eiji Sakashita, and Shunichi Shiozawa 1685

This study demonstrates that EDA + FN, a splice variant of FN that is detectable in association with cellular transformation and is highly concentrated and preferentially expressed in rheumatoid joints, enhances adhesion of synovial cells onto cartilagenous matrix through the Hep2 (carboxyl-terminal heparin-binding) domain of EDA + FN. In this way, EDA + FN may contribute to rheumatoid joint destruction.

Pia Isomaki, Reijo Luukkainen, Paavo Toivanen, and Juha Punnonen 1693

The results of this investigation indicate that IL-13 is consistently present in rheumatoid synovium. In addition, exogenous IL-13 has antiinflammatory effects on synovial fluid mononuclear cells, suggesting that it may have therapeutic potential in the treatment of patients with RA.

Alexei A. Grom, Kevin J. Murray, Lorie Luyrink, Helen Emery, Murray H. Passo, David N. Glass, Terry Bowlin, and Carl Edwards, III 1703

This study provides evidence that not only TNFα, but also TNFβ, is involved in the pathogenesis of JRA and JSpA. The prominence of TNFβ in these diseases may represent a unique feature in comparison with adult RA. Furthermore, it may suggest that anti-TNF therapy directed toward both cytokines may be more beneficial in these diseases.

Kenneth G. Saag, Sheela Kolluri, Rachelle K. Koehnke, Thomas A. Georgou, John W. Rachow, Gary W. Hunninghake, and David A. Schwartz 1711

Interstitial lung disease, a serious extraarticular manifestation of RA, is of uncertain prevalence and has incompletely defined risk factors. Determining the independent significance of both cigarette smoking and arthritis-specific factors may have important implications for better understanding the pathogenesis of RA interstitial lung disease, and may help in early diagnosis and prevention of this condition.

Andrew D. Cook, Merrill J. Rowley, Ian R. Mackay, Andrew Gough, and Paul Emery 1720

The association of type II collagen antibodies with early progression to erosive disease in RA suggests that, in early polyarthritis, such antibodies appear to represent a sensitive marker for actual or impending cartilage damage. The presence in early RA of antibodies to collagen, in combination with the RA susceptibility motif, forecasts a rapidly progressive disease course, and, thus, detection of these antibodies could have valuable predictive utility and connotations regarding therapy.

Hisashi Hasegawa, Shin-Ichi Nishi, Satoshi Ito, Takako Saeki, Takeshi Kuroda, Hideki Kimura, Takeshi Watababe, Masaaki Nakano, Fumitake Gejyo, and Masaaki Arakawa 1728

Apolipoprotein E4 phenotype may be a risk factor for the development of amyloidosis associated with RA. Determination of the frequency of apolipoprotein E phenotype in patients with RA may enable physicians to predict the development of amyloidosis.

Tuija O. Kerttula, Pekka Collin, Anne Polvi, Markku Korpela, Jukka Partanen, and Markku Maki 1733

The results of this study indicate that patients with Sjogren's syndrome who have the alleles HLA-DRB1*0301, DQA1*0501, and DQB1*0201 are immunologically different from patients who do not have these alleles, in terms of alterations in circulating T cell receptor γ/δ subsets. These findings could be among the immunologic abnormalities typical of different autoimmune disorders in patients with the HLA-DR3 haplotype.

Patrick J. Branigan, Herve C. Gerard, Alan P. Hudson, and H. Ralph Schumacher, Jr. 1740

Screening systems based on PCR are being used more commonly in clinical laboratories for the assessment of pathogens in joints. Previous studies from a number of laboratories have yielded inconsistent results regarding the screening of synovial materials for Chlamydia trachomatis. The present study provides evidence that, in screening for Chlamydia, the type of sample used for preparation of nucleic acids in the PCR screening system is important, with synovial tissue more often yielding positive results in such assays than synovial fluid.

D. Sorbi, D. L. French, G. J. Nuovo, R. R. Kew, L. A. Arbeit, and B. L. Gruber .1747

This study demonstrated elevated levels of type IV collagenase (MMP-9) in the sera and at sites of disease involvement in patients with GCA. MMP-9 appears to be involved in degradation of vascular elastic tissue, which may play a key role in the pathogenesis of GCA. Further investigation is needed to determine whether circulating MMP-9 levels could be used as a clinical marker of disease activity.

Carol A. Langford, Michael C. Sneller, Claire W. Hallahan, Gary S. Hoffman, William A. Kammerer, Cheryl Talar-Williams, Anthony S. Fauci, and Robert S. Lebovics 1754

A long-term experience with subglottic stenosis (SGS) in 43 patients with Wegener's granulomatosis has provided unique insights into the clinical features, diagnosis, and treatment of this disease manifestation. Results from this study support the treatment of WG-related SGS with an intratracheal dilation and glucocorticoid injection procedure. In the absence of major organ disease activity, this procedure should be used without concomitant systemic immunosuppressive therapy, which may be ineffective for treating the subglottic lesion.