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. 1999 Dec;58(12):757–761. doi: 10.1136/ard.58.12.757

Increased IgA rheumatoid factor and VH1 associated cross reactive idiotype expression in patients with Lyme arthritis and neuroborreliosis

J Axford 1, D Rees 1, R Mageed 1, P Wordsworth 1, A Alavi 1, A Steere 1
PMCID: PMC1752811  PMID: 10577962

Abstract

OBJECTIVE—To investigate whether autoreactive mechanisms occur in Lyme disease (LD) by determining IgA, IgG and IgM rheumatoid factor (RF) concentrations and RF associated cross reactive idiotype (CRI) expression in the serum of LD patients, with comparison to patients with rheumatoid arthritis (RA).
METHODS—The RF isotype profiles were determined in 59 patients with LD; erythema migrans (EM) (n=19), neuroborreliosis (NB) (n=20) and Lyme arthritis (LA) (n=20). Mouse monoclonal antibodies (mAbs) G6 and G8 (VH1 gene associated), D12 (VH3 gene associated) and C7 (VκIII gene associated) were then used to determine the RF associated CRI expression on IgM antibodies in 16 of these LD patients (eight seropositive for RF); (EM (n=3), NB (n=6), LA (n=7)).
RESULTS—Seven (18%) patients with either NB or LA had increased concentrations of IgA RF compared with none with EM. Significant differences in the number of patients with raised concentrations of IgG RF or IgM RF were not found between the LD patient groups. Five (3NB, 1LA and 1 EM) (31%) and three (2NB and 1LA) (19%) of LD patients had raised concentrations of the CRIs recognised by mAbs G6 and G8, respectively. These CRIs were detected in LD sera both with and without raised concentrations of RF and were not demonstrated on anti-Borrelia burgdorferi antibodies using ELISA. No LD sera tested had raised concentrations of the determinants recognised by mAbs C7 or D12.
CONCLUSION—Significantly raised concentrations of IgA RF and increased use of VH1 germline gene associated CRIs are found on IgM antibodies in the serum of LD patients. These data indicate the recruitment of autoreactive B lymphocytes in some patients with the later stages of LD.



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Figure 3  .

Figure 3  

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G6 CRI concentrations in controls, patients with RA and patients with LD seropositive (LDRF+) and seronegative (LDRF−) for RF. Bar represents median value.

Figure 4  .

Figure 4  

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G8 CRI concentrations in controls, patients with RA and patients with LD seropositive (LDRF+) and seronegative (LDRF−) for RF. Bar represents median value.

Figure 1  .

Figure 1  

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IgA RF concentration in controls and patients with erythema migrans (EM), neuroborreliosis (NB), Lyme arthritis (LA) and rheumatoid arthritis (RA). Bar represents median value.

Figure 2  .

Figure 2  

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IgM RF concentration in controls and patients with EM, NB, LA and RA. Bar represents median value. Abbreviations as in figure 1.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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