Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1979 Dec;64(6):1652–1660. doi: 10.1172/JCI109627

Circulating Immune Complexes in Cutaneous Vasculitis

DETECTION WITH Clq AND MONOCLONAL RHEUMATOID FACTOR

Susan E Mackel 1,2,3, Gerhard Tappeiner 1,2,3, Hilton Brumfield 1,2,3, Robert E Jordon 1,2,3
PMCID: PMC371319  PMID: 500831

Abstract

To investigate the pathogeneic significance of immune complexes in cutaneous vasculitis, 107 patients with various forms of cutaneous vasculitis, including 59 patients with necrotizing (leukocytoclastic) vasculitis (group 1), and 48 patients with lymphocytic vasculitis, or a predominately lymphocytic perivascular infiltrate (group 2), were studied. Immunoglobulins or complement components in cutaneous blood vessels were detected by direct immunofluorescence in high frequency in both groups (91 and 88%, respectively). Using two radioassays for circulating immune complexes, Clq or monoclonal rheumatoid factor (mRF) reactive material was detected in 68% of the patients with necrotizing vasculitis but only 44% of the patients in the lymphocytic-perivascular group. The mRF radioassay was elevated in 58% of the first group of patients and 41% of the patients in group 2, although Clq binding activity was increased in 54% of the patients with necrotizing vasculitis but only in 9% of the patients with a lymphocytic vasculitis or lymphocytic perivascular infiltrate. By using both sucrose density gradient ultracentrifugation and Sepharose 6B gel filtration, the Clq and mRF reactive material detected in some patients with necrotizing vasculitis eluted in high molecular weight fractions that were also anticomplementary. In one patient with necrotizing vasculitis and hepatitis B antigenemia, these heavy molecular weight Clq and mRF reactive fractions contained a two- to three-fold increase in hepatitis B surface antigen when compared with lighter molecular weight fractions. Heavy and light molecular weight mRF reactive material could be detected in selected patients in the lymphocytic-perivascular group as well as in the necrotizing vasculitis group. These studies suggest that cutaneous vasculitis, including acute necrotizing (leukocytoclastic) vasculitis and some forms of lymphocytic vasculitis, and perhaps some diseases characterized by a lymphocytic perivascular infiltrate, may represent cutaneous expressions of immune complex disease.

Full text

PDF
1652

Images in this article

1655Image
on p.1655
1655Image
on p.1655
1658Image
on p.1658

Selected References

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

  1. Agnello V., Winchester R. J., Kunkel H. G. Precipitin reactions of the C1q component of complement with aggregated gamma-globulin and immune complexes in gel diffusion. Immunology. 1970 Dec;19(6):909–919. [PMC free article] [PubMed] [Google Scholar]
  2. Andrews B. S., Cains G., McIntosh J., Petts V., Penny R. Circulating and tissue immune complexes in cutaneous vasculitis. J Clin Lab Immunol. 1979 Feb;1(4):311–320. [PubMed] [Google Scholar]
  3. Barnett E. V., Bluestone R., Cracchiolo A., 3rd, Goldberg L. S., Kantor G. L., McIntosh R. M. Cryoglobulinemia and disease. Ann Intern Med. 1970 Jul;73(1):95–107. doi: 10.7326/0003-4819-73-1-95. [DOI] [PubMed] [Google Scholar]
  4. Bing D. H. Purification of the first component of human complement and its subunit C1 esterase. Methods Enzymol. 1974;34:731–746. doi: 10.1016/s0076-6879(74)34095-5. [DOI] [PubMed] [Google Scholar]
  5. Braverman I. M., Yen A. Demonstration of immune complexes in spontaneous and histamine-induced lesions and in normal skin of patients with leukocytoclastic angitis. J Invest Dermatol. 1975 Feb;64(2):105–112. doi: 10.1111/1523-1747.ep12510321. [DOI] [PubMed] [Google Scholar]
  6. Cream J. J. Anticomplementary sera in cutaneous vasculitis. Br J Dermatol. 1973 Dec;89(6):555–559. doi: 10.1111/j.1365-2133.1973.tb07579.x. [DOI] [PubMed] [Google Scholar]
  7. Cream J. J. Clinical and immunological aspects of cutaneous vasculitis. Q J Med. 1976 Apr;45(178):255–276. [PubMed] [Google Scholar]
  8. DIXON F. J., VAZQUEZ J. J., WEIGLE W. O., COCHRANE C. G. Pathogenesis of serum sickness. AMA Arch Pathol. 1958 Jan;65(1):18–28. [PubMed] [Google Scholar]
  9. GOLTZ R. W. Cutaneous manifestations of allergic angiitis. J Lancet. 1962 May;82:218–222. [PubMed] [Google Scholar]
  10. Gabriel A., Jr, Agnello V. Detection of immune complexes. The use of radioimmunoassays with Clq and monoclonal rheumatoid factor. J Clin Invest. 1977 May;59(5):990–1001. doi: 10.1172/JCI108722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Giangiacomo J., Tsai C. C. Dermal and glomerular deposition of IgA in anaphylactoid purpura. Am J Dis Child. 1977 Sep;131(9):981–983. doi: 10.1001/archpedi.1977.02120220047007. [DOI] [PubMed] [Google Scholar]
  12. Gilliam J. N., Smiley J. D. Cutaneous necrotizing vasculitis and related disorders. Ann Allergy. 1976 Nov;37(5):328–339. [PubMed] [Google Scholar]
  13. Handel D. W., Roenigk H. H., Jr, Shainoff J., Deodhar S. Necrotizing vasculitis. Etiologic aspects of immunology and coagulopathy. Arch Dermatol. 1975 Jul;111(7):847–852. doi: 10.1001/archderm.111.7.847. [DOI] [PubMed] [Google Scholar]
  14. Hartree E. F. Determination of protein: a modification of the Lowry method that gives a linear photometric response. Anal Biochem. 1972 Aug;48(2):422–427. doi: 10.1016/0003-2697(72)90094-2. [DOI] [PubMed] [Google Scholar]
  15. Heusser C., Boesman M., Nordin J. H., Isliker H. Effect of chemical and enzymatic radioiodination on in vitro human Clq activities. J Immunol. 1973 Mar;110(3):820–828. [PubMed] [Google Scholar]
  16. Jordon R. E., McDuffie F. C. Serum and blister fluid anticomplementary activity in pemphigus and bullous pemphigoid. Sucrose density gradient studies. Proc Soc Exp Biol Med. 1976 Mar;151(3):594–598. doi: 10.3181/00379727-151-39267. [DOI] [PubMed] [Google Scholar]
  17. LOWRY O. H., ROSEBROUGH N. J., FARR A. L., RANDALL R. J. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951 Nov;193(1):265–275. [PubMed] [Google Scholar]
  18. Levo Y., Gorevic P. D., Kassab H. J., Zucker-Franklin D., Franklin E. C. Association between hepatitis B virus and essential mixed cryoglobulinemia. N Engl J Med. 1977 Jun 30;296(26):1501–1504. doi: 10.1056/NEJM197706302962605. [DOI] [PubMed] [Google Scholar]
  19. Lightfoot R. W., Jr, Drusin R. E., Christian C. L. Properties of soluble immune complexes. J Immunol. 1970 Dec;105(6):1493–1500. [PubMed] [Google Scholar]
  20. Luthra H. S., McDuffie F. C., Hunder G. G., Samayoa E. A. Immune complexes in sera and synovial fluids of patients with rheumatoid arthritis. Radioimmunoassay with monocylonal rheumatoid factor. J Clin Invest. 1975 Aug;56(2):458–466. doi: 10.1172/JCI108112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. McDuffie F. C., Sams W. M., Jr, Maldonado J. E., Andreini P. H., Conn D. L., Samayoa E. A. Hypocomplementemia with cutaneous vasculitis and arthritis. Possible immune complex syndrome. Mayo Clin Proc. 1973 May;48(5):340–348. [PubMed] [Google Scholar]
  22. Nydegger U. E., Lambert P. H., Gerber H., Miescher P. A. Circulating immune complexes in the serum in systemic lupus erythematosus and in carriers of hepatitis B antigen. Quantitation by binding to radiolabeled C1q. J Clin Invest. 1974 Aug;54(2):297–309. doi: 10.1172/JCI107765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. SHULMAN N. R. Immunoreactions involving platelets. I. A steric and kinetic model for formation of a complex from a human antibody, quinidine as a haptene, and platelets; and for fixation of complement by the complex. J Exp Med. 1958 May 1;107(5):665–690. doi: 10.1084/jem.107.5.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Sams W. M., Jr, Claman H. N., Kohler P. F., McIntosh R. M., Small P., Mass M. F. Human necrotizing vasculitis: immunoglobulins and complement in vessel walls of cutaneous lesions and normal skin. J Invest Dermatol. 1975 Jun;64(6):441–445. doi: 10.1111/1523-1747.ep12512411. [DOI] [PubMed] [Google Scholar]
  25. Sams W. M., Jr, Thorne E. G., Small P., Mass M. F., McIntosh R. M., Stanford R. E. Leukocytoclastic vasculitis. Arch Dermatol. 1976 Feb;112(2):219–226. [PubMed] [Google Scholar]
  26. Schroeter A. L., Copeman P. W., Jordon R. E., Sams W. M., Jr, Winkelmann R. K. Immunofluorescence of cutaneous vasculitis associated with systemic disease. Arch Dermatol. 1971 Sep;104(3):254–259. [PubMed] [Google Scholar]
  27. Soter N. A., Austen K. F., Gigli I. The complement system in necrotizing angiitis of the skin. Analysis of complement component activities in serum of patients with concomitant collagen-vascular diseases. J Invest Dermatol. 1974 Aug;63(2):219–226. doi: 10.1111/1523-1747.ep12679439. [DOI] [PubMed] [Google Scholar]
  28. Soter N. A., Austen K. F., Gigli I. Urticaria and arthralgias as manifestations of necrotizing angiitis (vasculitis). J Invest Dermatol. 1974 Dec;63(6):485–490. doi: 10.1111/1523-1747.ep12680443. [DOI] [PubMed] [Google Scholar]
  29. Soter N. A. Clinical presentations and mechanisms of necrotizing angitis of the skin. J Invest Dermatol. 1976 Sep;67(3):354–359. doi: 10.1111/1523-1747.ep12514705. [DOI] [PubMed] [Google Scholar]
  30. Soter N. A., Mihm M. C., Jr, Gigli I., Dvorak H. F., Austen K. F. Two distinct cellular patterns in cutaneous necrotizing angiitis. J Invest Dermatol. 1976 Jun;66(6):344–350. doi: 10.1111/1523-1747.ep12482901. [DOI] [PubMed] [Google Scholar]
  31. Stringa S. G., Bianchi C., Casala A. M., Bianchi O. Allergic vasculitis Gougerot-Ruiter syndrome. Arch Dermatol. 1967 Jan;95(1):23–27. [PubMed] [Google Scholar]
  32. Tappeiner G., Heine K. G., Kahl J. C., Jordon R. E. C1q binding substances in pemphigus and bullous pemphigoid. Detection with a [131I] C1q binding assay. Clin Exp Immunol. 1977 Apr;28(1):40–48. [PMC free article] [PubMed] [Google Scholar]
  33. WINKELMANN R. K., DITTO W. B. CUTANEOUS AND VISCERAL SYNDROMES OF NECROTIZING OR "ALLERGIC" ANGIITIS: A STUDY OF 38 CASES. Medicine (Baltimore) 1964 Jan;43:59–89. doi: 10.1097/00005792-196401000-00003. [DOI] [PubMed] [Google Scholar]
  34. Wands J. R., Mann E., Alpert E., Isselbacher K. J. The pathogenesis of arthritis associated with acute hepatitis-B surface antigen-positive hepatitis. Complement activation and characterization of circulating immune complexes. J Clin Invest. 1975 May;55(5):930–936. doi: 10.1172/JCI108022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Zubler R. H., Lange G., Lambert P. H., Miescher P. A. Detection of immune complexes in unheated sera by modified 125I-Clq binding test. Effect of heating on the binding of Clq by immune complexes and application of the test to systemic lupus erythematosus. J Immunol. 1976 Jan;116(1):232–235. [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES