A search has been made for the presence of an initiating antigen in rheumatoid arthritis to which rheumatoids would specifically respond in vitro tests of delayed hypersensitivity. This has involved the testing of 25 synovial specimens prepared in a variety of ways. Crude synovial homogenates containing soluble and insoluble material have been tested in the leucocyte migration test (LMT) and the lymphocyte transformation test (LTT). Protein eluates and detergent solubilized protein have also been tested. Results have been presented indicating that rheumatoid arthritis patients and age and sex-matched controls will respond to the same extent to an ubiquitous test antigen, streptokinase and to a non-specific cell membrane antigen from homogenized erythrocytes. However RA's do respond specifically to IgG in both native and aggregated forms to which controls do not respond in the LMT. A protein has been eluted from inflammatory synovium which induces equal inhibition of migration in the LMT of both RA and control leucocytes and stimulation of RA and control lymphocytes in the LTT. The mechanism of action of this protein in the LMT and LTT has been discussed in the light of reports in the literature. A role for this protein as an initiating factor in rheumatoid arthritis has not been established. A speculative role in the perpetuation of this chronic rheumatoid response has been presented in terms of the aetiology and pathogenesis of this disease.
|Date of Award||1978|