GAMMA GLOBULIN COMPLEXES IN RHEUMATOID ARTHRITIS AND CERTAIN OTHER CONDITIONS

Abstract

The sera of 11 patients, 7 with advanced rheumatoid arthritis, one with questionable rheumatoid arthritis, and 3 with obscure disorders, showed large amounts of unusual gamma-globulin complexes with sedimentation rates ranging from 9 to 17 S. These were observed by direct ultra-centrifuge analyses of whole serum as well as gamma-globulin and euglobulin fractions. In some sera they made up most of the gamma-globulin fractions. The complexes were readily dissociated to 7S units in acid buffers and in 4 to 6 [image] urea. Addition of normal 7S gamma-globulin to the sera and euglobulin fractions produced marked effects on the complexes A pronounced shift to lower S-rate components was observed with disappearance of the larger 12 - 17S moieties. The complexes were devoid of rheumatoid factor activity but were present in sera showing high titers in the serological reactions for rheumatoid factor. This relationship however was not a direct one. The complexes demonstrated strong inhibiting activity in certain of these reactions and were found to complex with rheumatoid factors giving rise to components with S-rates as high as 28 - 31 S. Some evidence was obtained for a relationship to "spontaneous precipitates" The difficulties involved in distinguishing certain of these sera from those of Waldenstrom macroglobulinemia and the importance of acid dissociation experiments are discussed. The possibility is discussed that these complexes might represent antigen-antibody complexes of the gamma-globulin-anti-gamma-globulin type. Evidence is presented suggesting that they are the 7S counterparts of the 19S rheumatoid factors combined with ordinary gamma-globulin. Further observations with a more sensitive method of detection are required to determine the exact incidence and distribution of these complexes in rheumatoid arthritis and other diseases.