LOCAL ANTI-TYPE-II COLLAGEN ANTIBODY-PRODUCTION IN RHEUMATOID-ARTHRITIS SYNOVIAL-FLUID - EVIDENCE FOR AN HLA-DRL-RESTRICTED IGG RESPONSE

Objective. To investigate the production of type II collagen (CII) antibodies in the synovial fluid (SF) of rheumatoid arthritis (RA) patients, and to examine the HLA dependence of this local production. Methods. The ELISPOT method was used for enumerating anti-CII-reactive cells. Serologic tissue typing was performed. Results. Anti-CII-reactive cells were found in the SF of 16 of 31 patients, but not in any of the peripheral blood samples obtained in parallel. SF anti-CII antibody production showed no correlation with clinical parameters, but its frequency increased significantly with age. The IgG anti-CII response occurred exclusively in patients who were positive for HLA-DR4 and was significantly associated with DR4. Conclusion. Anti-CII production may be important in local immune complex formation. The indirect demonstration of a DR4-restricted T cell response to CII is an indication of a pathogenetic role of collagen autoimmunity in RA.