Immune Complexes in Juvenile Idiopathic Arthritis
#MMPMID27242784
Moore TL
Front Immunol
2016[]; 7
(?): 177
PMID27242784
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Juvenile idiopathic arthritis (JIA) reflects a group of clinically heterogeneous,
autoimmune disorders in children characterized by chronic arthritis and
hallmarked by elevated levels of circulating immune complexes (CICs) and
associated complement activation by-products in their sera. Immune complexes
(ICs) have been detected in patients' sera with JIA utilizing a variety of
methods, including the anti-human IgM affinity column, C1q solid-phase assay,
polyethylene glycol precipitation, Staphylococcal Protein A separation method,
anti-C1q/C3 affinity columns, and Fc?RIII affinity method. As many as 75% of JIA
patients have had IC detected in their sera. The CIC proteome in JIA patients has
been examined to elucidate disease-associated proteins that are expressed in
active disease. Evaluation of these ICs has shown the presence of multiple
peptide fragments by SDS-PAGE and 2-DE. Subsequently, all isotypes of rheumatoid
factor (RF), isotypes of anti-cyclic citrullinated peptide (CCP) antibodies, IgG,
C1q, C4, C3, and the membrane attack complex (MAC) were detected in these IC.
Complement activation and levels of IC correlate with disease activity in JIA,
indicating their role in the pathophysiology of the disease. This review will
summarize the existing literature and discuss the role of possible protein
modification that participates in the generation of the immune response. We will
address the possible role of these events in the development of ectopic germinal
centers that become the secondary site of plasma cell development in JIA. We will
further address possible therapeutic modalities that could be instituted as a
result of the information gathered by the presence of ICs in JIA.
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