The study of a factor which can be demonstrated using Coons
indirect fluorescent antibody technique, in the serum of patients with
Systemic Lupus Erythematosus (and some other diseases) has been
described.
An outline of the historical development of the concept of
auto-immune disease has been presented, incorporating the technical
advances which assisted in elucidation of auto-immune phenomena and an
indication of the possible relevance of these to systemic lupus. The
main technique used in the study, fluorescence microscopy, was described
in detail. A study of the sera of 845 individuals revealed the
presence of the factor in 62 of 63 cases of systemic lupus (58 of these
were L.E. cell positive), 19 of 132 cases of Rheumatoid Arthritis, 14 of
110 cases of Thyroid Disease, 5 of 39 cases of Liver Disease, 10 of 75
cases of Discoid Lupus, and 5 of 258 cases in the control groups.
Quantitation of the factor by serial dilution showed that; the
majority of systemic lupus sera had a high titre, while the remaining
diseases showed moderate or low amounts of activity.
A comparison with other reported series revealed a variation in
sensitivity of the test in different hands, and the possible
interpretations of occasional low titre findings were outlined. The
171
results with the indirect fluorescent antibody technique were compared
with other ways of showing anti-nuclear .ctivity. Histochemical,
absorption and precipitation studies on sera with anti-nuclear activity
suggest that the nuclear antigen concerned in most instances was a complex
of D.N.A. and histone, and a similarity to the L.E. cell factor was noted
in this respect. It was concluded that the fluorescent antibody
technique whilst not able to distinguish easily between the reactions to
the several nuclear components which have been implicated, was a sensitive
and reliable method of detecting the factor in human sera, and that it
would be difficult to sustain a firm diagnosis of systemic lupus in the
absence of a positive test.
A study of the nature of the factor by eleotrophbretic,
chromatographic, ultracentrifugal and thiol degradation methods,
indicated that it was an immunoglobulin of the 7 S type in the sera
from the caseeof systemic lupus examined and that it was either of this
type or of 19 S macroglobulin type in Rheumatoid Arthritis, Liver or
Thyroid Disease; a few sera from Rheumatoid Arthritis cases appeared
to contain a mixture of the two types. These findings were compared
with reports of similar studies, stressing the importance of analysing
the "pure" fractions obtained by these procedures with sensitive
immunodiffusion techniques
