Summary
In vivo deposits of IgG have previously been demonstrated in the epidermal intercellular area of clinically unaffected skin from 68% of patients with primary Sjögren's syndrome (primary SS). This study compared circulating IgG from patients with primary SS with that from secondary SS in their ability to bind normal human epidermal cells in vitro. We observed a granular pattern of IgG binding to the normal epidermal cell surfaces with 9 of 18 sera from patients with primary SS (50%), 3 of 19 sera from patients with SS secondary to rheumatoid arthritis (16%) (p=0.025), and none of 24 normal control sera (p<0.001). In a subsequent analysis of polyethylene glycol separated sera from two normal controls and two primary SS patients, the epidermal IgG binding capacity was found only in the precipitates of the patients. These findings support our previous hypothesis that the in vivo intraepithelial IgG deposits in primary SS patients are due, at least in part, to cell surface-bound immune complexes.
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Alexander EL, McNicholl J, Watson RM, Bias W, Reichlin M, Provost TT (1989) The immunogenetic relationship between anti-Ro(SSA)/LA(SSB) antibody positive Sjögren's/lupus erythematosus overlap syndrome and the neonatal lupus syndrome. J Invest Dermatol 93:751–756
Arnett FC, Edworthy SM, Bloch DA McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, Medsger TA Jr, Mitchell DM, Neustadt DH, Pinals RS, Schaller JG, Sharp JT, Wilder RL, Hunder GG (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
Atkinson JC, Fox PC, Travis WD, Popek E, Katz RW, Balow JE, Pillemer SR (1989) IgA rheumatoid factor and IgA containing immune complexes in primary Sjögren's syndrome. J Rheumatol 16:1205–1210
Braathen LR, Thorsby E (1980) Studies on human epidermal Langerhans cells. I. Allo-activating and antigen-presenting capacity. Scand J Immunol 11:401–408
Bjerke JR, Krogh H-K, Livden JK, Matre R, Ulvestad E (1985) Fc receptors on keratinocytes. 7th European Immunology Meeting. Jerusalem, Israel, 8–13 September (abstr)
Furukawa F, Kashihara-Sawami M, Lyons MB, Norris DA (1990) Binding of antibodies to the extractable nuclear antigens SSA/Ro and SSB/La is induced on the surface of human keratinocytes by ultraviolet light (UVL): implications for the pathogenesis of photosensitive cutaneous lupus. J Invest Dermatol 94:77–85
Lee LA, Harmon CE, Huff JL, Norris DA, Weston WL (1985) The demonstration of SS-A/Ro antigen in human fetal tissues and in neonatal and adult skin. J Invest Dermatol 85:143–146
Lee AL, Weston WL, Krueger GG, Emam M, Reichlin M, Stevens JO, Surbrugg SK, Vasil A, Norris DA (1986) An animal model of antibody binding in cutaneous lupus. Arthritis Rheum 29:782–788
Lee LA, Gaither KK, Coulter SN, Norris DA, Harley JB (1989) The pattern of cutaneous IgG deposition in cases of subacute cutaneous lupus erythematosus is reproduced by infusing purified anti-Ro(SSA) antibodies into human skin grafted mice. J Clin Invest 83:1556–1562
LeFeber WP, Norris DA, Ryan SR, Huff JC, Lee LA, Kubo M, Boyce ST, Kotzin BL, Weston WL (1984) Ultraviolet light induces binding of antibodies to selected nuclear antigens on cultured human keratinocytes. J Clin Invest 74:1545–1551
Mannik M (1989) Development of immune complexes in the skin. J Invest Dermatol 93:73S-77S
Manthorpe R, Frost-Larsen K, Isager H, Prause JU (1981) Sjögren's syndrome. A review with emphasis on immunological features. Allergy 36:139–153
Manthorpe R, Oxholm P, Prause JU, SchiØdt M (1986) The Copenhagen Criteria for Sjögren's syndrome. Scand J Rheumatol [Suppl] 61:19–21
Nieboer C, Tak-Diamand Z, VanLeeuwen-Wallau AG (1988) Dust-like particles: a specific direct immunofluorescence pattern in subacute cutaneous lupus erythematosus. Br J Dermatol 118:725–734
Niedecken H, Wehrmann W, Bauer R, Kreysel HW (1988) Reaction of human keratinocytes with the monoclonal antibody anti-Leu-11:an immunohistologic study. J Am Acad Dermatol 18:504–510
Oxholm P (1989) Epithelial immunoglobulin deposits and Langerhans cells in patients with primary Sjögren's syndrome. Dan Med Bull 36:358–368 (thesis)
Oxholm P, GrÆm N, Oxholm A, Manthorpe R, Mansa B (1987) Circulating IgG from patients with primary Sjögren's syndrome deposited in the epidermis of normal human skin transplanted to athymic nude mice. Acta Pathol Microbiol Immunol Scand [A] 95:233–238
Oxholm P, Oxholm A, Thomsen BS (1987) In vitro binding of IgG from patients with primary and secondary Sjögren's syndrome to keratinized stratified squamous epithelia. Clin Exp Rheumatol 5:117–122
Oxholm P, Oxholm A, Prause JU (1987) Immunohistochemical characterization of intraepidermal in vivo IgG deposits in patients with primary Sjögren's syndrome. Acta Pathol Microbiol Immunol Scand [A] 95:239–244
Pease CT, Shattles W, Charles PJ, Venables PJW, Maini RN (1989) Clinical, serological, and HLA phenotype subsets in Sjögren's syndrome. Clin Exp Rheumatol 7:185–190
Penner E, Reichlin M (1982) Primary biliary cirrhosis associated with Sjögren's syndrome: evidence for circulating and tissue-deposited Ro/anti-Ro immune complexes. Arthritis Rheum 25:1250–1253
Simon M, Hunyadi J (1988) Leu-11b (CD16) antigen expression on human keratinocytes. Arch Dermatol Res 280:176–178
Sontheimer RD (1989) Subacute cutaneous lupus erythematosus: a decade perspective. Med Clin North Am 73:1073–1090
Talal N (1986) Recent developments in the immunology of Sjögren's syndrome (autoimmune exocrinopathy). Scand J Rheumatol [Suppl] 61:76–82
Thomsen BS, Oxholm P, Manthorpe R, Nielsen H (1986) Complement C3b receptors on erythrocytes, circulating immune complexes, and complement C3 split products in patients with primary Sjögren's syndrome. Arthritis Rheum 29:857–862
Thorbecke GJ, Silberberg-Sinakin I, Flotte TJ (1980) Langerhans cells as macrophages in skin and lymphoid organs. J Invest Dermatol 75:32–43
Tigalonowa M, Bjerke JR, Matre R (1989) Feγ-receptor as a functional marker on epidermal Langerhans cells in situ. Acta Derm Venereol (Stockh) 69:477–481
Velthuis PJ, Nieboer C, Kater L, Hene RJ (1989) A prospective immunofluorescence study of immune deposits in the skin of primary Sjögren's syndrome. Acta Derm Venereol (Stockh) 69:487–491
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Oxholm, P., Oxholm, A., Thomsen, B.S. et al. Epidermal cell surface-associated IgG in patients with primary Sjögren's syndrome: in vitro evidence for immune complex binding. Arch Dermatol Res 282, 423–427 (1990). https://doi.org/10.1007/BF00402616
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DOI: https://doi.org/10.1007/BF00402616