Summary
Fibronectin is a known component of plasma cryoprecipitates. It is seen in cryoglobulins from patients with monoclonal gammopathies and also from rheumatoid arthritis, and patients with systemic lupus erythematosus and other connective tissue diseases. We evaluated the clinical relevance of measures of cryoprecipitable fibronectin from the sera of 88 patients with rheumatic diseases and 27 healthy controls. There were 28 patients with rheumatoid arthritis, 19 with systemic vasculitis, 5 with cutaneous vasculitis, and 36 with a systemic connective tissue disorder. We measured total and cryoprecipitable fibronectin and for comparison immunoglobulins G, A, and M and complement C3 and C4. Cryoprecipitable fibronectin was detected in 33% control sera and 42% patient sera. The mean levels were higher in the sera of patients in all diagnostic groups. The highest levels were seen in rheumatoid patients with systemic disease, systemic vasculitis, and connective tissue diseases. The presence of cryoprecipitable fibronectin was related to the clinical activity of systemic vasculitis; none of the 6 patients with clinically inactive vasculitis had detectable fibronectin in their cryoprecipitates; but it was seen in 7 to 13 cases with active vasculitis. There were only weak relationships between cryoprecipitable fibronectin and immunoglobulin and complement levels in cryoprecipitates. We conclude that routinely measuring fibronectin levels in cryoprecipitates is generally of doubtful diagnostic value. However, it appears to be a useful marker of the clinical activity of systemic vasculitis and we recommend its use in the laboratory assessment of vasculitis.
Similar content being viewed by others
References
Anderson B, Rucker M, Entwistle R, Schmid FR, Wood GW (1981) Plasma fibronectin is a component of cryoglobulins from patients with connective tissue and other diseases. Ann Rheum Dis 40: 50–54
Wood G, Rucker M, Davies JW, Entwistle R, Anderson B (1980) Interaction of plasma fibronectin with selected cryoglobulins. Clin Exp Immunol 40: 358–364
Scott DL, Almond TJ, Naqvi SNH, Lea DJ, Stone R, Walton KW (1982) The significance of fibronectin in cryoprecipitation in rheumatoid arthritis and other disorders. J Rheumatol 9: 514–518
Beaulieu AD, Valet JP, Strevey J (1981) The influence of fibronectin in cryoprecipitate formation in rheumatoid arthritis and systemic lupus erythematous. Arthritis Rheum 24: 1383–1388
Carsons S, Lavietes BB, Diamond HS (1983) Factors influencing the incorporation of fibronectin into synovial fluid cryoprotein. J Lab Clin Med 102: 722–731
Villar M, Garcia-Bragado F, Jorem J, Blosca M, Antolin M, Rodrigo MJ, Schwartz S (1985) Cryoglobulinaemia and fibronectin. Acta Haematol 74: 161–163
Ferraccioli G (1986) Cryoprecipitation. In vitro studies on fibronectin as an independant cryoprecipitagogue. Ric Clin Lab 16: 315–320
Herbert KE, Jeffery E, Scott DL (1988) Interference by fibronectin in the crithidia inciliae tests for dsDNA antibodies in systemic lupus erythematosus. Br J Rheumatol [Suppl] 27: 21
Scott DGI, Bacon PA, Allen C, Elson CJ, Wallington TJ (1981) IgG rheumatoid factor, complement, and immune complexes in rheumatoid synovitis and vasculitis: comparative and serial studies during cytotoxic therapy. Clin Exp Immunol 43: 54–63
Scott DGI, Bacon PA, Elliot PJ, Tribe CR, Wallington TJ (1982) Systemic vasculitis in a district general hospital 1972–1978: clinical and laboratory features, classification, and prognosis in 80 cases. Q J Med 51: 292–311
Scott DGI, Blake DR, Blann A, Salmon M, Brailsford S, Winyard P, Bacon PA (1984) The role of lymphocytes and serum factors in vasculitic diseases. Ann Rheum Dis 43: 116
Scott DL, Farr M, Crockson AP, Walton KW (1982) Synovial fluid and plasma fibronectin levels in rheumatoid arthritis. Clin Sci 62: 71–76
Morrison PR, Edsall JT, Miller SG (1948) Preparation and properties of serum and plasma proteins. XVIII Separation of purified fibrinogen from fraction I of human plasma. J Ann Chem Soc 70: 3103–3108
Edsall JT, Gilbert GA, Scheraga HA (1955) The non-clotting component of the human plasma fraction I-1 (cold insoluble globulin). J Am Chem Soc 77: 157–161
Stathakis NE, Mosesson MW, Chen AB, Galanakis DK (1978) Cryoprecipitation of fibrin-fibrinogen complexes induced by cold insoluble globulin of plasma. Blood 51: 1211–1222
Stathakis NE, Mosesson MW (1977) Interactions among heparin, cold insoluble globulin and fibrinogen in the formation of the heparin-precipitable fraction. J Clin Invest 60: 855–865
Garelli S, Eroni PL, Montani F, Inveruizzi F (1986) Fibronectin and cryoprecipitation. Ric Clin Lab 16: 321–326
Menzell EJ, Smollen JS, Liotta L, Reid KBM (1982) Interaction of fibronectin with Clq and its collagen-like fragment (CLF). FEBS Lett 129: 188–192
Hautanen A, Keski-Oja J (1983) Affinity of myeloma IgG proteins for fibronectin. Clin Exp Immunol 53: 233–138
Carter SD, Scott DL, Elson CJ (1986) Fibronectin associated with immunoglobulin aggregates in sera and synovial fluid in rheumatoid arthritis. Br J Rheumatol 25: 353–358
Herbert KE, Coppock JS, Griffiths AM, Williams A, Robinson MW, Scott DL (1987) Fibronectin and immune complexes in rheumatic diseases. Ann Rheum Dis 46: 734–740
Sorvillo J, Gigli I, Realstein E (1986) Fibronectin binding to Clq associated with antigen-antibody complexes in EDTA treated plasma. Scand J Immunol 23: 153–160
Seeling R, Pott G, Seeling HP, Lichr H, Metzger P, Waldherr R (1984) Virus-binding activity of fibronectin: masking of hepatitis A virus. J Virol Methods 8: 335–347
Inman RD, Hodge M, Johnston MEA, Wright J, Heathcote J (1986) Arthritis, vasculitis, and cryoglobulinaemia associated with relapsing hepatitis A virus infection. Ann Intern Med 105: 700–703
Savage COS, Ng YC (1986) Aetiology and pathogenesis of major systemic vasculitides. Postgrad Med J 62: 627–636
Ronco P, Verroust P, Mignon F, Kourilsky O, Vanhilte P, Meyrier A, Mery JP, Mord-Maroger L (1983) Immunopathological studies of polyarteritis nodosa and Wegener's granulomatosis. A report of 43 patients and 51 renal biopsies. Q J Med 52: 212–223
Tzioufas AG, Manoussakis MN, Costello R, Silis M, Papadopoulos NM, Moutsopoulos HM (1986) Cryoglobulinaemia in autoimmune rheumatic diseases: evidence of circulating monoclonal cryoglobulins in patients with Sjögren's syndrome. Arthritis Rheum 29: 1098–1104
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Robinson, M.W., Walton, K.W., Scott, D.G.I. et al. Diagnostic relevance of fibronectin in cryoprecipitates. Rheumatol Int 10, 81–84 (1990). https://doi.org/10.1007/BF02274788
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02274788