intrinsic-factor and Arthritis--Rheumatoid

The occurrence of autoantibodies against intrinsic factor, H,K-ATPase, and pepsinogen was analysed by means of enzyme-linked immunosorbent assay in three groups of sera. Group 1 comprised sera from 14 rheumatoid arthritis patients with normal acid secretion; group 2, sera from 18 rheumatoid arthritis patients with reduced acid secretion; and group 3, sera from 11 patients with pernicious anaemia or achylia. Groups 1 and 2 were rheumatoid factor-positive, and group 3 was negative. Intrinsic factor autoantibodies were low in groups 1 and 2. In group 3, 9 of the 11 sera (82%) scored positive. The highest titres of H,K-ATPase and pepsinogen autoantibodies were found in groups 2 and 3. Only one serum in group 1 scored positive against H,K-ATPase, and two against pepsinogen, whereas corresponding values were 11 (61%) and 7 (39%) in group 2, and 10 (91%) and 6 (55%) in group 3. Autoantibodies against H,K-ATPase from a pool of patient sera recognized both the alpha- and beta-subunits of the enzyme. The present results support the hypothesis of an autoimmune disease overlap between non-organ-specific rheumatoid arthritis and organ-specific pernicious anaemia.

Topics: Adenosine Triphosphatases; Adult; Aged; Anemia, Pernicious; Arthritis, Rheumatoid; Autoantibodies; Enzyme-Linked Immunosorbent Assay; Gastritis, Atrophic; H(+)-K(+)-Exchanging ATPase; Humans; Intrinsic Factor; Middle Aged; Pepsinogens

We examined 51 sera from patients with pernicious anaemia for their capacity to block maximal gastrin stimulation of acid secretion by isolated rodent gastric parietal cells. 14C-aminopyrine accumulation was used as the index of acid secretion in vitro. Sera from patients with pernicious anaemia gave significantly (P less than 0.005) more block of maximal gastrin stimulation of acid secretion (61.7 +/- 37.8%) than sera from 10 patients with systemic lupus erythematosus (19.6 +/- 17.7%), 10 with scleroderma (34.2 +/- 22.3%), five with rheumatoid arthritis (22.4 +/- 15.6%) or 30 from healthy persons (27.4 +/- 12.8%). Maximal histamine stimulation of acid secretion was not inhibited. The blocking factor was present in serum IgG fractions, and serum and IgG fractions gave parallel dose-response and dilution curves. The serum block was abolished by absorption with gastric mucosal cells and correlated with the presence of parietal cell surface autoantibody. We conclude that serum immunoglobulin in pernicious anaemia can block gastrin stimulation of acid secretion and suggest that this block may be mediated by competition with gastrin for surface receptors on parietal cells.

Topics: Adult; Aged; Aminopyrine; Anemia, Pernicious; Animals; Arthritis, Rheumatoid; Autoantibodies; Binding, Competitive; Dose-Response Relationship, Immunologic; Female; Gastric Acid; Gastrins; Humans; Immunoglobulin G; In Vitro Techniques; Intrinsic Factor; Lupus Erythematosus, Systemic; Male; Middle Aged; Parietal Cells, Gastric; Rats; Rats, Inbred Strains; Scleroderma, Systemic

Acute phase reactants are nonspecific indicators of tissue necrosis and/or inflammation but may be helpful in determining activity of disease. Rheumatoid factor is likewise rather nonspecific, but its presence is helpful in predicting the course, severity, and complications of rheumatoid arthritis. Numerous antinuclear antibodies have been identified in collagen vascular diseases; perhaps the most specific association is between anti-Sm antibody and systemic lupus erythematosus. Anti-smooth-muscle and antimitochondrial antibodies can aid in differential diagnosis of liver disease, while antithyroid antibodies can perform a similar function in diffuse goiter. Anti-parietal-cell and anti-intrinsic-factor antibodies are quite specific for pernicious anemia.

Topics: Acute Disease; Adolescent; Adult; Aged; Antibodies; Antibodies, Antinuclear; Arthritis, Rheumatoid; Autoantibodies; Blood Sedimentation; C-Reactive Protein; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunologic Techniques; Infant; Infant, Newborn; Intrinsic Factor; Lupus Erythematosus, Systemic; Middle Aged; Pregnancy; Rheumatoid Factor

In a study of 99 patients with pernicious anaemia the incidence of clinical rheumatoid arthritis was normal but rheumatoid factor was present significantly more often than in controls. This was not related to the presence of circulating antibody to intrinsic factor.Intrinsic factor antibody was not detected in any of 151 latex-fixation-positive rheumatoid sera.

Topics: Adolescent; Adult; Aged; Anemia, Pernicious; Arthritis, Rheumatoid; Autoantibodies; Female; Humans; Intrinsic Factor; Latex Fixation Tests; Male; Middle Aged; Rheumatoid Factor

Topics: Adult; Anemia, Pernicious; Antibody Formation; Arthritis, Rheumatoid; Autoantibodies; Female; Fluorescent Antibody Technique; Folic Acid; Gastric Juice; Hemagglutination Tests; Hodgkin Disease; Humans; Immunodiffusion; Intrinsic Factor; Leukemia, Lymphoid; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Male; Middle Aged; Multiple Myeloma; Pyrazoles; Radioimmunoassay; Vitamin B 12

Topics: Achlorhydria; Adult; Agammaglobulinemia; Anemia, Pernicious; Antibodies; Arthritis, Rheumatoid; Atrophy; Autoimmune Diseases; Colitis, Ulcerative; Diarrhea; Female; Fluorescent Antibody Technique; gamma-Globulins; Gastric Mucosa; Gastritis; Giardiasis; Humans; Hypersensitivity; Hypersensitivity, Delayed; Infections; Intrinsic Factor; Male; Middle Aged; Vitamin B 12

Topics: Adult; Aged; Aged, 80 and over; Anemia, Megaloblastic; Anemia, Pernicious; Antibodies; Arthritis, Rheumatoid; Female; Folic Acid Deficiency; Humans; Intrinsic Factor; Male; Middle Aged; Vitamin B 12 Deficiency

Topics: Age Factors; Aged; Antibodies; Arthritis, Rheumatoid; Autoimmune Diseases; Complement Fixation Tests; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Hematocrit; Hemoglobins; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Schilling Test; Stomach; Vitamin B 12

Topics: Agammaglobulinemia; Anemia, Hemolytic, Autoimmune; Animals; Arthritis, Rheumatoid; Autoantibodies; Autoimmune Diseases; Coombs Test; gamma-Globulins; Glomerulonephritis; Graft vs Host Disease; Humans; Intrinsic Factor; Rheumatoid Factor; Thyroglobulin; Thyroiditis, Autoimmune; Uveitis