392 C3D as a marker of extraarticular manifestations of rheumatoid arthritis

392

i’3D AS A MARKER OF EXTRAART ICULAR OF RHEIIMATOID ARTHRITIS. A. Peretz, r!r:~5se13, Rclqilim.

MAN I FESTAT IONS J. Duchateau.

394

iG)mp’er~ent evaluations were performed in 48 RA patient: cjnd compared to those of 38 patients with other inflammatory rheumatic diseases (IRD). rD.rA anficoaquiated 31asma were collected to measure hcmoLytic activity (CH50), C3 and C4 camp ! emen? fractions (nephelometry) and C3d, a breakdown product of C3 (radial immunodiffusion after 27% PEG voI/vol mixing and centrifuqation). 16 IJA o3tients had extraarticular features (EAF+). Tne IRD were either exclusively localized in 13 subjects (qOLJt, chondro calcinosis) or associated to extr~larticrliar infiammatory process (Reiter, Lrohn,.,.) in 25. No significant differences were noticed for CH50, C3 and C4 among these groups, while the Levels of C3d and the ratio C3d/C3 were significantly increased inRApatients with FAF ver-sus those without it (p < 0.002). A similar difference was observed when RA EAF+ patients were compared to IRD patients (p
393

FOOD-INDUCED(ALLERGIC) ARTHRITIS,

I,

RHEUMA-

TOID ARTHRITIS EXACERBATED BY MILK, R. S. Panush, R. M. Stroud, E. M. Webster, muman. Univ Florida and VAMC, Gainesville, FL 32610. Suggestive, but largely unproven, observations associated RA with environmental antiaens. including foods. We studied a patiertt Gith-RA in a prospective, blinded, contrulled fashion to determine whether symptoms related to food sensitivities. This 52 yo WF, with II. yri of class I, stage I, active RA, had exacerbations allegedly associated with meat, milk, and beanc. We observed increased symptoms followinc an unblinded food challenge. She‘was then studied in our CRC. On her normal diet for 6 d. she avriraaed 30 min AM stiffness, 9 tender and 3 swollen joint scores, 87% subjective and 89y examiner assessments (100% = best possible). While fasting (3 d) or on Vivonex (2 d), we noted nu AM stiffness, 1 tender and 0 swollen joint scores, and assessments of 100% (~~0.05 vs. normal diet)She was then nourished with Vivonex for 33 d without difficulty and challenged at meal times with lyophyllized foods in opaque capsules, blind1.y. 4 milk challenges ( T8.02 per Neal) produced-up to 30 min AM stiffness. 14 tender and 4 swollen joint scores, 85% sibjective and 80%: objective assessments (~~0.05 vi. fasting-Vivonexj, peaking 24-48 hrs post-challenge. Placebo and other foods were without effect. She had delaved and immediate cutaneous reactivity to milk, Ro +IgE anti-milk, but marked +IgG and IgG4 anti-milk. These observations associate symptomatic exacerbation of RA with milk and suggest new insights as to the pathogenesis of inflammatory arthritis and its therapeutic control.

IMMUIi'ECOMPLEX(IC)-INDUCED ENTEROPATHY:CHARACTER OF TiiE C0MPLEXF.SAND EFFECT OF BLOCKADE OF THE l@i?lf#UCLEARPHAGOCYTESYSTEM (MPS). KJ Bloch, M.D., RP Perry, B.S., M Bloch, M.S., and AW Walker, M.D., Boston, Massachusetts In IC-induced enteropathy in the rat, the small intestine showed bands of serosal hyperemia alternating with non-hyperemic bands. Histologically, vascular congestion and mucosal edema were observed; more severe lesions showed hemorrhage and sloughing of villi. The present Antistudy characterized the IC involved. bovine serum albumin (BSA) antibodies were induced in rats injected with BSA and complete After 2 booster injections, Freund's adjuvant. antiserum was obtained at week 6. IC were prepared at 4OC for 2 hours followed by centriThe supernatants from mixtures prefugation. pared in antibody excess, equivalence and 5x or greater antigen excess were injected into fasted rats; only complexes prepared in 5x antigen Similar reexcess elicited typical lesions. sults were obtained with rat anti-BSA antibodies purified on BSA-immunoabsorbents. Rat antisera prepared as described contained predominantly IgG2a and IgGl antibodies; complexes prepared with either class of antibody elicited To test whether blockthe intestinal lesions. ade of the MPS would enhance the intestinal lesions, rats were injected with colloidal carbon. In comSeveral hours later, IC were injected. the intestinal lesions parison to controls, were more severe in rats pre-treated with carthe antigenbon. These studies have identified antibody ratio and isotypes capable of inducing IC-mediated enteropathy and have shown that MPS blockade enhances the severity of lesions.

VARIABILITY OF FOODANTIGENS USED IN SKIN AND W. Brummund, MD, S. Bar-,Sela, MD, R. Wyrick, PhD, J. Yunginger, MD and J.N. Fink, -nilwaukee, Wisconsin. a lack of correlation between skin test results and patient histories in SUSIn addition, marked skin petted food allergy. reactivity to the fresh food may occur without skin reactions to the corresponding food extract. This studv was done to determine the extent to RAST TESTING.

which

skin

and RAST reactivities

are

related

to

the type of food preparation used in patients Skin prick and RAST studies with food allergy. were carried out in 10 subjects with histories of anaphylaxis, angioedema or asthma following injestion of a specific food, and in 2 control Four different forms of 7 individual subjects. foods were used, including the fresh food, a fresh aqueous extract of the lyophilized food, and commercially obtained aqueous and glyceriFoods studies included nated food extracts. apple, banana, carrot, celery, green Pepper, tomato and watermelon. Skin test results deronstrated that the greatest percent of subjects with histories of food sensitivity reacted with the oertlnent fresh food preparation. The fewest &mber of individuals'reacted with the aqueous commercial preparation; the other extracts were intermediate in reactivity. False aositive skin reactions were less than 18%. kA?&ults were uniformly negative independent of the food or form of food used in the assay. This study indicates that there is a broad variability In currently available Food preparations

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clinical

testing

for

food

allergy.