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Arthritis associated with chronic active hepatitis: complement activation and characterization of circulating immune

J R Wands, E Alpert, K J Isselbacher

    Gastroenterology
    |December 1, 1975
    PubMed

    Insights

    Immune complexes in chronic active hepatitis (CAH) patients with arthritis contain Hepatitis B surface antigen and complement components. Their presence suggests a role in arthritis development, unlike in CAH without joint symptoms.

    Area of Science:

    • Immunology
    • Hepatology
    • Rheumatology

    Background:

    • Chronic active hepatitis (CAH) can present with joint pain.
    • The role of immune complexes in CAH-associated arthritis is not fully understood.

    Purpose of the Study:

    • To investigate the presence and composition of immune complexes in patients with CAH and arthritis.
    • To determine if these immune complexes are linked to the alternate complement pathway and Hepatitis B surface antigen.

    Main Methods:

    • Isolation and analysis of cryoproteins from serial serum samples of CAH patients.
    • Detection of immunoglobulins (IgG, IgM, IgA), complement components (C3, C4, C5), and Hepatitis B surface antigen within cryoprecipitates.
    • Assessment of C3 activator fragment in serum from patients with and without arthritis.

    Main Results:

    • Circulating immune complexes were identified in cryoproteins from CAH patients with arthritis, but not in those with uncomplicated CAH.
    • Cryoprecipitates from arthritic CAH patients contained IgG, IgM, IgA, C3, C4, and C5.
    • Hepatitis B surface antigen was concentrated in these immune complexes. The C3 activator fragment was present in arthritic patients but absent in others.

    Conclusions:

    • The presence of circulating complement-fixing immune complexes, particularly those containing Hepatitis B surface antigen and activating the alternate complement pathway, is associated with arthritis in CAH patients.
    • These findings suggest that immune complexes play a significant role in the pathogenesis of arthritis in chronic active hepatitis.

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