Specificity of autoantibodies to lactate dehydrogenase isoenzyme subunits

We studied serum from 12 unrelated patients with variant electrophoretic patterns for lactate dehydrogenase (EC 1.1.1.27; LD) isoenzymes characteristic of LD-immunoglobulin complexes. Immunoglobulin class was identified in four cases. In all 12 cases, mixing the patient's serum with control serum altered the mobility of normal LD isoenzymes to that of the variant. To determine antigenic specificity, we mixed ammonium sulfate-precipitated fractions of patient's samples with purified LD1 (H tetramer) or LD5 (M tetramer) prepared by anion-exchange chromatography. In six cases the fractionated antibody displayed a pure M-subunit specificity. In four cases it acted against both M tetramers and H tetramers, and in two cases the antibody affected the migration only of LD isoenzymes containing both M and H subunits (i.e., hybrid isoenzymes). Depending on the relative excess of antibody or LD5 in such mixtures, various different anomalous electrophoretic patterns were produced. These results indicate that apparent differences between variant LD isoenzyme patterns in whole serum of different individuals can arise from autoantibodies with similar reactivities being present in various ratios of antigen to antibody.