Immune complexes and the evolution of lyme arthritis. Dissemination and localization of abnormal C1q binding activity

J. A. Hardin, A. C. Steere, S. E. Malawista

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

In a prospective study of 78 patients with Lyme arthritis, abnormal serum C1q binding activity was present at the initial onset of erythema chronicum migrans in nearly all cases. The abnormal binding persisted in patients with subsequent nerve or heart involvement. In contrast, among those with only subsequent arthritis, it usually disappeared within three months (P = 0.018). However, in the synovial fluid of affected joints abnormal binding was uniformly present, and always to a greater extent than in the circulation. The abnormally reactive material behaved like antigen-antibody complexes. It had a density of 19S or greater, dissociated below pH 4.2, and lacked antiglobulin activity. Cryoprecipitates containing immunoglobulin were good but insensitive predictors of its presence, but immune complexes themselves did not seem primarily responsible for cryoprecipitability. Thus, as judged by C1q binding, immune complexes remain disseminated in certain patients with Lyme arthritis but localize to joints in others.

Original languageEnglish (US)
Pages (from-to)1358-1363
Number of pages6
JournalNew England Journal of Medicine
Volume301
Issue number25
StatePublished - 1979
Externally publishedYes

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Lyme Disease
Antigen-Antibody Complex
Erythema Chronicum Migrans
Joints
Synovial Fluid
Arthritis
Immunoglobulins
Anti-Idiotypic Antibodies
Prospective Studies
Serum

ASJC Scopus subject areas

  • Medicine(all)

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Immune complexes and the evolution of lyme arthritis. Dissemination and localization of abnormal C1q binding activity. / Hardin, J. A.; Steere, A. C.; Malawista, S. E.

In: New England Journal of Medicine, Vol. 301, No. 25, 1979, p. 1358-1363.

Research output: Contribution to journalArticle

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