Yasutaka Yamauchi

Antinuclear antibodies in healthy aging people: a prospective study

In order to evaluate the expression of antinuclear antibodies (ANA) in normal elderly individuals over time and clinical significance, a cross-sectional ANA testing in healthy Japanese was performed, followed by annual evaluations of ANA positive aged (> or = 65 years) and a control group. ANA was more prevalent in the aged (11.4% vs. 3.8%) and most were persistent after 4 years. Anti-ssDNA and anti-histone antibodies were increased in aged ANA positive as compared to ANA negative controls. Except for a history of spontaneous abortion, there was no differences in clinical findings. HLA DRB1*0901 and the DQB1*0602 + 0302 + 0303 set of alleles were increased in ANA positive. Therefore, ANA in the aged were persistent, apparently directed toward chromatin elements, and shared MHC associations with autoimmune diseases. Longer follow-up may be necessary to improve the evaluation of clinical significance of ANA in the aged.

Familial Occurrence of impaired interleukin-2 activity and increased peripheral blood B cells actively secreting immunoglobulins in systemic lupus erythematosus

PURPOSE We tested the hypothesis that some abnormalities of immune functions are genetically controlled in patients with systemic lupus erythematosus (SLE). SUBJECTS AND METHODS We used a phytohemagglutinin-induced interleukin-2 (IL-2) activity assay and a spontaneous plaque-forming cell assay to evaluate T-cell and B-cell function, respectively, in 34 clinically healthy family members of six SLE probands. RESULTS Impaired IL-2 activity was found in 15 of the 29 consanguineous relatives. There was no relation between the household relatives and the nonhousehold relatives; none of the five nonconsanguineous household persons had abnormal results. Results for the B-cell assay were abnormal in 22 of the 29 consanguineous relatives. The B-cell abnormalities were more commonly observed in the consanguineous household relatives; four of the five nonconsanguineous household relatives also had abnormal assay results. CONCLUSION The findings indicate that the impaired IL-2 activity in relatives appears to strongly correlate with a genetic relationship. Although the evidence favors a genetic basis for the B-cell abnormalities, environmental effects may also contribute to the familial occurrence of these abnormalities.

SUPPRESSIVE EFFECTS OF A HERBAL FORMULA, TBL-1, ON TYPE II COLLAGEN-INDUCED ARTHRITIS IN DBA/1J MICE

1. The effects of a formula of traditional Chinese medicine, TBL‐1, on collagen‐induced arthritis (CIA) were investigated in DBA/1J mice.

Study of efficacy of 'Tsu-hi rei' on collagen-induced arthritis.

It was demonstrated that the oriental medication‘Tsu-hi-rei’is clinically useful and effective in treatment of patients with rheumatoid arthritis in China. This effect was supposed to be due to immunomodulation by decreasing of rheumatoid factor and immunoglobulin levels and various parameters of inflammation.So a basic experiment to investigate its mechanism of action was scheduled by using collageninduced arthritis in DBA/1J mice. From 4 weeks after booster injection of type II collagen, “Tsu-hi-rei”and western medication such as indomethacin and an immunomodulator were given, and their effects were compared by clinical observation, X-ray findings and pathologic examination. Anti-collagen antibody was also measured in each treatment group by ELISA.“Tsu-hi-rei”showed suppression of collagen-induced arthritis in frequency and severity. The soft X-ray study revealed decreased bone-destruction and, in sera, titers of anticollagen antibody were lower than in controls.These data suggest that“Tsu-hi-rei”has an antiinflammatory and immunosuppressive effect on collagen-induced arthritis.

A case of primary sjoegren syndrpome associated with neurogenic bladder.

63才,女性.以前より口内および眼乾燥感があり,半年前より頻尿出現,膀胱炎の治療うけるも軽快せず,入院.舌は乾燥,口角炎(+),頻尿(+), IgG 2996mg/dl,抗核抗体10倍(Speckled), SS-AIは64倍と陽性.唾液腺生検などよりSjogren症候群(SJS)と診断し, SJSに起因する神経因性膀胱を疑い,ステロイド薬治療で軽快した.自己免疫機序によるS2, 3, 4レベルの後根神経節炎による神経因性膀胱が生じ,頻尿をきたしたものと推測される.