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SUMMARY
Plasmapheresis fltiids from 20 palients with clinically active SLE. from three patients with
Waldenstrom's disease, from three patients with rheumatoid arthritis, two patients with myasthenia
gravis and other diseases including aetive systemic disorders were precipitated using polyethylene
glycol 6000 (PEG). By applying ethidium bromide staining, plasma nucleic acids (PNA) could be
demonstrated in PEG-precipitates of SLE patients exclusively. Purified immunoglobuhns of SLE
plasma precipitates were shown to form antigen-antibody complexes with PNA as dcmonstraied by
eleclronmicroscopy. Further charactcrizalion o^ PNA by agarose gel eleetrophoresis revealed a
molecular weight up to 20 kbp. Cesium chloride buoyant density gradients showed non-
homogeneous molecules, excluding pure microbial origin. In spite of RNase digestion, the PNA
contained RNA with 30-70"ii riboguanosine as shown by nucleoside analysis. The high amount of
guanosine-rich RNA was further supported by similarities between PNA and polyriboguanylic acid
in hyperehrome shifting due to thermic denaturation. HPLC analysis showed a molecular weight of
ribonucleic acids of more than 60 b thus excluding mere oligonueleotides. In contrast to B-type
dsDNA. PNA from SLE patients were immunogenic. Antibodies against PNA could be induced in
rabbits by subcutaneous injection. The anliscra thus obtained showed crossrcactivity with
polyriboguanylic acid and dsDNA preparations.
RESULTS
Characterization of PNA
Negative hybridization with BLUR 12 (Bam H I-Linked
Unique Repeat) DNA, recognizing highly dispersed alu
sequences, exeluded the possible origin ofPNA from unselected
human DNA (data not shown). In addition, free haemoglobin
was determined to be less than 5 /Jg/ml in all cases studied,
indieating no relevant cell rupture during plasmapheresis (less
than 0-01 "-iO.
Applying CsCl buoyant density eentrifugation. a non-
homogeneous density of PNA was demonstrated, indicating a
high complexity of PNA (Fig. I).
Gel eleetrophoresis showed PNA of non-homogeneous Fig. I. An analytic cesium chloride buoyant density gradient of PNA
molecular weights. However, the presenee of high molecular from one patient with SLE as compared to a nucieic acid preparation of
weight NA comigrating with 20 kbp linear dsDNA was E. coli obtained under same conditions.
demonstrated in most ofthe preparations investigated (Eig. 2).
Nucleoside analysis after complete DNase 1. PI nuclease,
and alkaline phosphatase digestion showed an elevated dG-dC
eontent as eompared to random human genomic and mitoehon-
drial DNA (Table 1) of hepatoeytes.
lo lb 2a 2b 3o 30 4c 4b 5a 5b W 6a I I
Poor methylation of deoxyeytosine, about I % as compared
to 2-5-4-5'Mi of human eellular DNA, eould be proven by
nueleoside analysis (data not shown).
In spite of RNase A digestion during the preparation of
rtfl 23 I kbp
9 4 kbp
PNA, high amounts of ribonucleosides. espeeially riboguano- 6 6 kbp
Deoxyribonucleosides (mol %)
human D N A
nuclear 29 21-4 21-2 28-4 42-6 50-2 0'99 I 02
t milochondrial 27-8 2 2 1 2 2 1 27-8 44-3 50-0 1-00 ! 00
* dC plus m-dC
t Pooled fraction.
JAndersoncf a/. (1981).
Patient rA rC rG rU Purines
FM 20 30 34 16 54
FH 23-5 23-5 37-5 155 61
HH* 17 16 55 12 72
HI 26 19-5 40-5 14 66-5
KA* 17 18 53 12 70 Q
dto* 23 20 43 14 66 O
Fig. 4. Electronmicroscopy of the in-vitro formation oT antigen-antihody complexes consisting of PEG-precipitib!e PNA and
immunoglobulins from SLE patients. Note that the interaction between the antibodies and the nucleic acids is focused on strand crosses
or links.
dsDNA pG
Days after immunization Days after immunization
0 21 35 60 67 Injected NA 0 21 35 60 67
10 10 10 10 10 salmon testis 10 40 40 10 10
10 10 40 20 10 dto. plus mBSA 10 40 40 160 320
10 10 10 80 160 pG 10 10 160 160 160
10 10 10 640 1280 dto. plus mBSA !0 320 160 1280 1280
10 10 160 320 320 SLE-PNA [0 10 SO 320 320
10 160 20 40 40 dto. plus mBSA 10 10 10 10 10
10 10 io 10 20 mBSA (control) 10 10 10 10 10
Immunogenicity of PNA in animals A fluid phase inhibition ofanti-dsDNA titres of 80% could
Since common B-DNA has no immunogeneic potency (Stollar, be achieved by pre-incubation ofthc antisera with 0-1-10/<g calf
1986). the capacity o\' PNA from SLE patients to induce thymus DNA, corresponding to 10 '^-10 •* M dsDNA (not
antibody production in animals was investigated. For this shown). Using the described ELISAassay, it was not possible to
purpose PNA. dsDNA and pG were injected into rabbits. As directly compare rabbit anti-sera titres with those obtained from
shown in Table 3. PNA-induccd antisera reacted not only with actual SLE patients. A similar assay applied for human anti-
PNA, but also with dsDNA and pG. Similar results were DNA antibody detection showed anti-dsDNA titres ranging
obtained using pG as immunizing agent, whereas it was not from l/lOO- l/IO** in SLE patients with identical estimation of
possible to induce such antibody specificities by the application OD values, suggesting comparable amounts of anti-DNA
ofdsDNA(Tablc3). activity (data not shown). However, the application of a
Anlihody-bound nucleic acids in SLE patients 341
commercially available FARR assay system (Amersham) failed induce antibodies cross-reaetive with dsDNA. Indeed, the
lo detect DNA precipitating activity of rabbit antibodies, thus presence of mBSA carrier in the immunization mixtures con-
indicating a lower allinity of polyclonal rabbit antisera as taining PNA abolished the immunogenic potency of DNA
compared to some of the sera derived from patients with (Tabte 3) almost completely, indicating that conformational
clinically active SLE. rather than linear nucleotide antigenic determinants are crucial
for antigenicily. In contrast, animals immunized with dsDNA
did not produce antibodies against NA. A transient low anti-
DISCUSSION DNA antibody titre was probably due to a polyclonal B cetl
Antibodies against dsDNA and/or ssDNA are a characteristic response to Freund's adjuvant. These data strongly indicate that
finding in sera of patients suffering frotn SLE. Steinman and RNA or DNA/RNA mixtures induce antibodies cross-reacting
Ackad (1977) suggested that the amount of DNA in the plasma with dsDNA. which might compete with plasma nucleases and
correlated directly wilh the severity of the disease and especially inhibit the enzymatic digestion of circulating DNA in the scrum
to vasculitic symptoms. A diminished activity of plasma (Chitrabamrung el ai. 1984). Further investigations will be
nucleases corresponding to disease activity was suggested to be necessary to determine if this phenomenon is responsible for the
responsible for this finding (Chitrabamrung. Rubin & Tan., induction of polynuelcotide antibodies found in SLE patients.
1984). Upon involvement of glomerulonephritis in advanced A possible origin of plasma DNA could be undermethy-
stages of the disease, the formation and deposition of DNA- lated, GpC-rich 'HTF-islands' in the human genome, as
anli-DNA immune complexes appears to be crucial. reported by Bird (1986), since these islets have similar features to
The demonstration of uncommon biological properties or those demonstrated in the plasma DNA in the present investiga-
PNA of SLE patients was primarily attributed to the molecular tion. The origin of RNase-resistant purine-rich RNA with more
weight. The steady increase of molecular weight of the detected than 60 b is unknown, but long purine stretches are frequently
NA described during the past years by several authors (Sano & observed in unusually structured RNA, eg. rRNA. Yet this
Morimoto, 1982); McCoubrcy-Hoyer er «/., 1984; van Helden, presumption needs experimental support.
1985: Rieber ei at. 1986) is possibly due to methodological
iinprovements. However, high amounts of dG-dC base pairs
and potential Z-DNA forming regions in the isolated NA ACKNOWLEDGMENTS
molecules were reported also (van Helden, 1985). This work was supported hy the Deutsche Forschungsgemeinschaft.
The existence of DNA-anti-DNA immune complexes in Grants SFB 118 Bl and Kr 798.1-1. The editorial help of Mrs U. Rath
plasmapheresis fluids of SLE patients, in contrast to all controls, and Mrs L. Kaunt? is gratefully acknowledged by t!ie authors.
could be demonstrated by rc-association experiments applying
purified NA and Ig. We detected measurable amounts of NA
(> 20 ng/ml) exclusively in plasmapheresis fluids of SLE
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