title: VH4-34 (VH4.21) gene expression in the chronic arthritides of childhood: studies of associations with anti-lipid A antibodies, HLA antigens, and clinical features.
abstract: OBJECTIVE
  To determine if the germ line gene VH4-34 (VH4.21) encodes the antimonophosphoryl lipid A (MPL) polyspecific antibodies found in oligoarticular arthritis of childhood.
  
  
  METHODS
  Sera from a range of rheumatic diseases of childhood were assayed for VH4-34 derived antibodies by ELISA using the antiidiotype monoclonal antibody 9G4. Results were compared to assays for anti-MPL antibodies, C4d, and Bb, and for HLA type, joint count, and sedimentation rate.
  
  
  RESULTS
  VH4-34 derived antibodies were elevated in all diseases studied except rheumatoid factor positive polyarticular disease. In oligoarticular arthritis, VH4-34 gene expression correlated with C4d concentration, and VH4-34 encoded globulins were more concentrated in synovial fluid than in blood. No association was found with HLA type. An association between VH4-34 expression and IgG anti-MPL was found in sera from patients from Cincinnati but not from Stanford. No other evidence supported a direct association between VH4-34 derived and anti-MPL antibodies in these children.
  
  
  CONCLUSIONS
  The expression of VH4-34 is increased in several rheumatic diseases of childhood, but, as in adults, not in rheumatoid arthritis. VH4-34 expression is not associated with HLA type. The polyspecific autoantibody nature of some VH4-34 derived antibodies may explain the wide range of the unusual antibodies found in oligoarticular arthritis.
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, California, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Miller
authors.forename: M M
authors.initials: MM
authors.lastname: Bieber
authors.forename: J E
authors.initials: JE
authors.lastname: Levinson
authors.forename: S
authors.initials: S
authors.lastname: Zhu
authors.forename: E
authors.initials: E
authors.lastname: Tsou
authors.forename: N N
authors.initials: NN
authors.lastname: Teng
mesh_terms: D000906:Antibodies / Q000032:analysis; D000911:Antibodies, Monoclonal / Q000276:immunology; D001171:Arthritis, Juvenile / Q000235:genetics* / Q000276:immunology* / Q000503:physiopathology; D003167:Complement Activation; D003165:Complement System Proteins / Q000032:analysis; D015870:Gene Expression; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000032:analysis / Q000235:genetics*; D007135:Immunoglobulin Variable Region / Q000032:analysis / Q000235:genetics*; D008050:Lipid A / Q000031:analogs & derivatives / Q000276:immunology; D013582:Synovial Fluid / Q000276:immunology; D013997:Time Factors
chemical_list: D000906:Antibodies; D000911:Antibodies, Monoclonal; D006680:HLA Antigens; D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; D008050:Lipid A; D003165:Complement System Proteins; C048436:monophosphoryl lipid A