title: The pathogenic 16/6 idiotype in patients with silica associated systemic lupus erythematosus (SLE) and uranium miners with increased risk for development of SLE.
abstract: OBJECTIVE
  To investigate the prevalence of the 16/6 idiotype (16/6 Id), a major cross reactive idiotype of anti-DNA antibodies involved in the pathogenesis of experimental lupus, in subjects with an exogenous risk for the development of systemic lupus erythematosus (SLE).
  
  
  METHODS
  The titer of 16/6 Id was determined by ELISA in sera of uranium miners exposed to heavy quartz dust: 15 developed definite and 12 probable SLE, 34 had clinical symptoms, and 27 had only serological signs (medium to high titer anti-dsDNA antibodies) of possible connective tissue disease (CTD) development.
  
  
  RESULTS
  The prevalence of 16/6 Id was higher in all groups compared to healthy blood donors. It was 18.5% in miners with SLE (definite and probable) and 22.2-26.5% in miners with clinical and/or serological signs for developing CTD. All 16/6 Id positive miners were positive for anti-dsDNA antibodies and other autoantibodies associated with CTD. The prevalence of 16/6 Id in anti-dsDNA positive miners correlated slightly with CTD/SLE symptoms: 55.6% in patients with SLE, 47.4% in miners with possible CTD/SLE, and 22.2% in miners without CTD symptoms. Further, at short term followup, disease progressed in 2 miners of the 16/6 Id positive, but not in 16/6 Id negative miners.
  
  
  CONCLUSIONS
  The detection of 16/6 Id in miners exposed to quartz dust may indicate a higher risk for development of SLE, warranting further studies of the role of 16/6 Id in the development of SLE in a cohort with the same sex, ethnicity, geographic region, and occupation.
authors.affiliation: Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: K
authors.initials: K
authors.lastname: Conrad
authors.forename: Y
authors.initials: Y
authors.lastname: Levy
authors.forename: M
authors.initials: M
authors.lastname: Blank
authors.forename: J
authors.initials: J
authors.lastname: Mehlhorn
authors.forename: K H
authors.initials: KH
authors.lastname: Frank
authors.forename: B
authors.initials: B
authors.lastname: Roch
authors.forename: Y
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood*; D003240:Connective Tissue Diseases / Q000276:immunology; D004391:Dust / Q000009:adverse effects; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D008906:Mining; D009784:Occupational Diseases / Q000139:chemically induced; D011791:Quartz / Q000009:adverse effects*; D014501:Uranium / Q000009:adverse effects*
chemical_list: D000974:Antibodies, Antinuclear; D004391:Dust; D011791:Quartz; D014501:Uranium