Sera frour 146 patients with malignancy, 59 normal controls and 42 patients hospitalized with non-malignant diseases were examined by a precipitin test with monoclonal rheumatoid factor (mRF) for the presence of circulating immune complexes containing IgG. Forty-two (29%) of the sera from cancer patients but only two of the sera from patients in each of the control groups contained such material. Similar results were obtained with a radioimmunoassay for immune complexes based on the same mRF. Sera from 23 of 65 patients with metastatic malignancy (35%) had elevated levels of immune complexes by this latter test. The presence of the material was not related to the source of malignancy, presence of carcinoembryonic or hepatitis antigens or of such autoantibodies as rheumatoid factor or anti-DNA. By density gradient ultracentrifugation the reacting material was identified as being of molecular size 19s or greater. It has not yet been further characterized with regard to the nature of any antigens present.
Foundation, Rochester Minnesota 55901 A B S T R A C T The frequency and amount of IgM rheumatoid factor (RF) in the blood of patients with rheumatoid arthritis (RA) correlate with the severity of the disease and the number of complications. Though previous studies of RF in subacute bacterial endocarditis have shown that RF inhibits phagocytosis of microorganisms by granulocytes, the presence of low levels of complement (C) in blood and synovial fluid of patients with the highest titers of RF suggests that an interaction between RF and C may contribute to the -inflammatory process in RA. We thus employed a quantitative methodology to examine the effect of RF on complement-dependent phagocytosis of sheep erythrocytes by rabbit granulocytes. Addition of 2500 molecules of IgM RF to sheep cells heavily coated with IgG antibody (195,000 molecules per cell) resulted in virtually complete inhibition of uptake of C3 (flue) and prevention of phagocytosis, an effect resulting from inhibition of uptake of Cl by the cells. When erythrocytes coated with only 34,000 molecules of IgG antibody were employed, phagocytosis was similarly inhib.ited. However the effect of RF on such cells was shown to be primarily mediated through inhibition of C4 rather than Cl uptake. Although the results do not exclude the participation of an
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