Antinuclear antibody and lymphocyte responses to nuclear antigens in patients with lung disease

Abstract

The in vitro peripheral leucocyte migration test was used to study cell-mediated hypersensitivity to whole rat liver nuclei, calf thymus deoxyribonucleoprotein and highly polymerized calf thymus deoxyribonucleic acid (DNA) in patients with circulating antinuclear antibody (ANA) suffering from different pulmonary diseases. The group with pleuropulmonary systemic lupus erythematosus (SLE) showed significant inhibition of leucocyte migration to whole nuclei (P<0·001), DNA (P<0·025) and to nucleoprotein (P<0·05). In contrast, the groups of ANA-positive patients with cryptogenic fibrosing alveolitis (CFA) and asbestosis showed inhibition only to DNA (P<0·025). Individual patients with CFA and asbestosis showed evidence of lymphocyte sensitization to whole nuclei as well as to DNA. Involvement of delayed hypersensitivity to nuclear antigens in tissue damage is therefore possible in some, but not all patients with these diseases. There was no evidence of lymphocyte sensitization in any ANA-positive patients with intrinsic asthma, systemic sclerosis or Sjögren's syndrome. Corticosteroid therapy substantially reduced inhibition of leucocyte migration to whole nuclei and DNA in patients with SLE and CFA. From these studies it is concluded that lymphocyte sensitization is not constantly related to circulating ANA in patients with different types of pulmonary disease, and that nuclear antigens appear to stimulate variable immunological responses and it is suggested that this may depend upon the initiating circumstances and the host response.