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Serum protein changes in Caplan's syndrome

Gorringe, J. A. L

The University of Edinburgh 1960

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  • Título:
    Serum protein changes in Caplan's syndrome
  • Autor: Gorringe, J. A. L
  • Descrição: The British literature on Caplan's syndrome is briefly reviewed with particular reference to the pathogenesis of the pulmonary lesions and an investigation is described which was designed to throw fresh light upon this. Statistical analysis of the results revealed an association between the levels of several serum protein fractions am> the severity of the lung lesions independently of the severity of arthritis. Elevation of α2- and γ-globulins and reduction of albumin and of the albumin/ α2-globulin ratio are consistent with the tuberculous theory of the aetiology of these lesions, but a trend was also observed toward3 higher levels of ß-globulin with increasing severity of pulronary lesions. Rheumatoid arthritis itself rarely produces this effect and no increase of ß-globulin has been reported in tuberculosis. The previously observed association between the presence of "Caplan lesions" in the lungs and positive haemagglutination tests for rheumatoid arthritis was confirmed and a significant correlation demonstrated between the agglutination titre and the ß-globulin level. The literature on the nature of the rheumatoid factor is reviewed and the conclusion reached that it exists naturally as a 19s macroglobulin migrating electrophoretically as a (ß2-globulin but that transformation to a 22s γ-globulin occurs when serum is stored in the liquid state Based on this conclusion and on the three-fold relationship observed between the severity of "Caplan lesions", the haemagglutination titre and the p-globulin level, a hypothesis is proposed that the nodular pulmonary lesions described by Caplan and perhaps some other lesions associated with rheumatoid arthritis such as subcutaneous necrobiotic nodules may be sites of synthesis of the rheumatoid factor. It is further suggested that the raw material for this synthesis may consist of ß-glycoprotein derived from the ground-substance of degenerating collagenous tissue. Observations consistent with this hypothesis are quoted from the literature and several experiments are suggested which, if done, might support or refute the hypothesis.
  • Editor: The University of Edinburgh
  • Data de criação/publicação: 1960
  • Idioma: Inglês
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