A Subgroup of Rheumatoid Arthritis (RA) Associated with Selective Binding of Rheumatoid Factors to Antigen Structures of Cytomegalovirus (CMV)

We compared antibodies (Ab) with both, antiviral and anti IgG properties in patients with rheumatoid arthritis with malignant progress, short remissions and no improvement to therapy. The selective binding of Rheumatoid Factor (RF) to antigen structures of CMV were tested in 180 patients by a newly established ELISA with antiidiotypic goat antibodies of CMV neutralizing human monoclonal Ab and against the virus antigen directly. Displacement reactions on the idiotypic bindingsite as well as comparative ELISA gave proof of the special RF activity. 24,2% of the patients suffering from RA, with IgM RF, showed selective binding to antigen structures of CMV and anti IgG activity.

The evidence of the specific binding capacity of RF to the virus antigen in chronic CMV infection as well as their defined binding capacity to the F_c Fragment of IgG suggest CMV specific RF as the pathogenetic factor of malignant forms of inflammatory rheumatism.