Lymphocytotoxic antibodies in systemic lupus erythematosus: their clinical significance.

Cold-reactive lymphocytotoxic antibodies are present in the serum of most patients with systemic lupus erythematosus (SLE) (Mittal et al., 1970; Terasaki et al., 1970). They appear to be equally cytotoxic for autologous and heterologous lymphocytes (Stastny and Ziff, 1971). Studies of the nature of these antibodies showed that their cytotoxic effect is temperature-dependent and maximal at 15°C, that their immunoglobulin class is IgM, and that they are equally reactive with T and B lymphocytes (Winfield et al., 1975a). Studies of the clinical significance of cold-reactive lymphocytotoxic antibodies in SLE have shown a consistent association with neuropsychiatric complications (Butler et al., 1972; Bluestein and Zvaifier, 1976; Bresnihan et al., 1977b). In other respects, however, clinical studies have been inconclusive, which may partly be related to the retrospective nature of most series. Previous studies have suggested an association between cold-reactive lymphocytotoxic antibodies and lymphopenia (Winfield et al., 1975b; Utsinger, 1976). A detailed prospective clinical analysis of SLE began at Hammersmith Hospital in 1973. In all, 50 patients have been investigated, and their clinical features have been described elsewhere (Grigor et al., 1978). This report relates the clinical features in these patients to the presence of lymphocytotoxic antibodies.