CHARACTERIZATION OF HUMORAL IMMUNOREACTIV ITY AGAINST CARTILAGE TISSUE IN PATIENTS WITH FAILURE OF CARTILAGE GRAFTING IN RECONSTRUCTIVE SURGERY

The problems with repeated failure of cartilage grafting in reconstruc tive surgery are not yet resolved. Humoral immunoreactivity against ch ondrocytes as well as typical cartilage collagens type II, IX and XI w as investigated in patients who showed resorptions and/or rejections o f transplanted cartilage grafts. The presence of antibodies against is olated human chondrocytes was determined using an indirect immunofluor escence method, an enzyme linked immunosorbent assay (ELISA) for chond rocytes and immunoblotting with chondrocyte cell membranes. Furthermor e, an ELISA for collagens type II, IX and XI as well as immunoblotting with purified collagens type II and XI were used. The control groups consisted of patients with successful cartilage transplantation, patie nts suffering from rheumatoid arthritis and healthy persons. Patients with unsuccessful cartilage transplantation showed significantly eleva ted titres of antibodies against chondrocytes (p < 0.001) and collagen s type IX and XI (p < 0.001) compared to the control groups. In one pa tient with unsuccessful cartilage graft, we could also find a humoral reactivity against collagen type XI by immunoblotting. In contrast, no humoral immune reactivity was demonstrable against chondrocyte cell m embranes by immunoblotting. In all examined patients fifty percent of patients with repeated resorptions or rejections of transplanted graft s showed antinuclear antibodies (ANA), demonstrating a possible but no t yet declared autoimmune disease. These data confirm a humoral immuno reactivity against chondrocytes as well as against collagen which coul d be responsible for resorptions and/or rejections observed after cart ilage graft.