Search

An immunoalkaline phosphatase (IAP) technique was used to determine the class of cytoplasmic immunoglobulin presenting in the malignant plasma cells of patients with multiple myeloma. Using monoclonal antibodies against different human immunoglobulins (Igs) as the primary antibodies, and calf intestinal phosphatase as the enzymatic indicator. The presence of monoclonal immunoglobulin was demonstrated within the cytoplasm of malignant plasma cells. These results correlate well with the electrophoretic patterns of the Igs present in the serum samples of these patients. This IAP technique is suggested as a practical method for evaluating the immunophenotype of multiple myeloma.

The volunteers studied included 6 tuberculoid and 11 lepromatous leprosy patients (Ridley and Jopling). Each received intradermally 0.1 ml of lepromin (Wade method) and 0.1 ml of autoclaved BCG (grown on Dubos medium) at 2 separate sites on the left upper arm. Observations were made at weekly intervals, and biopsy specimens were taken at the fourth wk. Within 3 to 4 wk all 6 tuberculoid patients responded to lepromin with typical granulomas (5 of which measured 5 mm or more in diameter) composed of epithelioid cells, lymphocytes and giant cells. In contrast, 8 of the 11 lepromatous patients remained negative; the other 3 developed tiny papules less than 3 mm in diameter which disappeared after 2 wk. Biopsy specimens taken from injection sities at the fourth wk showed essentially normal histology. All 1 patients developed typical granulomas to heat-killed BCG (non were less than 5 mm in diameter and most were larger) consisting of epithelioid cells, many lymphocytes and a few giant cells. The reaction in tuberculoid leprosy was stronger than that in lepromatous leprosy and the reaction to BCG in tuberculoid leprosy was stronger than that to lepromin, but the differences were not very remarkable.

Factors affecting induction and expression of human blood suppressor cells including the concentration of concanavalin A (Con A), the exposure time of lymphocytes to Con A, and the ratio of suppressor cells and responder cells, were studied in Con A induced lymphocyte transformation by both the tube method and the microplate method. The most optimal concentration of Con A for suppressor cell induction was found to be 40 micrograms/ml (tube method) or 40 micrograms/well (microplate method). However, a range from 10 micrograms to 40 micrograms/ml or 10 micrograms to 80 micrograms/well was almost equally effective. At least 16 hr of incubation with Con A was required for generation of suppressor cells, but 2 hr incubation with Con A followed by 22 hr without Con A was also effective. As far as the effect of the ratio of suppressor cells to responder cells on the expression of suppressive effect is concerned, 1:1 was enough but 2:1 was more effective. There was no marked difference in results obtained by both methods. However, the microplate method is simple, quick and economic and, therefore, is highly recommended in our country.

Thirty-one patients with rheumatoid arthritis in the Veterans General Hospital from July 1978 to June 1979 were treated with acetylsalicylic acid. The serum salicylate level was determined twice a week. The dose of acetylsalicylic acid was adjusted to keep the serum salicylate level around 15-30 mg%. All patients were started with an initial dose of 65 mg/kg/day. The serum salicylate levels at the 4th day varied greatly from 5.6 to 29.5 mg%. Tinnitus was noted in 24 patients. It occurred when the serum salicylate level reached 28.41 +/- 1.84 mg%. Abnormal liver function was noted in 19.35% (6/31) patients during treatment. It returned to normal after withdrawal of acetylsalicylic acid in 3 cases, after decrease of the dosage in 2 cases and on the same dosage in 1 case. Patients with positive FANA and RF were more prone to develop abnormal liver function during treatment. Monitoring of serum salicylate level may decrease the incidence of hepatic toxicity and maintain the dosage of acetylsalicylic acid in optimal range.

Forty-eight cases of systemic lupus erythematosus (SLE) were studied for lymphocyte subpopulations, and 42 cases were studied for lymphocyte response to mitogen stimulation. A decreased percentage of thymus-derived cells (T cells) and an increased percentage of bursa-equivalent derived cells (B cells), null cells (N cells), double labelled cells (D cells) were found in non-treated cases of SLE. There was no significant difference in these lymphocyte subpopulations in the treated cases in comparison with the normal control. There was an inverted linear relationship between T cells and N cells (p less than 0.001). No such relationship was found between B cells and N cells. The lymphocyte transformation in response to phytohemagglutinin (PHA), pokeweed mitogen (PWM) and concanavalin A (Con A) was expressed in three ways: (1) the net count of transformed data, (2) the difference between the square roots of the isotope incorporation in the stimulated and the non-stimulated cultures (Dsq), and (3) the stimulation index (SI). There were significantly decreased lymphocyte transformation in response to PHA, PWM stimulation in both the non-treated and the treated cases of SLE when results were expressed as net count and Dsq. But decreased counts in response to Con A was only found in non-treated cases. In contrast, no significantly lowered response to all three mitogens was found when data were expressed as stimulation index. Simultaneous study of the percentages of T cells, B cells, N cells, and D cells might be helpful in assessing the clinical activity of SLE and monitoring the effect of therapy. In the study of lymphocyte response to mitogen stimulation, Con A response was a more sensitive indicator of disease activity. The stimulation index was not a good method to demonstrate the result of lymphocyte response to mitogen stimulation in cases of SLE.

The histocompatibility antigens were determined in 170 normal Chinese by a modified micro-lymphocytotoxicity test of Terasaki using 26 typing sera obtained from Behring Laboratories and Stanford University, and the data were compared with those obtained from 36 systemic lupus erythematosus, 30 rheumatoid arthritis, 17 ankylosing spondylitis as well as 45 leprosy patients. In normal individuals HLA-A2,A11 and A9 were dominant in locus A, the frequency were 42.35%, 41.76% and 32.35% respectively. HLA-Bw17, B13 and B5 were dominant in locus B, the frequency were 55.29%, 19.41% and 14.70% respectively. In systemic lupus erythematosus, the frequency of B8, Bw38 and A3 were slightly higher than normal (relative risk2); the frequency of Bw21 and B7 were little lower (risk of Bw210.5, frequency of B75% in normals but none in patients). In rheumatoid arthritis, the frequency of A28 and A10 (Aw25+26) were slightly lower than normal (risk0.5). In ankylosing spondylitis, the frequency of B27 was extremely high (risk = 44.92), Aw24 was also rather high (risk2); the frequency of B5, Bw35 and A10 (Aw25+26) was low (risk0.5), Bw15 and Bw215% in normals but none in patients. In leprosy, the frequency of B18 was relatively high (risk2); A3, Aw30+31+32, B27 and Bw35 were somewhat low (risk0.5). Because of the small sample size, however, the differences were not significant by Chi square analysis except the high frequency of B27 in ankylosing spondylitis (corrected P0.001).

Two monoclonal antibodies, designated 4C4 and 4G1, were produced by immunization of BALB/c mice with a human esophageal carcinoma cell line, CE69T/VGH, followed by fusion of the spleen cells from an immunized mouse with myeloma cells NS-1. 4C4 showed strong binding activity to three human esophageal carcinoma cell lines and one human hepatoma cell line, but not to any other cell lines tested. 4G1 reacted with three human esophageal carcinoma cell lines and four other cell lines. By peroxidase-antiperoxidase staining, 4C4 and 4G1 detected antigens of the epithelial cells on 10 pairs of esophageal carcinoma and normal esophageal specimens. 4G1 recognized a CE69T/VGH antigen with a molecular weight of 180K. Since 4G1 also reacted with purified carcinoembryonic antigen (CEA) and immunoprecipitated 125I-CEA, 4G1 seems to be an antibody recognizing CEA produced by CE69T/VGH cells. Since 4C4 also bound to the epithelial cells of normal uterine, vaginal, breast and liver tissues, it seems to recognize an epithelial antigen, and can be used to characterize the antigen in the specialization or differentiation of epithelial cells.

The autologous mixed lymphocyte reaction in patients with systemic lupus erythematosus was lower than that of normal individuals (p less than 0.05). The impairment was not due to the dysfunction of various regulatory lymphocytes, but there was a negative correlation with the B cell function. The low autologous mixed lymphocyte reaction was found in patients with high B cell function.

Three different groups of patients were studied: group A was on active attacks of asthma with bronchodilator therapy; group B was also on active attacks of asthma but free of any treatment; and group C was of remissive asthma due to hyposensitization, and free of any other treatment. Active E rosette forming populations of all the three groups showed much less reduction by beta-adrenergic agonist isoproterenol as comparing to normal controls, but had equal degrees of inhibition by cAMP and theophilline to normal subjects. Dysfunction of beta-adrenergic receptors in bronchial asthma, as presented in this study, was in accordance with Szentivanyi's theory of beta-adrenergic blockage. Therapy with sympathomimetic bronchodilators might have desensitizing effect on beta-adrenergic receptors. Symptom-relieving hyposensitization could'nt restore the beta-receptor functions in asthmatic patients. The significance of beta-receptor dysfunction in bronchial asthma was discussed.

The airborne fungal spore count was determined daily from 1975 to 1979 at six different stations in the Taipei Area. The count per year was 5656/cm2 in average. More than 75% of the spores could be identified microscopically and classified into 14 genera. The spore season was found from May to October in the Taipei Area. The count per month during this period reached 632/cm2. Only 311/cm2/month was found from November to April. Data collected from the six stations differed slghtly, the count was low in the city (4853/cm2/year) and high in the suburbs (8801/cm2/year). The counts were very close in the first four years (4325-4677/cm2/year), but dropped dramatically in the fifth year (2017/cm2/year). The spore count was influenced by temperature, humidity, rainfall as well as wind velocity. Among the 14 genera found by the slide method, six could not be isolated by the plate culture method. Other 24 genera isolated with plates did not appear on the slides.

Allergens of bermuda grass pollen extract have been studied and identified. Immunoblotting studies revealed that at least 12 SDS-denatured polypeptide showed IgE-binding activity. Molecular weight was estimated between 10,000 to 90,000 daltons. An allergenic component was isolated by a combination of ion exchange chromatography and gel filtration chromatography. The allergen preparation was shown to be homogeneous by PAGE and SDS-PAGE studies. Allergen was found to be an acidic protein with a molecular size of the order of 16,300 daltons. Ultraviolet spectrum scanning showed weak absorption at 280 nm. Amino acid analysis revealed that the purified allergen contained no tyrosine, proline and cysteine residues but contained a high percentage of glutamic acid and aspartic acid residues. The results of amino analysis indicate that tyrosine, proline and cysteine residues are not involved in the allergenic determinant site.

Using monoclonal antibodies with different specificity against the major allergenic components of ragweed pollen, we analyzed their cross-reactivity with two tree pollens, two grass pollens and five other weed pollens which are common in Taiwan by the immunoblot method. It was found that besides reacting with AgE and AgK of the ragweed pollen, the monoclonal antibody 48-5 also reacted with antigens of yellow dock pollen with molecular weights of 40K, 38K, 24K, and 21K. In a preliminary study, sera of two patients containing IgE antibodies to ragweed pollen antigens also reacted to the 40K component of the yellow dock pollen. Furthermore, from the results of allergenic skin testings on 109 patients with bronchial asthma, we found that of 22 patients who had a positive reaction to a crude extract of ragweed pollen, 18(81.8%) also reacted to the crude extract of yellow dock pollen. In conclusion, our results suggest that there exists a common allergenic determinant between pollens of ragweed and yellow dock. It may play an important role in the expression of the sensitivity of patients to these two kinds of pollens.

An eight-point diagnostic criteria for SLE was proposed and evaluated at the Veterans General Hospital (VGH), Taipei. It consists of 8 points and 12 items, 3 points being required for an accurate diagnosis. All of 94 cases of SLE whether they could or could not be diagnosed with the ARA criteria fulfilled 3 or more points of the VGH criteria. None of the 17 cases of rheumatoid arthritis fulfilled 3 or more points of the VGH criteria.

A water-insoluble material was obtained from either short ragweed (Ambrosia elatior) or false ragweed (Franseria acanthicarpa) pollen extracted by organic solvent (50% N,N-dimethylformamide). Further investigation of this water-insoluble material showed it contained at least five proteins. Two of them were isolated and shown to possess antigenicity as well as allergenicity. RFA2 contains carbohydrate and is a glycoprotein. RFB2 not only possesses antigenic determinants found in the water-soluble antigens AgE, AgK and Ra3, but also contains a separate and unique antigenic determinant. Immunodiffusion tests of RFB2, isolated from false ragweed and short ragweed, showed immunological identity. This communication further supports the suggestion that aqueous-organic solvent systems may be useful for the extraction of the biologically-active protein components from short ragweed pollen which can not be obtained with the currently used standard aqueous buffer system.

Conversion of leprolin and early lepromin reactions was achieved by two injections of transfer factor made of lymphocytes from lepromin-positive tuberculoid leprosy patients. However, the late reaction to lepromin remained unchanged. The importance of the degree of sensitivity of the cell donor was demonstrated, and a booster dose was also found to be useful. The feasibility of using transfer factor in treatment of lepromatous leprosy is briefly discussed.