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Background Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus. Methods and Results A random subcohort of 349 participants was selected from the DCCT / EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT , and 1 to 2 years post‐ DCCT ( EDIC years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F 2α isoprostanes, and its metabolite, 2,3 dinor‐8 iso prostaglandin F 2α . Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8 iso prostaglandin F 2α , an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase, P iso prostaglandin F 2α , P =0.0092). In contrast, the oxidative markers myeloperoxidase and F 2α isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between DCCT intensive and conventional treatment groups in the change in all biomarkers across time segments. Conclusions Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifiers: NCT 00360815 and NCT 00360893.

A patient with multiple myeloma was noted to have an IgA deficiency during investigation of a possible transfusion reaction due to IgA deficiency and anti-IgA. Because of the patient's age, otherwise good health, and early stage of disease, he was enrolled in a research treatment protocol that involved an allogeneic bone marrow transplant (BMT). The BMT successfully put the patient in complete remission from his multiple myeloma and corrected his IgA deficiency. Class-specific IgG anti-IgA antibody that had been identified prior to BMT was no longer detectable in his plasma. Anaphylactic transfusion reactions were successfully avoided by using a combination of IgA-deficient and washed blood components including the marrow graft, and IgA-reduced intravenous immunoglobulin.

A 28-year-old male medical student underwent splenectomy at 8 years of age due to traumatic rupture of the spleen sustained in a motor vehicle accident. Eighteen years later the patient had major abdominal surgery performed for an unrelated condition and, at the time of surgery, over 100 splenic nodules were found embedded throughout the patient's omentum, small bowel, and mesentery. An extensive study of immunological functions was carried out during the following 2 years. Through the course of this investigation, it was determined that the patient's peripheral blood smear lacked Howell-Jolly bodies and deformed or damaged erythrocytes, indicating that the splenotic tissue had the capacity to remove intranuclear inclusions from circulating red cells and to phagocytose old erythrocytes. The patient's levels of complement, serum immunoglobulins and the numbers of circulating T and B lymphocytes, helper T cells, and cytotoxic/suppressor T cells all were within the normal range. The response to Streptococcus pneumoniae polysaccharides was also normal, with increased levels of specific antibodies to all serotypes included in the vaccine 4 months after immunization. Finally, histological examination of his biopsied splenotic nodules revealed tissue that was indistinguishable from normal spleen.

The goal of this study was to characterize the isotypes and reactivity of human autoantibodies to copper oxidized LDL (oxLDL). Forty-six purified oxLDL antibodies contained immunoglobulins of the three major isotypes, with a predominance of IgG, subclasses 1 and 3. These IgG isotypes are known to interact with FcRgammaI and to activate the complement system and thus are potentially able to activate macrophages and cause foam cell formation. The same purified antibodies were tested for cross-reactivity with malondialdehyde (MDA)-, glycated (Glyc)-, and native (n)LDL and cardiolipin. Absorption with oxLDL resulted in a decrease of reactivity of 77.2 +/- 4.7%. Absorption with MDA-LDL resulted in a wider range of reduction of reactivity values, ranging from 50 to 87%, possibly reflecting differences in the degree of MDA modification. Absorption with Glyc- and nLDL caused a minor decrease in the reactivity of antibodies to oxLDL (5.9 +/- 7.1 and 6.8 +/- 6. 4%, respectively), comparable to the reduction of reactivity (2.1 +/- 4.0%) measured after absorption with transferrin, an irrelevant protein used as a negative control. These results suggest that oxLDL antibodies recognize primarily MDA epitopes. To determine whether purified oxLDL antibodies also recognize other epitopes known to be generated during copper oxidation of LDL, such as 4-hydroxynonenal (HNE)- and N(epsilon)(carboxymethyl)-lysine (CML), two additional sets of experiments were carried out. First, we monitored the formation of CML-, MDA-lysine, and HNE-lysine at different times during copper oxidation of two LDL pools. Both pools showed simultaneous increases in protein modification, as indicated by increasing fluorescence emission at 430 nm, and in immunoreactivity with oxLDL antibodies, coinciding closely with MDA modification of lysine groups. Second, we assessed whether the reactivity of oxLDL antibodies could be blocked by absorption with CML- or HNE-LDL. HNE-LDL did not react with isolated oxLDL antibodies. Highly modified CML-LDL (>90% of lysine residues modified) reduced the reactivity of oxLDL antibodies, but only by 25.5%. Finally, we investigated the possible cross-reactivity of oxLDL antibodies with cardiolipin. Seventeen purified oxLDL antibodies were used in this study, which showed that absorption with oxLDL or nLDL did not affect their reactivity with immobilized cardiolipin.

A patient with multiple myeloma was noted to have an IgA deficiency during investigation of a possible transfusion reaction due to IgA deficiency and anti-IgA. Because of the patient's age, otherwise good health, and early stage of disease, he was enrolled in a research treatment protocol that involved an allogeneic bone marrow transplant (BMT). The BMT successfully put the patient in complete remission from his multiple myeloma and corrected his IgA deficiency. Class-specific IgG anti-IgA antibody that had been identified prior to BMT was no longer detectable in his plasma. Anaphylactic transfusion reactions were successfully avoided by using a combination of IgA-deficient and washed blood components including the marrow graft, and IgA-reduced intravenous immunoglobulin.

The purpose of this study was to examine the relationship between active versus inactive lifestyle and immunocompetence in older women. A sample of 46 independently dwelling, ambulatory and mentally alert women 60-98 years was examined, 25 who rated themselves as 'active' and 21 who rated themselves as 'inactive'. Lymphocyte subpopulations were analyzed by flow cytometry using selected monoclonal antibodies. The self-reported active subjects (also validated by their current unsolicited participation in a formal exercise class) demonstrated significantly higher percent change in CD25 mitogen stimulated lymphocytes (P = 0.0335) than those who reported themselves to be sedentary.

Two IgM paraproteins of different electrophoretic mobility were detected in the serum of a patient with Waldenstrom's disease. Both were type kappa, existed as high molecular weight polymers, and contained J-chain. The fastermoving protein contained a greater amount of carbohydrate, in both H and L chains.

Immunoglobulins G, A, and M were measured by radial immunodiffusion and by laser nephelometry in sera from 33 patients and in a preparation of purified colostral IgA. In general the results agreed for the two methods, with some exceptions attributed to the physicochemical characteristics of the immunoglobulins assayed: low-molecular-weight (monomeric) IgM gives falsely high values and IgA proteins (consisting predominantly of polymeric molecules) give falsely low values when assayed by radial immunodiffusion. Results from laser nephelometry apparently are not affected by the molecular-size characteristics of the proteins assayed.

We report an immunonephelometric assay for apolipoprotein AI, which involves use of a laser nephelometer and an antiserum prepared in our laboratory. Coefficients of variation were 2.5% within-run, 6.3% between-run. Several types of manipulation of the samples (heating, delipidation, dissociation with urea), reportedly necessary for accurate determinations by radioimmunoassay or gel diffusion immunoassay, did not substantially affect results obtained with our technique. The assay is sensitive, reproducible, and simple, and appears suitable for routine use.

A case of atypical B cell dyscrasia is described. The patient presented with a history of weakness, bone pain, and bleeding. A K-type paraprotein was found in serum and urine. The histology of bone ma

There was evidence of mild renal dysfunction in three of the cadmium-exposed individuals out of the total of 39. However, in none of them did we find a fully developed tubular proteinuria in which moderate increases of total proteinuria, increased lysozymuria and beta-2 microglobulinuria, and excretion of low molecular weight proteins by SDS-PAGE would also be found. Out of the four parameters determined, only one patient had three of them in the abnormal range, but this patient showed predominant elimination of high molecular weight proteins, compatible with glomerular damage, an unexpected finding in cadmium poisoning. Renal dysfunction was detected in one control subject who had increased total protein classified as tubular. There were two abnormal SDS-PAGE patterns found in the control group in which the other parameters measured were normal as was the case in the cadmium exposed patients.

Clinical signs of hyperviscosity syndrome in a 6-year-old dog included listless-ness, polydipsia, anorexia, vomiting, and recurrent bleeding from the gums. Fundoscopy showed the typical retinal changes associated with this syndrome. A polymeric IgA cryoglobulin characterized in the dog’s serum was later isolated and structurally studied. It was found to contain J chain but no secretory component. The heavy and light chains were covalently bound.

The synthesis and secretion of immunoglobulins by human peripheral blood mononuclear cells in cultures stimulated with pokeweed mitogen or Staphylococcus aureus Cowan I were evaluated by enumeration of cells containing cytoplasmic immunoglobulins and cells actively secreting immunoglobulins, and by quantitation of immunoglobulins released into culture supernatants. The two mitogens caused comparable stimulation of immunoglobulin production; however, in contrast to pokeweed mitogen, S. aureus was active in cultures depleted of T lymphocytes, and its stimulatory effects were resistant to the influence of suppressor T cells generated by co-stimulation with concanavalin A or by preincubation without mitogenic stimulus. These results indicate distinct pathways of induction and suppression of immunoglobulin synthesis for these two polyclonal B cell activators, and suggest that stimulation by S. aureus is less thymus dependent than that induced by pokeweed mitogen.

We have examined, in vitro, the effects of autologous erythrocytes (RBC) coated with soluble immune complexes (RBC-IC) on the interactions of polymorphonuclear leukocytes (PMN) with human endothelial cell (EC) cultures. RBC-IC were prepared by incubating human RBC with soluble immune complexes, prepared with keyhole limpet hemocyanin (KLH) and rabbit anti-KLH in antigen excess, using normal human serum as a complement source. Several parameters believed to be related to EC-PMN interactions, including adherence of PMN to EC, detachment of EC after incubation with media harvested from RBC-IC-stimulated PMN, and the release of 2-deoxy-D-[3H]glucose from damaged EC, were investigated. The proportion of PMN adhering to EC increased in direct proportion to the number of RBC-IC used to stimulate PMN. Media harvested from PMN stimulated with RBC, RBC incubated with complement, RBC-IC, or opsonized zymosan caused variable degrees of detachment of cultured EC. The percentage of EC detached was directly related to the intensity of the PMN degranulation as measured by lysozyme release with a correlation coefficient of 0.935, comparing the natural log of the lysozyme released to the percentage EC detachment. Finally, RBC-IC added to PMN and EC induced PMN-mediated EC damage as measured by the release of 2-deoxy-D-[3H]glucose from the labeled EC. The release of 2-deoxy-D-[3H]glucose from the labeled EC was directly related to the number of RBC-IC used to stimulate the PMN. These data indicate that RBC-IC are able to stimulate the type of interactions between PMN and EC that are believed to cause EC damage and may play a role in the initiation or exacerbation of inflammatory vascular lesions.