A rheumatoid arthritis B cell subset expresses a phenotype similar to that in chronic lymphocytic leukemia

An abnormal subpopulation of B cells expressing the T1 antigen, which is normally restricted to T cells, was demonstrated in the peripheral blood of 16 patients with rheumatoid arthritis. This T1+ B cell population accounted for a mean of 19.6% (upper limit 48%) of the circulating B cells and did not correlate with clinical disease activity, rheumatoid factor, or drug treatment. The highest percentage of T1+ B cells found in the blood of 8 patients with connective tissue diseases, including systemic lupus erythematosus, was 5% of the B cells, and for normal controls, it was was 3% of the B cells. As previously reported, we confirmed that the T1+,Ig+ phenotype was a feature of leukemic cells in B-type chronic lymphocytic leukemia. The finding of increased numbers of T1+ B cells in patients with rheumatoid arthritis and those with B-type chronic lymphocytic leukemia raises the possibility that these cells play a role in a spectrum of diseases, including those involving autoimmunity and malignancy.     

Nutritional assessment and treatment of hospital malnutrition.

A thorough awareness of the nutritional and metabolic status of the hospitalized patient is crucial for all persons directly involved in patient care. The catabolic nature of the body's response to illness or injury induces a serious drain on vital organs and tissues. Therefore, a complete assessment of the body's various compartments must be carefully taken, and any nutritional depletion must be quickly alleviated. Due to the alarming incidence of often undetected severe malnutrition in hospitalized patients, if becomes imperative that attention be paid to nutritional status, to decrease unnecessary morbidity and mortality.     

Urethritis due to Neisseria meningitidis in a London genitourinary medicine clinic population.

A retrospective study was performed in a department of genitourinary medicine to determine the prevalence and clinical features of urethral and cervical infection with Neisseria meningitidis among patients being screened for sexually transmitted diseases. During the 28 month period of the study 11 isolates (from 10 patients) of N. meningitidis were identified from 5571 urethral cultures from homosexual men (0.2%). This compares with an isolation rate of 4.7% for N. gonorrhoeae; 1.2% samples screened for chlamydial antigen were positive. There were no isolates from 8992 urethral cultures from heterosexual men or 15,976 cervical cultures. Eight of the cases identified had features of urethritis at diagnosis; 6 were diagnosed initially as non-specific urethritis (NSU) and 2 as gonorrhoea on the basis of microscopy of a urethral smear. Eight of the 10 patients were treated with amoxycillin and/or a tetracycline, and all but one had a clinical and microbiological cure. In the study population the prevalence of N. meningitidis infection was low and restricted to homosexual men; however, it may be associated with symptoms.     

The first international standard for antibodies to double stranded DNA.

This paper announces the availability of the first international standard for anti-double-stranded DNA (anti-dsDNA). The material, coded Wo/80, was obtained after recalcification of plasma taken from a patient with systemic lupus erythematosus. Vials were filled with 500 microliters serum and freeze dried. The serum contains no other autoantibodies in measurable quantities. The vials should be stored at -20 degrees C. The standard should be used for establishing national, regional, or local standards. In eight laboratories satisfactory results with the immunofluorescence technique on Crithidia luciliae were obtained; the titres varied between 1/20 and 1/640 (mean 1/160). In seven laboratories the Farr assay, with the so called 'Amersham kit', was performed. At a dilution of 1:40 a mean binding percentage of about 50% was observed. After reconstitution with 500 microliters of distilled water, the vial contains 100 IU/500 microliters or 200 IU/ml. The standard can be obtained from the custodian of WHO: Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, PO Box 9190 1006 AD Amsterdam, The Netherlands.     

The inhibitory effect of D-penicillamine on human lymphocyte cultures stimulated by phytohaemagglutinin, the antagonistic action of L-cysteine and synergistic inhibition by copper sulphate.

The inhibitory effects of D-penicillamine (D-Pen) on lymphocyte activation by PHA are found to be dose-dependent, showing significant effects above a concentration of 50 microgram/ml. The cells show a diminished sensitivity to D-Pen added after 24 hours in culture, although the dose-response relationship is maintained. L-cysteine is usually found to have an insignificant effect on PHA stimulation, although enhancement and inhibition are also sometimes observed. The supplementation of culture medium with L-cysteine abolishes the inhibitory effect of D-Pen, whilst copper sulphate synergistically inhibits PHA-induced transformation. The balance between the availability of naturally occurring thiols, copper ions and administered D-Pen may be critical in determining the eventual effect of the drug on the lymphoid system. Lymphocyte suppressive soluble factors appear in the sera of patients with rheumatoid arthritis and are modified by treatment with D-Pen. Although our experiments suggest possible modes of action of the drug on the immune system as a therapeutic agent as well as a potent inducer of autoimmunity in its own right, further work is required to delineate its precise mechanism of action.