Leukocyte antibodies in human sera and in immune rabbit sera

A study of leukocyte antibodies is presented using (1) the sera of rabbits immunized with human leukocytes, and (2) the sera of three patients screened forthe presence of such antibodies from among 36 patients with hematologic disease,31 of whom (including the 3 studied in detail) had received multiple transfusions.The following technics are described and were employed: Leukoagglutination,leukoprecipitation including tube and agar-plate methods, agglutination ofantigen-coated tanned and untanned sheep erythrocytes, the effect of antiseraupon phagocytosis of heat-killed staphylococci by leukocytes, and upon ameboidmotility of leukocytes.

The leukoagglutinin test gives reliable clearcut results providing that appropriate controls are included and certain criteria adhered to, in order to facilitatethe recognition of clumping due to other factors than true antigen-antibodyunion.

No leukoprecipitins were detected in human sera with the technics used inthis study. Immune rabbit sera, on the other hand, gave two reaction-lines inagar media, when set up against leukocyte extract.

Immune rabbit sera reacted strongly with antigen-coated tanned sheep redblood cells. Human sera did not so react. One of the three selected human serareacted with antigen-coated untanned erythrocytes, suggesting the presence of apolysaccharide antigen extractable from human leukocytes and capable of stimulating antibody formation in the human. Immune rabbit sera, and otherhuman sera, did not react in this test.

A suggestive but perhaps not a conclusive effect upon phagocytosis of bacteriaby leukocytes exposed to human leukocyte antibody for 1 hour could be demonstrated.

By means of ameboid motility studies, a cytotoxic effect of the human antiseraupon human leukocytes could be demonstrated after 18 hours of incubation, butnot after 3 hours. This was interpreted as evidence of a delayed reaction.

Certain cardinal points from a clinical and theoretical standpoint with regardto the genesis of leukocyte antibodies in man are briefly reviewed. A possibleanalogy between leukocyte antibody formation and the homograft reaction isdiscussed. It is suggested that the rarity of leukocyte iso-antibody formationfollowing transfusion is related to the fact that the intravenous pathway may bea poor route of immunization for these antigens.

Submitted on April 4, 1957 Accepted on July 1, 1957     

Hepatitis C virus liver disease in women infected with contaminated anti-D immunoglobulin

Screening for hepatitis C virus (HCV) infection is carried out by detection of antibodies to the virus (enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA)) with confirmation by identification of HCV RNA genome in serum (polymerase chain reaction (PCR)). We describe the histological features on liver biopsy in 88 women with chronic HCV infection (serum positive on ELISA, RIBA and PCR) acquired from virus contaminated anti-D immunoglobulin. For the majority of these patients the time interval from virus infection to presentation was between 17 and 18 years. We separately assessed necroinflammatory disease activity and architectural features on liver biopsy and applied a scoring system which permitted semi-quantitative documentation of abnormal features. Only three women showed liver biopsies within normal limits (± focal steatosis). The remaining 85 cases showed a predominantly mild or moderate degree of disease activity with interface hepatitis (56.8% of cases), spotty necrosis, apoptosis and focal inflammation (88.6% of cases) and portal inflammation (90.9% of cases). Confluent necrosis was an uncommon finding (2.3% of cases). Assessment of architectural features showed normal appearance in 35.2% of biopsies. The predominant architectural abnormality noted was portal tract fibrosis. Ten per cent of cases, however, showed significant fibrous band and/or nodule formation.     

CHILDHOOD ACROMEGALY SUCCESSFULLY TREATED WITH INTERSTITIAL IRRADIATION USING YTTRIUM-90

ABSTRACT. A child with a growth hormone producing tumour presented at the age of 4 1/2 years. The onset of the disease was at 18 months of age. Treatment was given with three doses of interstitial irradiation using yttrium-90 implants. There were no local complications from the procedures. Now, 11 years after diagnosis, she is asymptomatic, of normal appearance, and her height and the size of the pituitary fossa are normal. Growth hormone levels are almost normal, thyroid function is intact, and she is maintained on prednisone and sex hormones.     

THYMOPOIETIN IN RHEUMATOID ARTHRITIS

In a controlled study involving 36 patients, thymopoietin wasshown to be more effective than levamisole and as effectiveas penicillamine in improving the clinical status of patientswith rheumatoid arthritis. There were small reductions in erythrocytesedimentation rate and IgG which did not achieve statisticalsignificance. Rheumatoid factor titre did not change. Althoughits mechanism of action is almost certainly related to its immunomodulatoryproperties it does not seem to be the same as that of levamisole.