Complement activation by malignant B cells from patients with chronic lymphocytic leukaemia (CLL).

It has previously been reported that the expression of the complement receptors CR1 (CD35) and CR2 (CD21) on malignant B cells in CLL is reduced compared with the expression on normal B cells, while deposition of complement C3 fragments, as a consequence of alternative pathway (AP) activation of complement, is observed on mononuclear cells from patients with B CLL. Following our demonstration that normal B cells are capable of activating the AP of complement in a CR2-dependent fashion, we have chosen to re-examine the complement-activating ability of B CLL cells in relation to their altered phenotype with respect to CR2 and the complement regulatory membrane proteins, CR1, decay accelerating factor (DAF) (CD55) and membrane cofactor protein (MCP) (CD46). Flow cytometry was used to measure expression of complement receptors and regulatory proteins on CD5+ B cells from CLL patients, as well as the deposition of C3 fragments occurring both in vivo and after in vitro AP activation. We have confirmed the reduced expression of CR1 and CR2 on CLL cells and have shown that AP activation in the presence of homologous, normal serum was reduced on B CLL cells compared with normal B cells. The degree of AP activation correlated directly with CR2 expression. In addition, we observed that CLL cells bear in vivo-deposited C3d,g, although at a significantly lower level than normal B cells.     

Circulating immune complexes in ulcerative colitis.--II. Correlation with serum protein concentrations and complement conversion products

Several serum proteins were quantified in twenty-two patients with active ulcerative colitis, and the findings were related to disease activity and occurrence of circulating immune complexes (IC). Conversion of C3 was significantly more frequent in the IC-positive group (eight patients) as compared to the IC-negative group (fourteen patients). Factor B was demonstrable in fifteen out of the twenty-two patients and seven out of the eight IC-positive patients had detectable levels of factor B. There was no difference between the IC-positive and the IC-negative group as regards serum concentrations of the complement factors C3, C4 and factor B, or serum orosomucoid, albumin, IgM and IgG. In contrast, the serum IgA levels tended to be reduced in the IC-positive group. C3 and factor B were significantly elevated in four patients with severe disease activity. In addition, C3, factor B and C4 concentrations showed a positive correlation to the serum orosomucoid levels. The serum concentrations of orosomucoid and albumin were inversely correlated to each other.     

Quantitative studies of Fc receptors on human monocytes: characterization by binding of homologous and heterologous monomeric IgG and soluble immune complexes of different composition

The binding of 125I-labelled monomeric human and rabbit IgG (H-IgG, R-IgG) and rabbit IgG immune complexes (IC) to monocyte-enriched human peripheral blood cells had been investigated quantitatively. Scatchard plots at 4 degrees demonstrated that R-IgG bound to the same number of Fc receptors per cell (19,000) as H-IgG, but with a lower affinity (2.4 +/- 0.9 X 10(8)/l/mol and 3.5 +/- 1.1 X 10(8)l/mol, respectively). Inhibition studies demonstrated that the two ligands could mutually inhibit each other, H-IgG having higher inhibitory efficiency versus R-IgG than the reverse. It seems likely that R-IgG reacts with the Fc receptor for the homologous IgG, although with lower affinity. Binding of soluble R-IgG anti-bovine serum albumin (BSA) IC, prepared at molar antigen:antibody (Ag:Ab) ratio of 2:1 and 12:1, showed quite different behaviour, the IC binding with association constants almost 10-fold lower than the affinity of monomeric R-IgG, but binding six- to seven-fold as many IgG molecules per cell at saturation.     

Humoral Immunity to Dietary Antigens in Atopic Dermatitis

Enzyme-linked immunosorbent assays (ELISA) employing a biotin-avidin amplification step are described for the quantification of human serum IgG antibodies to the dietary antigens ovalbumin (OA) and beta-lactoglobulin (BLG). The analytical quality of these assays was acceptable. Antibodies were measured in 16 patients with mild or moderate atopic dermatitis (AD), in 31 patients with a history of AD, and in closely matched controls. Levels of serum anti-OA antibodies did not differ in patients and controls, whereas anti-BLG antibodies tended to be higher in patients with mild or moderate AD than in controls (P less than 0.05).     

Detection of IgG aggregates or immune complexes using solid-phase C1q and protein A-rich Staphylococcus aureus as an indicator system.

A radioimmunoassay for detection of C1q-binding IgG aggregates and antigen-IgG antibody complexes is described. The assay makes use of solid-phase C1q and 32p-labelled protein A-rich Staphylococcus aureus as an indicator system. Both 19S and heavier IgG aggregates that fixed C1q were detected. The sensitivity of the assay permitted detection of heavy (19-25S) IgG aggregates at a concentration of 8 mug/ml or less. The results indicated that detection of IgG in this assay is dependent on the degree of IgG polymerization and the molar ratio between the solid-phase C1q and the IgG polymers. Albumin-anti-albumin complexes, preformed at equilibrium with antibody to antigen molar ratios of 2:1 to 3:1 and at antigen concentrations of 25 to 40 mug/ml, were also detectable using the described radioimmunoassay.     

A prospective study of methylenetetrahydrofolate reductase and methionine synthase gene polymorphisms, and risk of colorectal adenoma

We examined the relationship between a functional polymorphism (667C-- >T, ala-->val) of the methylenetetrahydrofolate reductase gene (MTHFR) and the risk of colorectal adenomas in the prospective Nurses' Health Study. Among 257 incident polyp cases and 713 controls, the MTHFR val/val polymorphism [relative risk (RR) = 1.35, 95% confidence interval (CI) 0.84-2.17] was not significantly associated with risk of adenomas. This lack of association was observed for both small (RR = 1.36, 95% CI 0.76-2.45) and large (RR = 1.32, 95% CI 0.66-2.66) adenomas. Furthermore, there was no significant interaction between this polymorphism and consumption of either folate, methionine or alcohol. We also examined the relationship of a newly identified polymorphism (asp919gly) of the methionine synthase gene (MS) with the risk of colorectal adenomas in the same population. The MS gly/gly polymorphism was also not significantly associated with risk of colorectal adenomas (RR = 0.66, 95% CI 0.26-1.70). These results, which need to be confirmed in other studies, suggest that the MTHFR val/val polymorphism, which has been previously inversely associated with risk of colorectal cancer, plays a role only in a late stage (adenoma-- >carcinoma) of colorectal tumorigenesis, and/or may protect against malignant transformation in the subset of benign adenomas, which may progress to malignancy.      

Complex fractures of the clivus: diagnosis with CT and clinical outcome in 11 patients

During a 20-month period, fractures of the clivus occurring after craniocerebral trauma were diagnosed with computed tomography (CT) in 11 patients. Five patients had longitudinally oriented fractures; these were fatal in four patients due to either vertebral-basilar artery occlusion, brain stem trauma, or both. Six other patients had transversely oriented fractures that extended through the carotid canal and petrous temporal bone. While less frequently contributing directly to mortality, transverse fractures were also associated with cerebrospinal fluid leaks (two patients) and a cavernous sinus-carotid fistula (one patient). They were not as frequently associated with Horner syndrome or cranial nerve deficits as suggested in the current literature. This retrospective evaluation reveals two distinct injury patterns that demonstrate a difference in related morbidity and mortality.