A nephelometric study of the reaction of monoclonal rheumatoid factor with heat aggregated gamma globulin and sera from patients with immune complex diseases.

Monoclonal rheumatoid factors (MCRF) have previously been used in a variety of assays for the detection of IgG-containing circulating immune complexes. We have isolated a MCRF from a patient with a lymphoproliferative disorder and have used a nephelometric technique to characterize its reaction with heat-aggreagated gammaglobulin (HAGG) used as a source of artificial immune complexes. The method is simple, economical and rapid and will detect as little as 6 microgram/ml of HAGG over a wide range of physicochemical conditions.

Inhibition of neutrophil migration by sera from patients with rheumatoid arthritis.

Sera from patients with rheumatoid arthritis inhibited the migration of human neutrophils in 63% (twenty-two out of thirty-five) of the cases tested. The inhibition was not due to a toxic effect of the serum as it was reversed by a chemotactic stimulus. There was a strong correlation between the degree of inhibition of neutrophil migration and the amount of immune complexes present in the sera as determined by the C1q binding activity.

Inhibition of human neutrophil migration by aggregated gammaglobulin.

Heat-aggregated human gammaglobulin has been shown to inhibit the random migration of human neutrophils in serum-containing medium. This inhibition was not due to metabolic exhaustion or deactivation of the cells, since migration in the presence of aggregated gammaglobulin and casein as a chemotactic stimulus was not inhibited. The inhibition of migration was not mediated by a negative chemotactic gradient produced as a result of complement activation, and could be demonstrated in complement-depleted serum.

Cerebrospinal fluid immunoglobulin quotients, kappa/lambda ratios, and viral antibody titres in neurological disease.

A description has been given of cerebrospinal fluid (CSF) immunoglobulins in 355 patients with demyelinating, infectious, neuropathic, and other neurological disorders. An increase in the CSF IgG/albumin quotient was observed in 19/36 (53%) cases of definite multiple sclerosis (MS), in 13/47 (28%) cases of probable or possible MS, in 6/9 (67%) cases of proven herpes simplex viral encephalitis (HSVE), in 3/4 (75%) cases of neurosyphilis, in 1/1 case of subacute sclerosing panencephalitis (SSPE), in 2/9 )22%) cases of other central nervous system infections, and in 2/12 (17%) cases of polyneuritis when compared with a group of 236 patients having other neurological disorders. In constrast, a relative increase in the CSF IgA of IgM was seen only in some of the patients with central nervous system infections.

Factors relating to circulating immune complexes in rheumatoid arthirits.

Evidence has been presented suggesting that circulating immune complexes occur in over half of the sera of patients with rheumatoid arthritis. These IgG-containing complexes were small, eluting between IgG and IgM on gel filtration on Sepharose 6B and were not seen in the sera of healthy control subjects. These complexes were detected in the sera of both seronegative and seropositive patients and their quantity did not correlate with IgM rheumatoid factor titre.

Relationship between paraprotein polymerization and clinical features in IgA myeloma.

The clinical manifestation fo IgA multiple myeloma are usually not considered distinguishable from those of IgG myeloma despite the fact that IgA differs from IgG in several characteristics, particularly molecular size heterogeneity. The clinical and laboratory features of 25 patients with IgA myeloma seen during a 5 year period are presented. The degree of paraprotein polymerization was observed to vary greatly in these patients but remained chronologically constant in six individuals studied on several occasions over this period.

Polymeric IgA myeloma, hyperlipidaemia and xanthomatosis: a further case and review.

A patient is described who had myeloma of the polymeric IgA variety, together with a striking hyperlipidaemia and xanthomatosis. Investigations into the protein and lipid abnormality failed to demonstrate any mechanism for the hyperlipidaemia. A review of the literature, however, validates this clinical entity and some of the suggested explanations are discussed.

Immunosuppression in the treatment of inflammatory bowel disease. I. Changes in lymphoid sub-populations in the blood and rectal mucosa following cessation of treatment with azathioprine.

Lymphoid subpopulations in the blood and rectal mucosa were studied in six patients with ulcerative colitis or Crohn's disease who had been treated for over three years with azathioprine. Serial assays were performed to observe the changes occurring up to 12 weeks after treatment with azathioprine was stopped. While the patients were on the drug two lymphoid populations showed marked depression.