Natural HLA antibodies

"Natural antibodies" directed against antigens of the Major Histocompatibility Complex have been observed in aged mice but very seldom in humans. It is likely that HLA natural antibodies are more common than previously supposed: our results suggest they may be found in 1% of normal blood donors. Most of these antibodies seem to be weak and can only be detected when B lymphocytes (BL) are used as target cells in the lymphocytotoxicity technique or when indirect immunofluorescence is used with peripheral blood lymphocytes (PBL). The behavior of these natural IgM antibodies was compared to that of weak immune IgG HLA antibodies detected in the same way. Absorption tests showed that "natural antibodies" were very specifically absorbed, whereas "immune antibodies" could also be absorbed by cells not carrying the specific antigen. Furthermore, about half of the "natural antibodies" detected to date carried the HLA-B8 specificity. Various hypotheses have been put forward to attempt to explain the appearance of these antibodies.

[Deformability of thawed erythrocytes: introduction of a new preservative solution]

Recently, KANE et al. (Centre de Transfusion Sanguine, Strasbourg) designed an original preservative medium, called ESOC, allowing a prolonged storage of thawed RBC. We studied on 15 days the evolution of thawed RBC deformability, while RBC where kept preserved, on the one hand in this ESOC solution, on the other hand in physiologic water, without any preservative medium. We tried to correlate this rheological evolution with cellular ATP, cellular 2,3-DPG and membrane proteins evolution. Deformability was measured by filterability with an Hemorheometre. The results are given as a rigidity index, IR. In ESOC, IR and cellular ATP stay in normal values during the 15 days. In physiologic water, deformability decreases strongly and IR is out of normal values after the fifth day. Cellular ATP decreases out of normal values as soon as the third day. 2,3-DPG decreases in both media. Membrane proteins electrophoresis does not show any difference neither in ESOC nor in physiological water, all fifteen days long. We only observed parallelism between deformability and cellular ATP and IR was higher than normal values. We found no correlation between deformability and 2,3-DPG. We also can conclude, with this study, that ESOC allows a good preservation of thawed RBC and by this way complies with the needs for delayed transfusion in current practice.

[Hepatitis B virus, serological markers of viral infections and humoral immunity in alcoholic cirrhosis]

In order to define the role of hepatitis B virus (HBV) in alcoholic liver disease and to study the relationship between HBV and other common viruses, the serological markers of viral disease (HBV, Rubella, Polio, Herpes, and Cytomegalovirus-CMV) were compared in 163 patients with alcoholic cirrhosis (group C), 100 patients with alcoholic steatosis (group S) and in 168 non-alcoholic control subjects (group NA). A significantly increased prevalence of HBV markers in group C was related to the presence of anti-HBc antibodies, in 10.5 p. 100 of cirrhotic patients, vs. 1.2 p. 100 in group S and 1 p. 100 in group NA (p less than 0.01). In cirrhotic patients with HBV markers (HBV +) incidence of alcoholic hepatitis was 4 times lower and the total duration of alcohol overconsumption was significantly lower than in cirrhotic patients without these markers (HBV-). Hepatic function tests were not different in HBV + and HBV- cirrhotic patients, excepted for the ASAT/ALAT ratio (1.55 +/- 0.10 vs. 1.92 +/- 0.12; p less than 0.05). Prevalence of anti-CMV antibodies, and anti-herpes greater than 1/100 antibodies, was significantly increased in S and C groups (p less than 0.01). Anti-Rubella, Polio, and CMV antibody titers were higher (p less than 0.05) in HBV + than in HBV- cirrhotic patients. In cirrhotic subjects, titers of these 3 anti-virus antibodies were not related to alcoholic hepatitis or to IgG and IgM concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

[Biological studies and research of immunologic deficiencies in blood donors from a prison environment]

The prison population may be considered as a population at risk for AIDS. Biological parameters were studied in order to detect significant anomalies commonly observed in AIDS patients. With respect to are age matched control population of donors, there are no statistically significant differences concerning the nutritional and inflammatory states of the two populations. The investigation of the humoral immunity shows comparable levels of circulating antibodies in the two groups: a high level of anti-cytomegalovirus and anti-herpes antibodies is more frequently found in the penal population. The markers for hepatitis B were also studied. None of the individuals is a carrier of the HBs antigen. The percentage of individuals having biological markers of hepatitis B is higher in the at risk group (45%) than in the control group (10%). The evaluation of the cell-mediated immunity shows that there are no significant differences between the mean values found in the two groups for OKT3, T11, OKT4 and OKT8. There is no inversed OKT4/OKT8 ratio in the at risk group while one donor in the control group shows an inversed OKT4/OKT8 ratio.

[Assay of glycosylated hemoglobin by agar gel electrophoresis in an acid pH. Value of the determination of the stable fraction in clinical biology]

Total glycosylated haemoglobin (Hbg) has been determined by electrophoresis on agar gel, using commercially available materials. This method is simple and unaffected by changes of temperature or buffers pH. With a performing densitometer, its coefficient of variation is less than 4% within batch, less than 6% between batch. There is a significant correlation with the small column separation technique (r = 0,93; p less than 0,001). The labile glycosylated haemoglobin is removed by 5 methods: 18 hrs dialysis of haemolysate at 4 degrees C; 30 mn incubation of whole-blood with semi-carbazide and aniline at pH 5 and 37 degrees C; 6 hrs saline incubation of erythrocytes at 37 degrees C; 18 hrs saline incubation of erythrocytes at 25 degrees C; 7 days storage at 4 degrees C. The two first methods appear to be the best. In our study we can conclude that: 1) In basal conditions the size of the labile fraction of Hb g was close to the limits of variability of the methods (less than or equal to 10%). 2) Therefore, except for brittle diabetics, it is not necessary to determine the labile fraction routinely.

[Plasma and synovial fibronectin. Results of personal research]

The authors report the results of an assay of plasma fibronectin and synovial fluid fibronectin conducted in 104 patients with arthropathy, including 26 cases of rheumatoid arthritis, 43 cases of mechanical arthropathy and 35 cases of non-rheumatoid arthritis. The plasma fibronectin levels do not vary significantly between the different groups of patients, but the mean value for the whole group of patients is significantly lower than that of a control population. The mean value of synovial fluid fibronectin was significantly higher in the patients with rheumatoid arthritis (583 +/- 76 mg/1) than in the patients with non-rheumatoid arthritis (379 +/- 58 mg/1) or mechanical arthropathy (367 +/- 32 mg/1). The assay of synovial fibronectin could therefore provide useful information for the aetiological diagnosis of inflammatory arthropathies. The local origin, from the synovial membrane itself, of the fibronectin in the synovial fluid is suggested by the fact that the synovial concentration of this protein is superior to the serum concentration in 50 to 90 per cent of cases, depending on the disease.

[Comparative study of three presentations for research on HBs antigen by the immunoenzyme technique]

The authors present the results of a study comparing the detection of HbSAg by enzyme immunoassay using the following three different commercial kits and their corresponding apparatus: Auszyme II, Quantum II from Abbott; Enzygnost micro Elisa, Elisa Processor from Behring; Hepanostika, washer and reader micro Elisa system from Organon. The purpose of the study is to determine the sensitivity and specificity of the reaction and the extent of automation of this method. The sensitivity and specificity of the 3 kits are compared with those of a reference technique, the radioimmunoassay Ausria II, Abbott. The sensitivity of Auszyme II is equivalent to that of Ausria II and is approximately 0.2 mg/ml. The other two kits are somewhat less sensitive. The proportion of false negative is less than 1%, but with all 3 kits it is necessary to verify a negative result. The results of this study confirm the high level of sensitivity and specificity of the enzyme immunoassay for the detection of HbSAg in the serum or plasma of blood donors. This technique therefore offers an alternate method of HbSAg detection to laboratories which cannot or prefer not to use a radioimmunoassay.

[Hemoglobin E: report of the first 2 cases in French subjects]

Hemoglobin E has been discovered casually in the blood of two French donors: one coming from the Alsace region, the other one coming from the Champagne region. In the two cases, the hemoglobin E is in an heterozygote state and takes the place of 33 per cent of the total haemoglobin in the first and 24 per cent in the second. We investigated in their families and found that other members of these families had hemoglobin E. Each time, it was associated with a microcytosis and polycythaemia without anemy or iron deficiency. The red cells morphology shows many microspherocytes and target-cells. There is no relationship between these two families and the research of an asiatic antecedent proved negative. These two observations give a supplementary proof that the geographic repartition of the hemoglobin E is larger than what we read in the first publications and shows the interest to study the hemoglobin of unexplained polycythaemia with microcytes in the blood of blood donors.

[Hemoglobin A1c and its variations in pregnancy]

Variations in haemoglobin A1c were studied at different stages of pregnancy in 306 non-diabetic women, using a specific method. It was found that HbA1c levels progressively decreased during the first 25 weeks of pregnancy, then remained stable. No correlation was noted between carbohydrate metabolis and Hb A1c levels. The new assay provides additional information on glucose tolerance in pregnant women and could be used to detect gestational diabetes.

Effect of diabetic control on the level of circulating thyroid hormones

Basal plasma levels of thyroxine (T4), triiodothyronine (T3) and reverse T3 were determined by radioimmunoassay in 44 control subjects, 44 Type 1 (insulin-dependent) and 39 Type 2 (non insulin-dependent) diabetic patients aged from 15 to 75 years. All were clinically euthyroid. The quality of diabetic control was assessed by the percentage of glycosylated haemoglobin. In both the diabetic groups there was a significant decrease in T3 and a rise in reverse T3 whereas T4 was normal. We found no significant differences between plasma thyroid hormone levels in Type 1 and Type 2 diabetic patients. In the poorly controlled diabetics (glycosylated haemoglobin greater than or equal to 12%), T3 was 90 +/- 5 ng/dl, which differed significantly from the level found in the better controlled patients (106 +/- 5 ng/dl, p less than 0.01). In the diabetic patients without associated illness, a negative linear correlation was found between T3 and glycosylated haemoglobin and a positive correlation between reverse T3/T3 and glycosylated haemoglobin. No correlation between T3 or reverse T3 and fasting blood glucose could be established. In conclusion, many diabetics showed a low T3 syndrome suggesting that there may be an impairment in the extrathyroidal conversion of T4 to T3. This may well be enhanced by a poor diabetic control (glycosylated haemoglobin greater than or equal to 12%).

Effect of some physical features and of amino acid substitutions on the mechanical precipitation of hemoglobin

In 1973 Asakura demonstrated that, following mechanical shaking, oxy-Hb S was much less stable than oxy-Hb A (Nature 244: 437, 1973). We have studied the mechanical stability of Hb Crétil (beta 89 Ser leads to Asn), Hb Hope (beta 136 Gly leads to Asp), Hb Strasbourg (beta 23 Val leads to Asp), and the hybrid Hb S/Stanleyville-II (beta 6 Glu leads to Val: alpha 78 Asn leads to Lys) by the method of Roth et al. (Blood 45:377, 1975). Hb Créteil, Hb Hope, and Hb S/St-II were sensitive to mechanical shaking, while Hb Strasbourg was more stable than Hb A, a hitherto undescribed finding. The precise mechanisms responsible for this precipitation are not known. From comparisons with published results, but excluding thermosensitive Hbs, we conclude that: - standard methods for isolation of hemoglobins modify its mechanical stability, - alpha mutation increases the mechanical stability of Hb S in the hybrid Hb S/St-II, - some mutations produce a more stable hemoglobin than Hb A.

[HLA antigens and responsiveness to tetanic toxoid in man]

HLA-A, B, C and Bf antigens were studied in 153 blood donors who developped a titre of greater than or equal to 25 i.u./ml antitetanus antibodies following tetanus anti-toxin vaccination. Antigen frequency was compared with that of 412-464 normal blood donors living in the same area. Few significant differences were demonstrated: absence of Bw21 antigen and slight increase of Bf F antigen were observed in "good responders".

Lack of linkage between acute intermittent porphyria and the A and B loci of the HLA system

Forty-six members of a family known to have Porphyria were studied. As the disease is often latent clinically, erythrocyte uroporphyrinogen I synthetase activity was determined to classify the subjects as being healthy or carriers. HLA--A, B, C, Bf, GLO antigens were determined. No linkage between acute intermittent Porphyria and the HLA system was noted in this family.

[Incidence of monoclonal gammopathies in blood donors]

A routine screening of monoclonal gammopathies (M.G.) was performed in the serum from 36, 015 blood donors by cellulose acetate electrophoresis. The incidence of M.G. was estimated to 0.14 per cent. About 86 per cent of cases can be classified as asymptomatic M.G. and 14 per cent as malignant M.G. (myeloma or Waldenström macroglobulinemia). In asymptomatic forms, heavy chain classes are only IgG or IgM with a large predominance of IgG (86,4%). It is suggested that donors in whom M.G. have been detected should not be allowed to give blood. A yearly clinical, hematological and an immunoglobulin check-up is recommended to these patients in order to defect the first sign of a malignant process.

G6PD Vientiane: a new glucose-6-phosphate dehydrogenase variant with increased stability

A new G6PD variant, called G6PD Vientiane, has been discovered in a patient from Laos. The characteristics of this variant are: mild enzyme deficiency (about 50% of the normal activity) in the granulocytes and the red cells, with normal G6PD-related antigen concentration; increased stability; normal Km glucose 6-phosphate and NADP+; increased inhibition constant by NADPH; decreased inhibition by ATP; slightly increased utilization of the substrate analogue; abnormal pH curve, with maximum activity at pH 9.5; slightly reduced starch gel electrophoretic migration. The implications of the molecular stability of a deficient mutant variant are discussed.

Quantitative studies of Gm allotypes. II. G1m(1), G3m(5) and G3m(21) in sera from healthy caucasoid blood donors, and in a family with the inheritance of a gene responsible for a weak Gm1,17;..;21 haplotype

The quantitative expression of three allotypes--G1m(1), G3m(5) and G3m(21)--has been studied in normal caucasoid sera. A gene dosage effect, previously described for all of these allotypes, is not noticed for G3m(5) in the present study. The different content of G3m(5) and G3m(21) IgG3 molecules in heterozygous Gm5/Gm21 sera has been verified: these contents are respectively 75% and 25% of the IgG3 content. The same allotypes have been studied in a family which shows the inheritance of a weak Gm1,17;21 haplotype. The gene responsible for this abnormality is probably a new regulatory gene, and is transmitted without the 'aimed' haplotype.