Characterization of specific HLA-DQ alpha allospecificities by genomic, biochemical, and serologic analysis

Bgl II restriction endonuclease digestion of genomic DNA from lymphoblastoid cell lines homozygous for HLA DR and DQ serological specificities, followed by hybridization with a DQ alpha cDNA probe, identified a genomic polymorphism characterized by two reciprocal patterns, one associated with DR 3, 5 and 8 and the other with DR 1, 2, 4, 7, and 9. The former pattern corresponded precisely to the reactivity of monoclonal antibody SFR20-DQ alpha 5, shown by Western blotting to react with isolated alpha-chains, but not with beta-chains. Additional variants of the DQ alpha genes were identified by using a locus-specific oligonucleotide probe for the DQ alpha gene, indicating differences among the DQ alpha 5-negative set of alleles. This analysis defines a set of DQ alpha allelic markers that are distinct from the well-established DQ serologic specificities DQw1, 2, 3 or "blank." Although most DQ alpha 5+ cells carry the DRw52 specificity associated with the DR beta 2 gene, analysis of DQ alpha polymorphisms on DR5, DQw1; DR8, DQw1; and DRw13, DQw1 cells verified that this DQ alpha family of alleles was not invariably linked to the DR beta 2 locus.

Response of human chorionic gonadotrophin to luteinizing hormone-releasing hormone stimulation in the culture media of normal human placenta, choriocarcinoma cell lines, and in the serum of patients with gestational trophoblastic disease

In vitro and in vivo responses to luteinizing hormone-releasing hormone (LHRH) stimulation of human chorionic gonadotrophin (hCG) production were evaluated. We cultured placental tissues of ten weeks and term pregnancy, choriocarcinoma tissues, and monolayers of the BeWo cell line, and added serial dilutions of LHRH (1, 5 and 10 micrograms) to the media for five to seven days. In in vivo experiments, 100 micrograms LHRH was intravenously administered to 20 normally cycling women (control group), 27 women who were 'possible remission', and 21 women with 'minimal resistance' to gestational trophoblastic disease. After injection of LHRH, blood samples were collected at 0, 30, 60, 90 and 120 minutes. The concentrations of immunoreactive beta-hCG in in vitro culture media, and in sera from patients, were measured before and after LHRH stimulation by double-antibody radioimmunoassay. These in vitro and in vivo experiments revealed that normal and malignant trophoblastic cells responded to the LHRH stimulation by producing immunoreactive beta-hCG. Therefore, LHRH stimulation may be useful in detecting residual choriocarcinoma cells in gestational trophoblastic disease patients during their periremission periods.

HLA and leprosy in Koreans

HLA antigens in 157 unrelated Koreans with leprosy have been identified and compared with 162 healthy Korean controls. The patient group consisted of 124 with lepromatous leprosy and 33 with tuberculoid leprosy. Although no significant differences were detected between the two patient groups, several antigens were found to be increased in the combined patient group compared to healthy controls. Two Class I antigens were increased: HLA-A11 (22% vs 12%) and Aw33 (27% vs 14%). Four Class II antigens were increased: HLA-DR1 (16% vs 7%), DR2 (39% vs 21%), DRw9 (14% vs 6%) and DQw1 (74% vs 55%). HLA-DR4 (28% vs 48%), DRw53 (46% vs 69%) and DQw3 (50% vs 75%) in contrast were significantly decreased in patients. Interaction of DR1, DR2, DRw9 and DQw1 as risk factors was analyzed. HLA-DR2 appeared to be the strongest risk factor. No evidence for synergy between DR1, DR2 and DRw9 was detected. DQw1 was not significantly increased in patients in the absence of DR1 and DR2, and thus it was not apparent in this study that DQw1 was an independent risk factor.

Induction of Ia antigens on synovial cells by gamma interferon

Gamma interferon (IFN-γ) is a potent inducer of class II MHC antigens (la) in vitro. Enhanced Ia Expression is a characteristic feature of inflamed rheumatoid synovium. We investigated the potential of Ia induction upon non-inflammatory synovial cells under the influences of gamma interferon, alpha interferon and conditional medium from concanavalin A (Con-A) stimulated peripheral blood lymphocytes cultures (Con-A CM), Ia expression on enzyme dispersed cultured synovial cells decreased with time coincident with the loss of macrophage like cells. Addition of gamma interferon induced Ia molecules upon Ia negative synovial cells in a time and dose dependent manner, whereas alpha interferon treatment failed to induced Ia antigen. Con-A CM exerted the ability to induce Ia upon synovial cells. These findings suggest that: (1) Ia antigen expression by synovial tissue is the result of direct T cell influence: (2) non-inflammatory synovium has a potential to modulate Ia molecules under an altered environment.

Galactomannan antigenemia and antigenuria in aspergillosis: studies in patients and experimentally infected rabbits

Purified galactomannan (GM) from Aspergillus fumigatus was used in both a radioimmunoassay and an enzyme-linked immunoassay for antigen detection. Results of the two tests seemed interchangeable. By one or both assays, GM was detected in serum from four of 12 rabbits lethally infected with A. fumigatus in concentrations ranging from 108 to 356 ng/ml. Serum antigen was detected in only two of 12 patients with invasive aspergillosis. Results of assay for GM in urine were far more encouraging. Urinary GM was detectable throughout the course of lethal aspergillosis in all 16 rabbits, in concentrations of 24-1,900 ng/ml. Urine from seven of 13 patients with invasive aspergillosis had GM concentrations of 1-83 ng/ml. Antigen excretion roughly paralleled extent of disease.

The fate of prorenin during granulopoiesis in epithelioid cells. Immunocytochemical experiments with antisera against renin and different portions of the renin prosegment

Comparative immunocytochemical experiments with antisera directed against renin and three synthetical peptides (Pro 1, Pro 2A and Pro 3) covering almost the entire span of human renin prosegment were performed on human kidney tissue. With anti-Pro 1, i.e. the antiserum which recognizes the NH2 terminus of human prorenin, no clear immunolabeling of juxtaglomerular epithelioid cell secretory granules could be obtained. It is therefore concluded that the corresponding portion of human prorenin may be cleaved off in the Golgi complex. After application of anti-Pro 3, the antiserum which recognizes the COOH terminus of the prosegment, only the juvenile secretory granules of epithelioid cells were consistently labeled, whereas, in contrast, some of the intermediate and most of the mature secretory granules were anti-Pro 3-negative. As the immunoreactivity of mature renin increased remarkably from protogranules to mature secretory granules, it is suggested that the cleavage of the COOH terminus of the prosegment, i.e. the activation of renin, takes place in juvenile and intermediate granules during condensation of the enzyme. The immunoreactivity of Pro 2A, corresponding to the middle portion of the prosegment, disappeared in a somewhat earlier stage of granulopoiesis than that of Pro 3. It is therefore concluded that the corresponding segmental cleavage, the result of which is a truncated version of intact prorenin, occurs in the protogranules of epithelioid cells.(ABSTRACT TRUNCATED AT 250 WORDS)

The HLA system in the Korean population

The frequencies of HLA-A, B, C, DR, and DQ antigens, HLA-D (HTC-defined) haplotypes, and the HLA-linked genetic markers glyoxalase I (GLO), factor B (Bf), C2 and C4 were studied in 162 healthy unrelated Koreans. Antigens A2, A24, A26, B44, B51, Bw62, B35, Cw1, Cw3, DR2, DR4, DRw6, DR7, and DRw8 were observed at frequencies of 15% or greater, and GLO-2, BfS, C4A*3, C2C, C4A*4, C4B*1, and C4B*2 were also frequently observed. The antigens A23, A25, B18, Bw42, Bw47, and B21 were not observed at all. HLA-DR4 was the most common class II antigen and was associated with a series of HLA-D-defined haplotypes including Dw4, Dw10, Dw13, and Dw15. The HLA-DRw6, DR2,Dw8, and DRw8 haplotypes were also found frequently. DR2 haplotypes were either Dw2 or Dw12, while all DRw8 haplotypes tested corresponded to the DB7 or Dw "8.3" specificity that has been described in other Oriental populations. Significant linkage disequilibrium was found between the alleles A2,Cw1; A30,B13; A30,Cw6; A30,DR7; Cw1,Bw22; Cw5,B12; Cw6,B13; Cw6,DR7; B7,DR1; B12,Dw6; B12,DR7; B12,Dw7; B13,DR7, B17,DR3; Bw22,C4B*6; DRw6,BfF; and C4A*4,C4B*2. A comparison of gene frequencies and commonly observed haplotypes between Koreans, Chinese, Japanese, and Caucasians showed that while Koreans share several characteristics in common with other Oriental populations, there are allelic frequencies and haplotypes in Koreans that are distinct.

A deletion mutant defines DQ beta variants with DR4 positive DQw3 positive haplotypes

We describe the production of an HLA deletion mutation by radiation mutagenesis of a DR4- and DQw3-homozygous, Dw4- and Dw14-heterozygous cell line designed to analyze polymorphisms associated with DR4 and DQw3. Southern blot analysis confirms a deletion of class I and class II genes on one haplotype. Variation in DQ beta alleles associated with DQw3 was previously described by characteristic RFLP patterns for a DQ beta bene. One pattern, which correlated precisely with A-10-83 monoclonal antibody reactivity (TA10), defined an allele which we call DQ"3.1". The mutant cell line has lost the polymorphic bands on Southern blots corresponding to the DQ"3.1" allele, while the intact Dw14 haplotype retains the alternate allele at DQ beta which is DQw-3 positive. TA10-negative. These data demonstrate the segregation of two DQw3 positive DQ beta allelic variants, both associated with DR4, which can be distinguished on the basis of both RFLP and monoclonal antibody reactivity.

Purification of human plasma inactive renin by immunoaffinity chromatography on profragment-specific IgG

Inactive renin was purified to apparent homogeneity from human plasma by ion exchange, gel filtration, Affi-Gel blue, immunoaffinity chromatography on profragment-specific IgG coupled to Sepharose, and preparative HPLC. By this method, a 460000-fold purification was obtained. The purified renin was totally inactive and was activated by trypsin.

Specific genomic markers for the HLA-DQ subregion discriminate between DR4+ insulin-dependent diabetes mellitus and DR4+ seropositive juvenile rheumatoid arthritis

HLA-DR4, Dw4-associated haplotypes associated with IDDM and JRA were compared using genomic DNA restriction fragment analysis to distinguish among DQ beta and alpha alleles linked to DR4. DQ beta polymorphisms that subdivide the HLA-DQw3 specificity into DQ3.1 and 3.2 alleles were identified. More than 90% of DR4+ IDDM patients express one of these alleles, DQ3.2; restriction enzyme mapping indicates that the presence of this allele also accounts for the genomic fragment patterns previously reported in IDDM. Furthermore, haplo-identical siblings of DQ3.2 IDDM patients also carry the DQ3.2 allele, regardless of clinical presentation. In contrast, DR4+ JRA patients show no allelic preference at DQ beta, implicating different HLA genetic contributions in these two DR4-associated diseases.

A case report of tracheobronchitis by herpes simplex virus, type I

Herpes simplex virus (HSV) infection of the lung and lower respiratory tract has been thought to be a rare and fatal disease, usually in patients with immunosuppression, severe burns, or prolonged intubation. However, recently, increasing numbers of patients have been reported to have a localized infection and some of them have recovered without specific therapy.

In Korea, there has been yet no proven case of HSV infection of the lower respiratory tract. Recently, we saw a case of localized HSV infection of the tracheobronchus. A 78-year-old male patient was admitted in acute respiratory failure, with COPD and old pulmonary trberculosis. After the clinical condition improved, a bronchoscopy was done which revealed a localized area of swelling, hyperemia, and mucosal irregularity at the lower trachea and right upper lobar bronchus. Bronchial brushing and biopsy showed typical cytologic changes including intranuclear inclusion body. Viral culture of a bronchial washing revealed a growth of HSV, type I. The patient died of unrelated, acute myocardial linfarction.

Renin activation in juvenile secretory granules? Immunocytochemical experiments with an antiserum directed against the prosegment of human renin

In immunocytochemical experiments on human kidney tissue with an antiserum directed against the prosegment of renin, only juvenile granules were clearly labeled. As the concentration of renin increases from protogranules to more mature granules, while the concentration of its prosegment decreases to subthreshold levels, it is assumed that the cleavage of the prosegment, i.e. the activation of renin, takes place in juvenile granules parallel to the condensation of the enzyme.

Inhibition of cellular immunity by products of Aspergillus fumigatus

A fraction, FB, from extracts of Aspergillus fumigatus which previously was found to display a high degree of cellular hypersensitivity in skin tests in sensitized guinea-pigs but a low ability to affect transformation of lymphocytes in vitro, was studied. This fraction was found to be capable of inhibiting lymphocyte transformation induced in vitro by tuberculin and by T and B cell mitogens. The inhibitory properties of FB on lymphocyte activation were heat labile, destroyed by proteolysis, and could be reversed by washing 24 h after addition. Antibody to FB did not reduce inhibition of lymphocyte transformation. Fluorescence labeling studies showed a uniform and non-capping distribution of FB on lymphocyte surfaces which resulted in exclusion of attachment of fluorescein-labeled Concanavalin A to the cell surface.

D to H ratio and the origin and evolution of Titan's atmosphere

A value of 1.7 x 10(-3) has been reported for the ratio of CH3D to CH4 in the stratosphere of the saturnian moon Titan. A lower value of 6 x 10(-4) for this ratio in the deeper part of Titan's atmosphere was reported by de Bergh et al. For comparison we note that the CH3D to CH4 ratio on Saturn and Jupiter is 8.7 x 10(-5) and 6.7 x 10(-5), respectively. We estimate the uncertainties in all these observations and data reduction to be about a factor of 2. Despite these uncertainties it appears that Titan's atmosphere is enriched in deuterium by a factor of > or = 3 relative to Jupiter and Saturn. Potential causative factors examined here for this enrichment are condensation to form tropospheric methane clouds, fractionation occurring over a hypothetical CH4-C2H6 ocean and between the ocean and the clathrate crust beneath, fractionation which occurred during the formation of Titan and fractionation occurring as a result of the evolution of Titan's atmosphere. We conclude that the greater part of the observed fractionation is probably derived from the formation of Titan and the subsequent evolution of Titan's atmosphere driven by photochemistry.

A clinical study of adult Japanese encephalitis in the Chonnam District, Korea, during summer of 1982--a difference between improved and expired cases

In the summer of 1982, we experienced a great number of patients with Japanese encephalitis compared with the previous years. We have studied 85 adult cases of Japanese encephalitis which were diagnosed clinically and/or serologically. A difference between improved and expired cases was also investigated. We found that deteriorated mental state, elevated SGOT (AST) level, lower hemagglutination-inhibition(H-I) titer, and a more acute onset of the illness were associated with higher mortality. The mortality rate in our cases was 35.3 percent.

Identification of a polymorphic variant associated with HLA-DQw3 and characterized by specific restriction sites within the DQ beta-chain gene

Restriction endonuclease digestion of genomic DNA from 24 lymphoblastoid cell lines homozygous for the HLA class II specificity DQw3, followed by hybridization with a DQ beta-chain cDNA probe, identified a genomic polymorphism with variable BamHI and HindIII recognition sites. This restriction fragment pattern was found for several haplotypes associated with the DQw3 specificity, including some haplotypes positive for the HLA-DR specificities DR4, DR5, DRw8, and DRw12. The variant fragment pattern corresponds precisely with the reactivity of a monoclonal antibody, A-10-83, previously shown to define a serologic split of DQw3. Serologic detection of the specific DQw3.1 genomic polymorphism indicated that the corresponding DQ beta-chain variants are expressed. This polymorphic restriction fragment pattern, then, represents a selective marker for DQ beta-chain genes that appear to define a DQ beta-chain-associated specificity, here called DQw3.1.

Effects of exercise on blood pressure, plasma catecholamines, potassium and the electrocardiogram after diuretic and neural-blocking therapy for moderate hypertension

Blood pressure control in mild and moderate hypertension may reduce morbidity and mortality. On the other hand, antihypertensive drugs may cause adverse metabolic, electrolyte, neural and hemodynamic alterations that detract from their effectiveness. The effect of hydrochlorothiazide (HCTZ) on some of these factors was compared with that of HCTZ and a sympatholytic drug in 20 hypertensive patients with left ventricular hypertrophy and retinopathy. HCTZ controlled blood pressure at rest and during maximum treadmill exercise (-12 mm Hg systolic and diastolic pressure (p less than 0.05), reduced left ventricular mass by 7% (p less than 0.05) and lessened aerobic impairment at maximum treadmill exercise by 45% (p less than 0.05). These effects were further improved after "neural blockade." A potential adverse effect of HCTZ--hypokalemia (-0.6 mEq/liter, p less than 0.01)--and the associated incidence of ectopy during effort (50%) were lessened after neutralizing neural tone. Combination therapy with low-dose diuretic and sympatholytic drugs was effective and well tolerated in patients with cardiac and vascular sequelae of moderately severe hypertension.

HLA-DR4-associated haplotypes are genotypically diverse within HLA

Biochemical diversity among products of class II HLA genes has been observed in individuals who appear to be HLA-D and DR-identical by cellular and serologic typing. We used techniques of restriction enzyme fragment analysis by Southern blotting to analyze this diversity at the level of cellular DNA. A panel of 17 HLA-DR4 homozygous cell lines (HCL) were investigated by using cDNA probes homologous to DQ beta, DQ alpha, and DR beta genes. Each probe was hybridized to cellular DNA digested with a series of different restriction endonucleases. Polymorphisms were observed with the use of the enzymes Pst I, Hind III, and Bam HI: Hybridization of cellular DNA digested with Hind III and Pst I with the DQ beta probe revealed specific polymorphisms, as did hybridization of the Pst I digest with the DQ alpha cDNA probe and the Bam HI digest with the DR beta probe. The observed differences fall into two categories: first, considerable diversity was seen between HLA-DR4 HCL that represent different HLA-D-defined haplotypes; second, diversity was also observed among HCL of the same DR4-associated HLA-D cluster. In contrast to the DQ cDNA probes, hybridization with the DR beta probe revealed relatively limited polymorphism by using a panel of different restriction endonucleases. Thus, although there is a general pattern of polymorphic restriction enzyme fragments homologous to DQ probes within an HLA-D cluster, the pattern seen for any particular cell line was not sufficiently distinct to assign an HLA-D or DR specificity.

HLA-DR4-associated haplotypes are genotypically diverse within HLA

Biochemical diversity among products of class II HLA genes has been observed in individuals who appear to be HLA-D and DR-identical by cellular and serologic typing. We used techniques of restriction enzyme fragment analysis by Southern blotting to analyze this diversity at the level of cellular DNA. A panel of 17 HLA-DR4 homozygous cell lines (HCL) were investigated by using cDNA probes homologous to DQ beta, DQ alpha, and DR beta genes. Each probe was hybridized to cellular DNA digested with a series of different restriction endonucleases. Polymorphisms were observed with the use of the enzymes Pst I, Hind III, and Bam HI: Hybridization of cellular DNA digested with Hind III and Pst I with the DQ beta probe revealed specific polymorphisms, as did hybridization of the Pst I digest with the DQ alpha cDNA probe and the Bam HI digest with the DR beta probe. The observed differences fall into two categories: first, considerable diversity was seen between HLA-DR4 HCL that represent different HLA-D-defined haplotypes; second, diversity was also observed among HCL of the same DR4-associated HLA-D cluster. In contrast to the DQ cDNA probes, hybridization with the DR beta probe revealed relatively limited polymorphism by using a panel of different restriction endonucleases. Thus, although there is a general pattern of polymorphic restriction enzyme fragments homologous to DQ probes within an HLA-D cluster, the pattern seen for any particular cell line was not sufficiently distinct to assign an HLA-D or DR specificity.

Identification of plasma inactive renin as prorenin with a site-directed antibody

A sequence-specific antibody that recognizes a portion of the prosegment of human renin precursor was raised and used to provide direct evidence that plasma inactive renin contains the prosequence of renal renin and is therefore probably prorenin rather than an inactivated form of previously active renin. The information may help not only to resolve a major controversy concerning the nature of inactive renin in human plasma but also to elucidate its exact physiological role.

The Jovian stratosphere in the ultraviolet

The center-of-disk reflectivity of Jupiter in the wavelength range from 1450 to 3150 angstroms has been computed from 30 low-dispersion IUE spectra taken during solar maximum in 1978-1980. A vertically inhomogeneous radiative transfer program is used to compute model reflectivities of various stratospheric compositions for comparison. Ammonia and acetylene are well determined because they show narrow absorption bands in the ultraviolet. Above 1800 angstroms, these two gases provide a good fit to the data, but not below. At shorter wavelengths the fit would be much improved by a small amount (0.5-1.5 ppb) of propadiene/allene (C3H4). Voyager IRIS spectra show that the IR bands of allene are not strong enough to be detected in such a small amount. Additional absorption around 1600 angstroms can be reproduced best with the presence of cyclopropane (C3H6, <15 ppb), although other absorbers (e.g., hydrocarbon molecules with more than three carbon atoms, oxygen- or nitrogen-containing molecules, or a high-altitude haze) could also explain the spectrum in this region. The data are too noisy to detect possible CO Cameron band absorption near 2000 angstroms.

HLA-DR2 and DR4 further defined by two new HLA-D specificities (HTC) derived from Israeli Jewish donors: comparative study in Caucasian, Korean, Eskimo and Israeli populations

Two newly-identified HLA-D antigens were characterized by testing selected homozygous typing cells (HTC) against responder panels derived from Caucasian, Korean, Alaskan Eskimo and Israeli Jewish populations. The first specificity, defined by typing cell "AZH", is associated with DR2 haplotypes and is detected primarily in Israelis. The second specificity, defined by HTC "TAS", is associated with DR4 haplotypes and is detected with relatively high frequency in Koreans and Alaskan Eskimos. The data indicate that HTC-AZH and -TAS can be used to identify previously undefined splits or variants of lymphocyte-defined (LD) determinants associated with DR2 and DR4 haplotypes. Further, the study demonstrates the utility of comparative population analysis in identifying and characterizing alleles encoded by the HLA-D region and provides additional evidence of heterogeneity within the family of serologically-defined HLA-DR haplotypes.

Mitral E point septal separation: a reliable index of left ventricular performance in coronary artery disease

The diagnostic value of E point septal separation (EPSS) was assessed in 108 patients with coronary artery disease who underwent coronary angiography and M-mode echocardiography within a 2-year period at LAC/USC Medical Center. In patients with anterior myocardial infarction, EPSS correlated well with angiographic ejection fraction, with a specificity of 85% and sensitivity of 82%. In inferior myocardial infarction, a 21% frequency of falsely elevated EPSS values was encountered; the sensitivity for detecting reduced ejection fraction was 100% and the specificity was 67%. In combined anterior and inferior myocardial infarction, EPSS accurately estimated abnormal ejection fractions with a sensitivity and specificity of 100%. An abnormal EPSS (more than 7 mm) was found to be more sensitive (87%) and specific (75%) in detecting individuals with angiographically reduced ejection fraction (less than 50%) compared to other echocardiographic indices of pump function. Importantly, EPSS was effective in estimating left ventricular function in the presence of left bundle branch block, paradoxical septal motion, and angiographic septal, posterior, and anterior wall motion abnormalities.

Analysis of the HLA-DRw8 haplotype: recognition by HTC typing of three distinct antigen complexes in Caucasians, Native Americans, and Orientals

We have used seven HLA-D homozygous typing cells (HTC) in a comparative study of the DRw8 antigen complex in three racial groups. Three distinct HLA-D specificities were recognized, each associated with HLA-DRw8. Four of the HTC defined a DRw8-associated HLA-D specificity designated 8.1, one defined a specificity designated 8.2, and two defined a specificity designated 8.3. Each of the three specificities showed an association with a distinct racial group: Dw"8.1" in Caucasians, Dw"8.2" in Pacific Northwest Indians, and Dw"8.3" in Orientals. An informative primed lymphocyte (PLT) cell generated against a Dw"8.1" haplotype was able to distinguish 8.1 from 8.2 and 8.3. Using selected anti-DRw8 sera, a serologic distinction between 8.1 and 8.3 could also be made. It was thus possible, by using both cellular and serologic techniques in a comparative population study, to recognize at least three HLA-D-defined splits of the DRw8 haplotype.

Cytotoxic effector cells against HLA antigens in strong linkage disequilibrium: identification of a strong, new CML determinant

Three sets of cytotoxic effector cells were generated against the A1, B8, DR3 haplotype using haploidentical individuals in three different families. The three sets of effector cells generated against this haplotype showed excellent reproducibility testing, strong cytotoxicity against their specific targets, low autologous kill, and segregation with the sensitizing haplotype within the family. When tested against a panel of cells bearing all combinations of the A1, B8, DR3 antigens, a hierarchy of contribution of the individual HLA antigens as CML target determinants was seen. A new strong target cell determinant was identified by cytotoxicity with one of the effector cells not explicable in terms of the A1, B8, DR3 antigens or known HLA cross-reactivity. A family study demonstrated that this determinant clearly segregates with HLA. The success of this approach in defining new CML determinants may result from the generation of effector cells across a single haplotype in strong linkage disequilibrium or from the presentation of CML determinants in the context of self.

Differential behavior of cytotoxic effector cells against HLA antigens in strong genetic linkage disequilibrium

Five sets of cytotoxic effector cells were generated, using haplo-identical, first degree relatives in five different families, against the HLA-A3; B7 serological determinants combined with different DR antigens. When tested against a panel of cells bearing combinations of the HLA-A, -B and -DR antigens it was shown that the HLA-B7 antigen was as strong a CML target determinant alone as it was in the presence of HLA-A3. The strength of the HLA-A3 antigen as target determinant varied. With effector cells primed to the HLA-A3; B7; DR2 haplotype, the A3 antigen alone behaved as a weak target determinant. When the same target cells were tested with the effector cells generated against HLA-A3; B7 without DR2, the A3 antigen behaved as a strong target determinant. A number of target cells lacking the serologically detectable HLA determinants present on the sensitizing HLA haplotype were identified as being killed by specific effector cells. These data suggest either a number of new CML target determinants controlled by different loci or the presence of a single, new locus with multiple alleles controlling CML targets.

Clinical studies with cefoperazone in the treatment of bacterial infections in surgical practice

Cefoperazone was given to 33 surgical patients who had bacterial infections. A dose of 1 to 2 g bid was administered intravenously for an average of 8.2 days. The overall satisfactory response rate (which includes excellent and good responses) was 79%: 83% in 18 cases of peritonitis and/or intra-abdominal abscesses. 75% in 8 cases of hepatobiliary infections: 100% in 5 cases of skin and soft tissue infections; and 0 in 2 cases of sepsis. The satisfactory response rates according to the isolated organisms were: 11 of 15 Escherichia coli, 15 of 18 streptococci (including 4 of 6 enterococci) 3 of 6 Pseudomonas aeruginosa. 3 of 4 staphylococci 2 of 3 Proteus species, and 3 of 3 Klebsiella pneumoniae. No side effects were observed and there were no abnormal laboratory findings.

Frequency of alloantibodies reacting with PHA-activated T lymphocytes, unexplainable by known HLA activities

Two hundred and three sera obtained from multiparous women were screened to determine the frequency of the appearance of antibodies reactive with PHA-activated T lymphocytes, but not with resting B or T cells from the same donor. The panel of cells on which the sera were tested consisted of lymphocytes from 38 unrelated donors known to be homozygous at the HLA-D locus. Forty-two sera were shown to react uniquely with PHA-activated T cells. The reactivities of these sera could not be explained in terms of the defined HLA-A,-B,-C, or DR antigen specificities on the panel cells, nor on the basis of known cross-reactivities among these antigens. Most of the antisera showed strong cytotoxicity with the activated T cells. Such sera may define antigens presented to the maternal immune system during differentiation and development, which are not expressed on adult T cells unless they are activated.

DR-positive maternal engrafted T cells in a severe combined immunodeficiency patient without graft-versus-host disease

A 2 1/2-year-old male infant with severe combined immunodeficiency was documented by HLA typing and the presence of a female karyotype in the few spontaneously dividing cells to have an intrauterine-derived maternal lymphocyte graft. The presence of DR antigens on the engrafted maternal E rosette-forming T cells was demonstrated by both cytotoxicity and immunofluorescence techniques using both conventional and monoclonal antihuman DR antisera. These DR antigens were of the same allospecificity, DR4, as the mother's peripheral blood B cells. The patient's B cells and monocytes expressed DR alloantigens DR4 and DR3, corresponding to his genotype. Although fresh maternal lymphocytes react strongly in vitro against patient non-T cells, the engrafted maternal T lymphocytes no longer show this activity. Furthermore, clinical evidence suggesting mild graft-versus-host disease was completely resolved by the end of his first year. The presence of the DR-positive maternal cells may reflect the survival of a group of activated suppressor cells mediating graft tolerance of host tissue.