Metabolism of immunoglobulin A, lymphocyte function, and histocompatibility antigens in patients on anticonvulsants

Low serum IgA levels were found in patients taking phenytoin, together with evidence of depressed T cell function. There was no correlation between the dose or the serum level. A correlation was found, however, with HL-A status, patients with a low IgA showing increased frequency of HL-A2. It is suggested that epileptic patients with HL-A2 status are likely to develop IgA deficiency when given phenytoin.

Hereditary chorea without dementia

We describe here a distinct syndrome of chorea without dementia, occurring in three generations of a family and inherited as a mendelian dominant.

Histocompatibility antigens associated with motor neurone disease

The distribution of histocompatibility antigens was studied in 44 patients with motor neurone disease (MND). An unusually high incidence of HLA antigens A2 and A28 was found, compared to a control population.

Immunological abnormalities in patients who had the oculomucocutaneous syndrome associated with practolol therapy

Patients with and without adverse reactions on practolol therapy showed altered immune responses. There was cutaneous anergy to Candida albicans and streptokinase/streptodornase antigens and depression of lymphocyte function in vitro. Anticomplementary activity and a wide range of autoantibodies were found in patients who had received practolol.

Transfer-factor therapy in multiple sclerosis

The effect of transfer factor prepared from relatives of patients with multiple sclerosis (M.S.) and from unrelated donors on the clinical course of M.S. has been studied in fifteen male and fifteen female patients. Some patients were given transfer factor and some placebo (physiological saline). Results of three independent clinical examinations by different neurologists and subjective assessments by the patients showed no difference between those given transfer factor and those given placebo.

Studies on the nature of autoimmunity in myasthenia gravis. Evidence for an immunodeficiency type

Clinical and laboratory data continue to support the concept of a genetically determined breakdown of immunological tolerance in myasthenia gravis with immunological damage to the motor end plates. The demonstration of impaired function of thymus-derived lymphocytes and of IgA deficiency correlate well with the clinical data in which there is an increase incidence of autoimmune diseases associated with anergy. Whilst the exact pathogenesis of myasthenia gravis is unknown, the available data support the concept of an immune deficiency disorder.

Optic neuritis in the Landry-Guillain-Barré-Strohl syndrome

A patient with typical Landry-Guillain-Barré-Strohl syndrome (LG-BS) developed bilateral optic neuritis. Laboratory studies showed hypersensitivity to both central and peripheral nervous tissue myelin. The occurrence of optic neuritis is presumably due to autohypersensitivity to central nervous tissue myelin. The initial lesions of the LG-BS syndrome in the peripheral nerves might have liberated sequestered antigens that cross-reacted with central nervous system myelin.

Absence of cellular hypersensitivity to muscle and thymic antigens in myasthenia gravis

Humoral antibodies to skeletal muscle and its components and to thymus have been demonstrated in the sera of patients with myasthenia gravis. A role for cellular hypersensitivity to similar antigens in the pathogenesis of the disease has been suggested by some reports of the presence of cellular immunity. A detailed immunological study using muscle and thymic antigens, including those prepared from the patients' own tissues, failed to confirm these findings. It is suggested that previous reports of cellular hypersensitivity represent the demonstration of an epiphenomenon.

Experimental autoimmune demyelinating diseases: experimental allergic encephalomyelitis and experimental allergic neuritis

Experimental allergic encephalomyelitis (EAE) and experimental allergic neuritis (EAN) are reproducible models of auto-allergic demyelinating diseases of central and peripheral neurons tissue respectively. EAE bears a close resemblance to naturally-occuring post-infectious encephalomyelitis and EAN to Laundry-Guillain-Barré polyneuritis, in humans. In the experimental models the antigen responsible for disease induction is a different myelin basic protein in each disease. Although a variety of humoral antibodies to various neural fractions are found in both disorders, it has been shown that disease results from cell-mediated immune reactions to specific myelin antigens.