Blood and nasal epigenetics correlate with allergic rhinitis symptom development in the environmental exposure unit

BACKGROUND

Epigenetic alterations may represent new therapeutic targets and/or biomarkers of allergic rhinitis (AR). Our aim was to examine genome-wide epigenetic changes induced by controlled pollen exposure in the environmental exposure unit (EEU).

METHODS

38 AR sufferers and eight nonallergic controls were exposed to grass pollen for 3 hours on two consecutive days. We interrogated DNA methylation at baseline and 3 hours in peripheral blood mononuclear cells (PBMCs) using the Infinium Methylation 450K array. We corrected for demographics, cell composition, and multiple testing (Benjamini-Hochberg) and verified hits using bisulfite PCR pyrosequencing and qPCR. To extend these findings to a clinically relevant tissue, we investigated DNA methylation and gene expression of mucin 4 (MUC4), in nasal brushings from a separate validation cohort exposed to birch pollen.

RESULTS

In PBMCs of allergic rhinitis participants, 42 sites showed significant DNA methylation changes of 2% or greater. DNA methylation changes in tryptase gamma 1 (TPSG1), schlafen 12 (SLFN12), and MUC4 in response to exposure were validated by pyrosequencing. SLFN12 DNA methylation significantly correlated with symptoms (P < 0.05), and baseline DNA methylation pattern was found to be predictive of symptom severity upon grass allergen exposure (P = 0.029). Changes in MUC4 DNA methylation in nasal brushings in the validation cohort correlated with drop in peak nasal inspiratory flow (Spearman's r = 0.314, P = 0.034), and MUC4 gene expression was significantly increased (P < 0.0001).

CONCLUSION

This study revealed novel and rapid epigenetic changes upon exposure in a controlled allergen challenge facility, and identified baseline epigenetic status as a predictor of symptom severity.

A comparative evaluation of the sensitivity of five anti-hepatitis C virus immunoblot assays

BACKGROUND AND OBJECTIVES

In order to compare sensitivity, five anti-hepatitis C virus (HCV) immunoblot assays were tested (Deciscan plus, Inno-Lia III, Matrix, Murex Western blot and RIBA-3).

MATERIALS AND METHODS

The test panel (50 samples for each assay) included 6 anti-HCV-negative samples and 44 samples from 36 HCV-infected subjects.

RESULTS

There were minor differences in core reactivity among the assays. The smallest number of NS3-reactive results occurred with the Murex and Matrix assays, and the smallest number of NS4 reactives with RIBA-3 and Matrix. Among the 20 discrepant results for NS5 there was one clear false-negative with Inno-Lia. Only 28 of the 50 samples of the panel gave the same results in all the assays: 5 negatives and 23 positives. One of the 6 negative samples were indeterminate in 3 assays. Eighteen of the 21 other divergent results were interpreted as either indeterminate or positive, a common reactivity being exhibited by all 5 assays. The most important discrepancies occurred on 3 HCV-RNA-positive samples which came up negative in some assays: 2 samples with isolated NS3 reactivity were negative by Matrix and Murex Western blot, 1 of them being also negative by Inno-Lia III; another sample was negative by RIBA-3 and Matrix due to weak signals (< 1) on core and NS3 proteins, which did not exceed 1+ with the other assays.

CONCLUSIONS

With more uniform criteria for interpretation, the results would have been less divergent. Some assays should improve their sensitivity to the NS3 protein.

[Assessment of 32 months of continuous control of detection kits for anti-HIV and anti-HTLV antibodies and Hbs antigen used most commonly in transfusion biology. Retrovirus Study Group and Viral Hepatitis Study Group]

Controls were performed using a common internal panel specific for anti-HIV, anti-HTLV and HBs Ag. During the past 32 months, 5 anti-HIV1 + 2 antibody kits (Abbott, Behring, Biotest, Murex D. and Organon T., total of 199 lots), 4 anti-HTLV I/II antibody kits (Abbott, Murex D., Organon T. and Ortho C.D., total of 153 lots) and 5 HBs Ag kits (Abbott, S.D. Pasteur, Murex D., Organon T. and Ortho C.D., total of 244 lots) were used and controlled by the 14 participating laboratories. Analysis of the results showed the values obtained for the most representative sample of each panel to be within the limits m +/- 2 SD in 95 to 100% of the HIV1 + 2 kits, in 94 to 97% of the HTLV kits and in 92 to 100% of the HBs Ag kits. The specificity of the kits evaluated was on an average equal or superior to 99.5%, as required by the French Drug Agency in a blood donor population.

Germline mosaicism for an alanine to valine substitution at residue beta 140 in hemoglobin Puttelange, a new variant with high oxygen affinity

Hb Puttelange [beta 140(H18)Ala-->Val] was found as a de novo mutation in two siblings of a French family suffering from polycythemia. Both parents were phenotypically normal and exclusion of paternity has been ruled out by the study of several polymorphic markers located on different chromosomes. The structural modification of Hb Puttelange was established by reversed-phase HPLC analysis of the tryptic digest of the abnormal chain. The amino acid composition of an abnormal beta T14 peptide revealed that one of the four residues of Ala was replaced by a Val. Tandem mass spectrometry demonstrated that the substitution concerned position beta 140 (H18). This hemoglobin displays an increased oxygen affinity that is responsible for the polycythemia. De novo mutations, as demonstrated again in the case of this variant, have the highest probabilities of detection when they lead to pathological manifestations. They may result either from a somatic mutation in a very early stage of the embryological development of the propositus or may have a parental origin with occurrence of a germline mosaicism. The study of the beta-globin gene indicated that this case of Hb Puttelange probably arose from a mutation affecting a part of the germline of the father, therefore leading to a true recurrence risk.

[Epidemiology of genetic hemoglobin diseases in metropolitan France]

The number of subjects with heterozygous beta-thalassaemia and sickle-cell anaemia in metropolitan France can be evaluated by the distribution of populations originating from countries with a high prevalence of genetic haemoglobinopathies. Taking into account the movements of these populations observed since the 1982 census, the current prevalences of beta-thalassaemic and drepanocytic traits are higher than the figures of 180,000 and 130,000 respectively found at that date. On the other hand, it appears from episodic screenings performed during the last few years that the percentage of subjects with heterozygous beta-thalassaemia is 3.09% in Corsica, 0.77% in school-age population in the Marseille area, and 0.72% in the general population of Marseille, Toulon and Nice. In 1992, the number of patients with heterozygous beta-thalassaemia and with major sickle-cell syndrome is estimated at 250-350 and 1000-3000 respectively. Patients with sickle-cell anemia predominate in the Paris area, whereas those with heterozygous beta-thalassemia predominate in the provinces, notably in the Provence-Côte d'Azur and Corsica regions.

[Prevalence and epidemiologic features of subjects found to be infected with HIV when donating blood. CTS of the "Retrovirus" Study Group of the Société Nationale de Transfusion Sanguine]

HIV seroprevalence decreased from 0.62% in 1985 to 0.11% in the first 1990 semester. However, the number of regular blood donors screened as seropositive remains constant since 1988: 48 in 1988, 49 in 1989 and 25 in the first 6 months of 1990. From these data, from reports on recipients and due to the exclusion of 30% of such donors by anti-HBc screening, the residual risk to transmit HIV by blood transfusion was estimated to 17 blood donations per year in France. No significant change was observed throughout these years either in sex ratio or in the repartition into age groups. The number of HIV-infected subjects through the heterosexual route has not increased. The number of homosexuals and of IVDA has dramatically decreased since 1985, homosexuals still representing the major at-risk group.

[New methods of interlaboratory monitoring of HIV-1 ELISA kits. Comparative study of 2 periods: 1/12/1988 to 15/4/1989 and 15/4/1989 to 31/8/1989. Le Groupe Rétrovirus de la Sociètè Nationale de Transfusion Sanguine]

Since december 1st 1988, the Retrovirus study Group of the French Society of Blood Transfusion has initiated a systematic multicentric control of all anti-HIV screening EIA test kits lots used by each member of the group. For this purpose a special panel (GRV) has been designed and forwarded to each laboratory. From december 1st 1988 to august 8 1989, 6 HIV-1 kits have been in use (Diagnostics Pasteur Elavia 1; Diagnostics Pasteur Rapid'Elavia; Organon Vironostika; Abbott HIV recombinant; Du Pont env 9; Wellcome Wellcozyme). The GRV panel has been run 204 times on 102 different lots in 12 laboratories. Results after 9 months show that these 6 kits almost always properly recognize the 5 HIV 1 positive samples of the panel. However they differ in their ability to recognize HIV 2 positive samples. Variations in results are observed from lot to lot as well as between the first half of this period and the second.

Alpha-1-antitrypsin deficiency in a large sibship

We studied alpha 1-antitrypsin deficiency in a large family of 10 siblings: 3 subjects had PiZZ phenotype, but only 1 had emphysema; 2 subjects had no respiratory complaint. The patient with emphysema was a heavy smoker. According to the literature, this case suggests that, in PiZZ phenotype, emphysema appears earlier and is more severe if the patients smoke.

A randomized study of combined 5-fluorouracil and plasma perfusion over protein A-sepharose in human advanced colorectal carcinoma

To evaluate the advantage with regard to toxicity, response rate, time to progression and survival of combination chemoimmunotherapy over single-agent chemotherapy in patients with metastatic colorectal carcinoma (CRC), 30 patients were randomized to receive a combination of 5-fluorouracil (5-FU) by continuous i.v. infusion and plasma perfusion (PP) over protein A-Sepharose (group A), or a combination of 5-FU and PP over sepharose (group B) or 5-FU alone (group C). 5-FU was given at 1,000 mg/m2/d on days 1-5 of a 4-weekly cycle until progression. Patients of groups A and B received bi-weekly on-line PPs until disease progression or for a maximum of 19 treatments. PP was well tolerated and no severe or life-threatening toxicity was observed. The response rates were 10% for the group A (1 PR), 0% for the group B and 20% for the group C (1 CR + 1 PR). The times to tumor progression for patients in groups A and C were 22 months, 12 and 11 months, respectively and the median survival times were 17 months, 10 months and 9 months. Although the time to progression and survival tended to be higher in patients treated with protein A. PP, these differences were not statistically significant. This is the first report of a randomized trial showing some therapeutic advantage in combining protein A. PP with 5-FU in CRC patients. Further randomized studies are required to demonstrate the real true value of this chemoimmunotherapeutic approach.

Hb J-Cordoba [alpha 2A beta 2(95)(FG2)Lys----Met]. A new Hb variant found in Argentina

Hb J-Cordoba [alpha 2A beta 2(95)(FG2)Lys----Met], is one of the few hemoglobin variants discovered in Argentina. The structure and functional abnormalities are described. Hb J-Cordoba exhibits a slightly increased oxygen affinity, low cooperativity, and normal interaction with heterotropic cofactors.

Hemoglobin Saverne: a new variant with elongated beta chains: structural and functional properties

A 26-year-old French woman born in Saverne (France) was found to have Heinz body hemolytic anemia. Isoelectrofocusing showed the presence of an abnormal band amounting to 35% of the total hemoglobin concentration, suggesting a beta variant. Structural analysis of the abnormal beta chain showed an elongated C-terminal segment. Histidine 143 is replaced by a proline and the C-terminal sequence is identical to the corresponding segment of Hb Cranston. This new variant, named Hb Saverne, has beta chains composed of 156 amino acid residues. Studies of its functional properties showed that Hb Saverne is an unstable, high affinity variant with low cooperativity.

[Determination of sub-populations of circulating T lymphocytes in alcoholic cirrhosis using monoclonal antibodies OKT3, 4, 5, Leu 2 and Leu 15. Effect of hepatitis B virus infection]

Peripheral T lymphocyte subpopulations were quantified in 24 alcoholic cirrhotic patients, 11 of them having anti-HBs and/or anti-HBc antibodies, and were compared with 35 healthy control subjects, 10 of them having anti-HBs and/or anti-HBc antibodies. The monoclonal antibodies utilized (OKT3, OKT4, OKT8 in simple staining, Leu 2 and Leu 15 in double staining) are considered as markers of mature (CD3), helper (CD4), cytotoxic/suppressor (CD8, Leu 2), suppressor (Leu [2+ 15+), and cytotoxic (Leu 2+ 15-) T cells. In cirrhotics, when compared to controls, the number of CD3 cells was reduced (p less than 0.01); the proportion of CD4 cells was within normal range, and that of CD8 cells diminished (p less than 0.001), contrasting with an increased proportion of Leu 2+ cells (p less than 0.01), related to an increased proportion of Leu 2+ 15+ cells. Leu 2+ 15- lymphocytes were within normal range. In control subjects, a decreased proportion of Leu 2+ 15+ cells was found (p less than 0.05) when Ac HBs and/or Ac HBc were present. In cirrhotics having at least one serologic marker of hepatitis B virus infection, when compared with negative ones, increased proportions of Leu 2+ (p less than 0.05) and Leu 2+ 15+ (p less than 0.05) cells were found. These results show that data concerning T lymphocyte subpopulations are conflicting when various types of antibodies are used. However, they suggest abnormalities of immune regulation, possibly a defect of T suppressor cell function. Hepatitis B virus infection probably modifies immune regulation in alcoholic cirrhosis, and perhaps in normal subjects.

[Results of the first 9 months of testing for anti-HIV antibodies in blood donors in France]

An inquiry conducted in all the French blood transfusion centres from the 1st of July, 1985 to the 31st of March, 1986 in respect of blood donations confirmed to be positive for anti-HIV antibodies has given the following results: prevalence of 0.59 per thousand (1661/2,809,744); significant difference between first-time and regular blood donors (2.04% and 0.39% respectively); predominance of males (85%); 65% are less than 30 years old; the main risk factors are homosexuality (49%) and the use of I.V. drugs (28%).

[Wellcozyme: a new kit for the detection of anti-HIV antibodies. Considerations apropos of the initial trials]

We tested the Wellcozyme anti-HTLV III kit on: 600 blood donors fresh sera, simultaneously tested by Elavia (Diagnostics Pasteur) or Vironostika (Organon); 20 plasmas, known to be anti-HIV negative; 22 sera, already labelled, and a panel of 10 specimens from the "Retrovirus" study group of the French National Society of Blood Transfusion, also tested by Elavia, Vironostika, Abbott HTLV III EIA and by two confirmatory tests: Immuno-blot (Diagnostics Pasteur) and Abbott confirmatory test. The Wellcome kit is, at present, the only one to use a competitive Elisa method and not to require any sample predilution. The method is easy to perform, rapid (results in 1 h 30 time) and it tests as well serum as plasma. No interferences have been observed from high lipid concentrations or strong hemolysis on the Elisa reaction. The performances of the Wellcozyme test are satisfactory. We did not find any "false positive" result. But the study shows that this kit is not sensitive enough for the detection of anti-P25 antibodies, which appear on the beginning of seroconversion, unless the "grey range" is extended: the Wellcome Laboratories have just made this recommendation.

[A modification in technology improves the specificity of the Du Pont de Nemours immunoenzyme kit for the detection of anti-HIV antibodies]

Du Pont De Nemours perfected a new enzyme immunoassay for the screening of anti-HIV 1 antibodies, characterized by its rapidity: 2 hours of incubation, when the normal procedure needed 3 hours 30 minutes of incubation. We tested with the normal procedure and the shortened one 4,025 randomly selected blood donors. 55 samples of the SNTS panel and 10 sera representing the Western-Blot reference panel of the "Retrovirus" study group of the SNTS. We can say that shortening the incubation time results in certain advantages opposite the previous procedure: time saving (1 hour 30 minutes); improved specificity: the rate of false positive, 0.37% with the normal method, drops to 0.07% with the short one; good sensitivity, since all the individual positive samples were detected but it seems slightly less sensitive than the normal method for the diluted positive samples.

[Evaluation of malnutrition and immunity in alcoholic liver diseases]

Disorders of immunity and nutritional status are known to be present in alcohol-induced diseases of the liver, but their significance is still debated. Nutrition and immunity were evaluated at different stages of the disease in 58 alcoholic patients with steatosis (n = 20), alcoholic hepatitis (n = 14) or cirrhosis (n = 24). Most of the anthropometric data and biochemical values relating to nutrition were altered to the same degree in these 3 groups. Only patients with cirrhosis had significantly lower blood albumin and zinc levels (P less than 0.01). Humoral immunity was altered in cirrhosis only and cellular immunity in all 3 liver diseases. There was no correlation between immunity and nutrition (except for blood zinc and E rosettes; P less than 0.01) or between these and alcohol consumption. Like several nutritional parameters, blood lymphocyte values correlated negatively with a liver disease severity index. It is concluded that disorders of nutrition and immunity are broadly comparable in alcohol-induced liver diseases; there is no direct statistical correlation between these disorders which seem to be independent of the type of liver disease.

Relationships between 34 HLA-A, HLA-B and HLA-DR antigens and three serological markers of viral infections in alcoholic cirrhosis

In order to study the genetic risk of alcoholic cirrhosis, the frequency of 26 HLA-A and -B antigens was compared in 184 normal controls, 175 alcoholic cirrhotic patients and 83 alcoholic patients with hepatic steatosis of carefully selected ethnic origin. Eight HLA-DR antigens were also determined in 95 subjects of the normal control group and 63 patients of the alcoholic cirrhosis group. The incidence of hepatitis B virus antibodies (anti-HBc and anti-HBs) was defined in 74 patients of the alcoholic steatosis group, 170 patients of the alcoholic cirrhosis group and 111 normal controls different from the previously mentioned normal control group. The incidence and the titers of cytomegalovirus and rubella antibodies were also determined in 93 patients of the alcoholic cirrhosis group and the 111 normal controls. Serum immunoglobulin concentrations were measured in the same 93 cirrhotic patients. Compared with the controls, the alcoholic cirrhosis group revealed a significantly higher frequency of HLA-B15 (21.7 vs. 9.8%, p less than 0.00025, corrected p less than 0.050) and HLA-DR4 (38.1 vs. 17.9%, p less than 0.005, corrected p less than 0.050) and a significantly lower frequency of HLA-B13 (2.9 vs. 11.4%, p less than 0.025, corrected p less than 0.050). As for the frequency of all other HLA antigens, there was no significant difference between the three groups (normal controls, alcoholic cirrhosis and alcoholic steatosis).(ABSTRACT TRUNCATED AT 250 WORDS)

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.