Perspectives and future directions. Immunogenetics

An outline of the history of immunogenetics is presented. The usefulness of the Rh, HLA and Gm systems in disease prediction and prevention will increase with our capacity precisely to relate polymorphic variants to particular functions and pathophysiological events. Alloimmunization to Gm markers is common in rheumatoid arthritis, an allegedly autoimmune disease. This paradox and the paradox of nonnominal allotypes, disobeying Mendelian rules, are resolved by the interpretation that herpesviruses may transfer nonself polymorphic genes. Transduction of such genes may be important also in AIDS pathogenesis.

[The international network and Italian modernization. Ruggero Ceppellini, genetics, and HLA]

The paper reconstructs the scientific career of Ruggero Ceppellini, focusing especially on his role in the discovery of the genetic system underlying the Human Leucocyte Antigen. From his earliest investigations in blood group genetics, Ceppellini quickly became an internationally acknowledged authority in the field of immunogenetics--the study of genetics by means of immunological tools--and participated to the endeavor that ultimately yelded a new meaning for the word: thanks to the pioneering research in the HLA field, immunogenetics became the study of the genetic control of immune system. The paper will also place Ceppellini's scientific work against the backdrop of the modernization of Italian genetics after WWII, resulting from the efforts of a handful of scientists to connect to international networks and adopting new methodologies in life sciences.

The next big idea

George S. Eisenbarth will remain in our memories as a brilliant scientist and great collaborator. His quest to discover the cause and prevention of type 1 (autoimmune) diabetes started from building predictive models based on immunogenetic markers. Despite his tremendous contributions to our understanding of the natural history of pre-type 1 diabetes and potential mechanisms, George left us with several big questions to answer before his quest is completed.

HLA nomenclature and the IMGT/HLA sequence database

Early in their study it was recognized that the genes encoding the HLA molecules were highly polymorphic and that there was a need for a systematic nomenclature. The result was the WHO Nomenclature Committee for Factors of the HLA System, which first met in 1968, and laid down the criteria for successive meetings. This committee meets regularly to discuss issues of nomenclature and has published 16 major reports documenting firstly the HLA antigens and more recently the genes and alleles. The standardization of HLA antigenic specificities has been controlled by the exchange of typing reagents and cells in the International Histocompatibility Workshops. Since 1989 when a large number of HLA allele sequences were first analysed and named, the job of curating and maintaining a database of sequences has been of prime importance. In 1998 the IMGT/HLA database became the official repository for HLA sequences. In addition to the nucleotide and protein sequences the database contains information of the cell from which the sequence was obtained. The database which provides tools for sequence analysis and the submission of new data, is updated quarterly and now contains over 1500 HLA allele sequences.

The discovery of linkage between the MHC and genetic control of the immune response

Immunization of rabbits, and inbred strains of mice with branched, multichain, synthetic polypeptides, such as (T, G) - A--L and (H, G) - A--L, revealed striking differences in the ability of different strains of mice to produce specific antibody. F1 and F1 x parental backcross mice revealed clear genetic control. Initial attempts to link this genetic control to known genetic markers were unsuccessful. The second approach, which attempted to transfer response from high or immediate responders into low responder recipients, initially encountered graft vs. host and host vs. graft reactions. The transfer of F1 spleen cells into the low responder parent demonstrated that ability to respond was a property of immunocompetent cells (spleen cells), not of the recipient's background genes. Mapping studies with recombinant H2 haplotype congenic strains, and a classic 4-point mapping cross were concordant in placing the gene controlling this trait within the H2 complex, between the K and Ss loci. Subsequent studies mapped the genes for stimulation in the mixed lymphocyte culture reaction to the same position, suggesting cell surface expression. Production of antisera to 'I-region' products defined 'Ia' antigens, the 2-chain alpha/beta MHC class II molecules.

Ancient myth, modern reality: a brief history of transplantation

From trephination to modern surgical procedures, transplantation is an exciting technology that has evolved over centuries. This article reviews the historical incidences of organ and tissue transplantation among humans and reflects on accomplishments made in general surgery that assisted transplant technology. Following a brief historical overview, the article focuses on modern transplanting issues including: development of immunosuppressive therapy, organ availability, qualifications for donors and recipients, organ procurement, and new transplant technology.