The mode of formation and role of rheumatoid factors (RF) in transplantation were reviewed. RF might be produced through stimulation with altered transplantation antibody, which undergoes ...conformational changes resulting from the reaction with a graft. Some recipients might have such sources of infection as cytomegalovirus or human herpes virus 6 (HHV-6), because almost all patients were treated with immunosuppressive agents. Many bacteria and viruses have IgG Fc receptors on their surface. Herpes virus infection, such as herpes simplex virus, has been demonstrated to be capable of expressing Fc receptor on the infected cells. These Fc receptors could produce RF through the response of antibody production to anti-idiotype of Fc receptors. Also, IgG, which binds to Fc receptors, changes conformationally to produce RF. RF can also be produced as a result of graft versus host reaction. Although IgG RF reacting with homologous IgG is believed to have the most important role in pathogenic conditions, they have not been studied because of difficulties in their measurements. We developed an enzyme immunoassay for detection of IgG RF combining with homologous IgG. The wells of an assay plate were coated with Fc fragment of human IgG, and after incubation with tested serum, binding of IgG RF to the Fc was detected by means of goat anti-human IgG F (ab')2 antibodies followed by alkaline phosphatase conjugated rabbit anti-goat IgG and substrate. IgG RF were increased significantly more in transplantation sera of patients who rejected grafts than in those of patients who had satisfactory graft function. Some evidence for the role IgG RF in rejection, even if only circumstantial, has been provided.
We measured creatine kinase (CK) isoforms by a new immunoinhibition method to evaluate their usefulness in detecting early coronary reperfusion. Blood samples were collected at 15-minute intervals ...from 50 patients with acute myocardial infarction. CK isoforms were determined by a 10-minute immunoinhibition method with an autoanalyzer. Values for inhibited isoforms (MM3, MM2/2, and MB2/2) were divided by those of noninhibited isoforms (MM1, MM2/2, MB1, MB2/2, and BB) to calculate the isoform ratio. In the reperfused group the increase in the isoform ratio was 2.69 +/- 1.80 (SD) 30 minutes after reperfusion and 2.41 +/- 2.01 at 60 minutes, which was significantly higher than the corresponding values in the nonreperfused group (0.17 +/- 0.16 and 0.32 +/- 0.26, respectively). When an increase of 0.70 or more in the isoform ratio was used as the criterion for reperfusion, the sensitivity and specificity were 92% and 100% at 30 minutes and 100% and 100% at 60 minutes after recanalization, respectively. We conclude that the isoform ratio obtained by the new 10-minute assay of CK isoforms is useful for the noninvasive detection of reperfusion 30 and 60 minutes after recanalization in acute myocardial infarction.
Since symptoms typical for multiple chemical sensitivity (MCS) are induced by exposure to low levels of chemicals, we hypothesize that MCS represents an impaired recognition of odors or an increased ...emotional reaction to common odors. Twenty-five subjects with MCS, 20 women and 5 men, and 50 gender-and-age matched controls participated in this study. The University of Pennsylvania Smell Identification Test (UPSIT) and the Cross-Cultural Smell Identification Test (CC-SIT) were administered. In addition to selecting the most probable odor among the four, the subjects were asked their impression of each odor. Odor identifiability evaluated by the scores of two tests, were almost equal in MCS and control groups. The mean CC-SIT odor per person with pleasant feeling was lower in MCS than in controls. The mean odor per person creating an unpleasant sensation was higher in MCS than in the controls. Gingerbread was the only odor making MCS subjects more pleasant than the controls. Nine out of 40 UPSIT odors were felt as unpleasant by MCS subjects more than by controls. This study indicates that MCS subjects are able to identify the odors equally as well as the controls but feel unpleasant to a larger number of odors than the controls. Despite unknown mechanisms of the altered odor perception in MCS, the application of these tests for diagnostic procedure of MCS is proposed.
The case of a 40-year-old woman with Werner's syndrome associated with systemic lupus erythematosus (SLE) is reported. The patient exhibited short stature, slender extremities, thinned hair, ...high-pitched voice, cataracts, ulceration of the fingers, and mental retardation. Malar erythema, photosensitivity, and proteinuria had been noted since age 34. The serum contained high titers of antibodies to dsDNA, Sm, nRNP, and SS-A/Ro. The simultaneous presence of Werner's syndrome and SLE could be a coincidental occurrence of the two diseases, although it might be due to an abnormality in replication or degeneration of DNA leading to the development of both diseases.
The applicability of monitoring concentrations of serum KL-6 and serum surfactant protein-D (SP-D) in the detection of methotrexate-associated lung injury (MTX pneumonitis) in patients with ...rheumatoid arthritis (RA) was investigated. The concentrations of these markers, sequentially measured in two patients with RA complicated with MTX pneumonitis, were increased in accordance with the severity of MTX pneumonitis. Conversely, the concentrations of these markers were decreased with the improvement of MTX pneumonitis, suggesting that the monitoring of these markers could be applicable not only for detecting the onset of MTX pneumonitis, but also for detecting the therapeutic response of MTX pneumonitis. (Internal Medicine 41: 467-473, 2002)
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