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It is now 10 years since the first AIDS cases were reported in the USA. In that relatively short period of time, study of the disease has moved from the level of early clinical description to exhaustive and extensive laboratory characterization of the human immunodeficiency virus (HIV), the immune responses directed towards it and reasons for their failure. This volume provides contributions from clinical and basic scientists who are actively involved in research in a number of areas of current interest and controversy. Further progress in the clinical management of the HIV-infected patient will undoubtedly build on the basic knowledge about HIV and its modes of pathogenesis. The intimate relationship between HIV and the human immune system provides observations and questions that are relevant to viral immunopathogenesis in general. In the first chapter the clinical features of HIV immunodeficiency are re­ viewed, and aspects of its changing face are discussed. Dr Tersmette then presents evidence for changing viral characteristics at different stages of the disease. This view of close competition for ascendancy between HIV and the host immune response raises questions about current approaches to therapy.

This book incorporates the latest advances in immunopharmacological treatment. One objective has been to provide appropriate bridges between the basic sciences of immunology and pharmacology on the one hand and clinical medicine on the other. A further intention has been to emphasize those advances in immunology and pharmacology that are of clinical importance while retaining those facts that, while not new, remain clinically useful. The immunology section provides the necessary background for immunopharmacologi­ cal treatment. The chapters on individual cell types include normal surface markers, mode of activation, and activation markers and functions in health and disease. The chapters on pharmacology give comprehensive information on immunosuppressive drugs in regular use today, their biochemical and cellular mechanisms of action, pharmaco­ kinetics, dosage regimens, therapeutic responses, adverse reactions, and drug interactions and tolerance. In addition, certain therapeutic principles that are still in an experimental phase are described, for example, immunotoxins, thymic hormones, and interleukins. The book presents comprehensive information on various autoimmune diseases, the etiopathogenetic immune mechanisms where these are known, and the current possibilities for immunopharmacological intervention. The specific disease section also covers rare situations, fluctuations in disease patterns, and subgroups of patients and immunophar­ macological treatment in these situations. Altogether, the book represents a practical textbook for clinicians and advanced students who want to be updated on therapeutic principles with regard to autoimmune diseases and transplantation.

The 9th International Conference on Lymphatic Tissues and Germinal Centres in Immune Reactions was held in Oslo, 9-14 August, 1987. These conferen­ ces, by the regular devotees just referred to as the germinal centre con­ ferences or GCC, have been held regularly at roughly three-year intervals since 1966. The credo of these conferences is'in vivo veritas', signifying that investigating components, like molecules and cells, only gives partial truth. The components must ultimately be explored in their natural con­ text, to see how they interact with other parts and are integrated to a whole. To the biologist it is obvious that the world must be investigated at many different levels of organization. At each level the patterns observed represent just some of many possible ways of putting together the elements of the lower levels. These patterns are not predetermined, but the results of evolution, i.e. of a history in which stochastic processes play a major role. The organic world can therefore not be torn apart and then reconstructed from basic principles alone. This realization is often expressed as the whole being more than the sum of its parts.

When my interest was first drawn to the phenomenon of vaccination for virus diseases in the late 1930s, the state of the art and the science of vaccine design was not far advanced beyond the time of Jenner at the end of the 18th century and of Pasteur a century later. In the 1930s it was still believed that for the induction of immunity to a virus-caused disease the experience of infection was required, but not for a toxin-caused disease such as diphtheria or tetanus, for which a chemically detoxified antigen was effective for immu­ nization. This prompted the question as to whether it might be possible to produce a similar effect for virus diseases using nonreplicating antigens. When in the 1930s and 1940s it was found possible to propagate influenza viruses in the chick embryo, protective effects could be induced without the need to experience infection by the use of a sufficient dose of a noninfectious influenza virus preparation. Later in the 1940s, it became possible to propagate polio and other viruses in cultures of human and monkey tissue and to immunize against other virus diseases in the same way. Later, with the advent of the era of molecular biology and genetic engineering, antigens and vaccines could be produced in new and creative ways, using either replicating or nonreplicating forms of the appropriate antigens for inducing a dose-related protective state.

One of the main attractions of research into hypersensitivity disorders is that it brings together scientists from a very broad range of disciplines. As the most common hu­ man immunologic disorder, it excites the interest and concern of clinicians, geneticists, basic and clinical immunologists, molecular biologists, biochemists, and physiologists. General agreement has been forged on the the pathophysiology of the disease and the mechanisms responsible for its maintenance, but many areas remain as black boxes for which we have only hypotheses. In 1992 Vienna hosted an international symposium to consider the explosion of in­ formation being generated by the identification, cloning, and expression of common envi­ ronmental allergens: The present second international conference on the MOLECULAR BIOLOGY OF ALLERGENS AND THE ATOPIC IMMUNE RESPONSE, again jointly organized and co-chaired by Professors Alec Sehon (Winnipeg) and Dietrich Kraft (Vi­ enna), provided an exciting opportunity for many leaders in this field to share data, argue hypotheses and seek future opportunities to enlarge our understanding of these very com­ plex diseases. This symposium was co-sponsored by the International Union of Immu­ nological Societies (I. U. I. S.) and the International Association of Allergology and Clinical Immunology. It was held in the hospitable and comfortably elegant surroundings of Que­ bec City.

Stressproteinssuchastheheatshockproteins(Hsp)andglucose-regulatedproteins (Grp) are front-line molecules in responses to cellular insult and play key roles in the viability of single cell organisms exposed to environmental stresses. However, the discovery of the roles of Hsp and Grp as molecular chaperones indicates much wider functions in the physiology of cells and organisms. It is now clear that some stress proteins are expressed constitutively and are key mediators of housekeeping protein folding in the day-to-day existence of the cell. The maturation of enzymes, transcriptionfactors,andcellsurfacereceptorsreliesonthesefunctionsofthestress proteins. In addition, the ability of stress proteins to manipulate the structures of target proteins has lent them cell regulatory properties over and above their role in folding the proteome and they play key roles in controlling signal transduction, cell death pathways and transcription. Recently, novel extracellular roles for the Hsp have also emerged as it has become apparent that the Hsp can escape from the cytoplasm of cells and play a signi?cant extracellular role in signaling to neighbor cells and in immunosurveiIlance. As might be expected with such key molecules, dysregulation of Hsp expression over time can lead to disastrous results in terms of the health of the organism. Under-expression of the Hsp is associated with advanced aging and neurodegeneration. Elevated expression is associated with malignant progression. We have aimed in this volume to indicate advances in each oftheseaspectsofstressproteinresearch,withchaptersrangingfrombasicstudies of the role of Hsp in protein folding to reviews examining the breakdown of stress protein regulation in disease. Stuart K.

Chlamydia pneumoniae is a bacteria that is most commonly known for causing colds and pneumonia. However, researchers have recently found a link between C. pneumoniae and atherosclerosis, a clogging of the arteries that causes heart attack and stroke. In addition, ongoing research is showing that certain strains may play a role in asthma, multiple sclerosis, Alzheimer's disease, and arthritis. This volume, part of the Infectious Agents and Pathogenesis series, is a complete portrait of C. pneumoniae and what is currently known about it.

Systemic Lupus Erythematosus, Fourth Edition, provides an understanding of the basic mechanisms as well as the diagnostic and therapeutic aspects of lupus. This book is attractive to both the investigative community and clinicians. As lupus has become a paradigm for the study of autoimmune disease, immunologists investigating autoimmunity are becoming more interested in lupus. Basic immunology of phospholipid antibodies, clotting abnormailities, issues concerning pathogenetic fit with SLE, and newest methods of therapy of APLS are given in this newest edition of a classic reference. - Comprehensive current coverage of basic models of etiology and pathogenesis - Complete catalog of autoantibodies produced - Includes an outstanding review of imaging techniques for the diagnosis of lupus and its complications for each organ system - Includes CD-ROM of images excellent for teaching purposes and downloading into presentations

Advances in Immunology

Immunoregulation in Health and Disease, edited by Lukic, Colic, Mostarica-Stojkovic and Cuperlovic is a multi-authored volume covering the field of Immunoregulation, and will be essential reading for all researchers working in Immunology. Each section includes at least 10 papers contributed by experts from around the World, and covers in detail the wealth of knowledge relating to immunoregulation, both in health and disease. This book will provide an invaluable overview of immune system behaviour. The book is divided into four sections: - Regulatory, effectory, and accessory cells of the immune response - Molecular and cellular immunoregulatory mechanisms - Hypersensitivity and autoimmunity - Host reactivity to graft, tumour and infection

The study of immunology encompasses a vast and ever-growing body of information that in some way or other incorporates most areas of medical biological research. As the body of information in the medical sciences continues to increase its rate of expansion, one of the greatest challenges to investigators will be to integrate this information in a manner that is intellectually fruitful and productive. Considering the intended scope of this text, we could not pretend to have gone too far toward achieving such an integration--and considering the pace of change, in its very best form a measured approximation of such lofty goals might be the most we could hope for. Nevertheless, in these pages we have sought to produce a collection of information that is at once concise and up-to-date regarding areas where important developments are impacting on the way we understand the vertebrate immune system. In addition, although the information is geared toward advanced study, we have discussed some basic elements and concepts that we hope make the text a useful resource for both the immunologist and the nonspecialist. The intention is to provide the researcher, clinician, or advanced undergraduate student with a brief ov- view of specific components of the immune system, and to provide a place from which to begin further detailed study if necessary. To this end, we made every effort to supply extensive referencing--although limitations in space prevented exhaustive or complete referencing in some cases.

In 1964, George Solomon coined the term psychoneuroimmunology. In the intervening 30 years, this term has emerged into a dynamic field of study which investigates the unique interactions between the nervous, endocrine, and immune systems. The Handbook of Human Stress and Immunity is a comprehensive reference for this dynamic new field. Focusing on how stressors impact the central nervous system and the resulting changes in immune responses, the Handbook is the first to describehow stress specifically affects human immune systems. It discusses how stress generally makes people more susceptible to infection, how personal support systems can counteract the physiological effects of stress, and how stress, or lack of stress, affects the aging process. Chapters are authored by the leading names in the field and cover such diseases as autoimmune disease, viral pathogenesis, herpes, HIV, and AIDS.

Advances in Immunology

Emerging Infections is the first volume of the new Biomedical Research Reports Series, which will provide annual updates on hot topics of interest to a broad spectrum of the biomedical research community. This book provides state-of-the-art reviews of new and reemerging bacterial, viral, and parasitic infections, their life cycles, host defense evasion strategies, and clinical features. It includes the history of infectious disease outbreaks, population and evolutionary biology of human pathogens, and current epidemiological models that describe how ecological and demographic changes produce new epidemics. - Provides reviews on hot topics of interest to the biomedical research community - Editor and contributors are renowned international experts - Covers the major established pathogens as well as the new and sensational--such as mad cow disease, hantavirus pulmonary syndrome, pathogenic E. Coli, and flesh-eating bacteria