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Tissue typing was performed on lymphocytes of sixty-two patients with guttate psoriasis, in forty-four of whom this was the first manifestation of the disease. In 84% of cases, the guttate psoriasis was preceded by a clinical infection. A highly significant excess of antigen W17 (HLA-BW17) was found in patients when compared with a healthy population. In common with some other studies antigens HL-A13 (HLA-B13), W15 (HLA-BW15) and W21 (HLA-BW21) were found in excess but these became non-significant after correction for the number of antigens studied. 68% of patients who had guttate psoriasis de novo, subsequently developed persistent plaque psoriasis. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about an intestinal transplant for a patient with recurring mesenteric desmoid tumour.

Five polymorphisms in the C6 and C7 genes have been investigated in seven ethnic groups. The allele frequencies are broadly similar in most groups except C7 M/N which is monomorphic in our group of Africans, and C6 MspI and C7 S367T where the allele frequencies in African and Cape Coloured subjects are very different from the other ethnic groups. There is very little allelic association except between C6 A/B and C6 MspI. Seventeen of the 32 possible haplotypes have been observed, suggesting that much recombination has taken place. We describe a new method for the investigation of the MspI RFLP located in intron 3 of C6 (approximately 3 kbp 3' from exon 3 and 1.5 kbp 5' from exon 4) and its molecular basis, together with an improved method for the isolation of DNA from stored serum.

The effects of HLA matching and the presence of pre-existing anti-HLA antibodies, together with cross-match results, on heart and heart-lung transplants are discussed. Prospective HLA matching of donor and recipient is not usually performed for heart and heart-lung transplants. In a multi-centre study statistically significant improved survival with the better-matched heart grafts was found. In a small series of heart grafts it was also found that the improvement with HLA matching was confined to male recipients who were not blood group O. Heart graft recipients with wide panel reactive antibody had worse graft survival one year after transplant than the unsensitized. In several studies patients with a positive cross-match had a significantly lower survival rate than those with a negative cross-match. It is suggested that, minimally, pre-transplant screening and prospective cross-matching of highly sensitised patients is necessary.

Graft-versus-host disease is well recognized in bone marrow transplantation, but has only recently been described in solid organ transplantation. Two such cases in liver graft recipients, proven by the demonstration of donor type HLA antigens in the peripheral blood and marrow on tissue typing, are described in this paper. The literature on this subject is reviewed and the treatment discussed. It is postulated that there is an order of risk of development of graft-versus-host disease depending on the amount of viable lymphoid tissue included with the transplanted organ as follows: small bowel greater than heart-lung greater than liver greater than kidney greater than heart. It seems likely that this condition has been substantially underdiagnosed in the past and that greater awareness of the possibility of graft-versus-host disease in solid organ recipients will lead to the recognition of further cases and allow appropriate treatment to be promptly instituted.

Parallel studies were carried out on HLA antigens in patients with rheumatic heart disease and scleritis. Comparison with one control population showed a significant excess of BW15 in both disease samples, while a comparison with two other control populations, showed the excess not to be significant. Possible reasons for this discrepancy are discussed, together with the effect on statistical significance of a small percentage of false antigen assignments in one of the samples. A small systematic serological false assignment of an antigen can, by itself, produce a significant result more easily if the frequency of the antigen being detected is low than if it is high. It is suggested that this effect may contribute to the discrepant significant results obtained by different workers in some HLA and disease studies.

In preparation for the 7th International Histocompatibility Workshop 13 laboratories in the British Region participated in a local workshop. One hundred and twenty-three sera which had been previously shown to have activity on either normal B cells, CLL cells or B cell lymphoid lines in the absence of HLA-A, B or C activity were exchanged between the laboratories. These sera were tested on a total of 212 B cells, 101 CLL cells, 76 T cells and 76 lymphoid cell lines. The data was collected and analyzed in Oxford. The analysis showed that six groups of sera could be distinguished. When these groups were compared with the D locus typing of some of the lymphoid lines which were derived from individuals used as MLC typing cells, they were seen to have significant associations with D locus antigens. The serological groups defined were therefore given numbers corresponding to the D locus numbers they associate with, i.e. UK1 is associated with DW1 and so on for UK2, 3, 4, 5 and 7. Comparison of typing techniques showed that long incubation both with antiserum and then with complement, 1 hour + 2 hours gave the best and most reproducible reactions on normal B cells. Residual anti-HLA-A, B or C activity in some of the sera even after platelet absorption showed the importance of adequate checking on T cells after absorption.

In 1973 we reported significantly superior survival of kidneys transplanted to blood group O recipients compared with recipients of those from blood groups A, B, and AB taken together. In this extended series, the difference between these categories was less prominent and no longer significant. In the present study, blood transfusion significantly improved the survival of kidney grafts in patients of blood group O, but not of combined A, B. and AB groups. The difference between the graft protecting effect of transfusion in group O and combined groups A, B, and AB recipients was also significant. This suggests that the improvement in subsequent graft survival after transfusion is either confined to blood group O recipients, or is much stronger in them than in recipients of other groups. Our previous policy of restriction of blood transfusion is seen as one of the causes of the reduced superiority of group O over other groups in this extended series in comparison with our 1973 series. It seems that transfusion of group O recipients can markedly improve the prognosis of a subsequent first kidney graft.

The construction of permanent hybrid cell lines between xeroderma pigmentosum (XP) cells from different complementation groups allows analysis not only of the degree of repair correction but also of the restoration of biological activity to the UV-irradiated cells. With use of an immortal human cell line (HD2) that expresses excision repair defects typical of XP group D, a series of permanent hybrid cells has been produced with XP cells from groups A to H. Excision repair, as measured by incision analysis and unscheduled DNA synthesis, is restored to normal or near normal levels in crosses involving HD2 and cells from XP groups A, B, C, E, F, G, and I. All these hybrids show complementation for the recovery of normal UV resistance. As expected, hybrids expressing poor incision and hypersensitivity to UV were produced in crosses between HD2 and XPD fibroblasts, but they were also produced without exception when XPH was the partner. In the permanent HD2 x XPD or XPH hybrids, analysis of incision capacity reveals abnormally low activity and therefore that there has been no complementation. The true hybrid nature of HD2 x XPH cells has been confirmed by HL-A and -B tissue typing; moreover, detailed kinetic analysis of incision in these cells shows that the XPH phenotype, rather than the XPD, is expressed, i.e. breaks accumulate at low UV fluence of 1 J/m2. To help confirm these findings, another immortal XPD cell line was used in fusions involving HD2, XPH, or XPI. Cells resistant to ultraviolet were produced only with XPI fibroblasts. These data are discussed in terms of whether XPD and H mutations are likely to be allelic with respect to incision.

Fifteen equine leucocyte antigens were defined by absorption and titration analysis of alloantisera obtained by natural sensitisation through pregnancy and by planned experimental immunisation. Definitive sera were tested on the cells of 90 unrelated horses and members of eight equine families. The family data suggested that 13 specificities were coded by a single locus (first locus) and one specificity (Eq 14) was coded by a second linked locus. The remaining specificity (Eq 7) was controlled by a third locus unlinked to the first or second loci. Tests on the cells of unrelated horses showed that two first locus specificities (Eq 16 and Eq 17) had a supertypic relationship to other first locus antigens. No individual was found to possess more than two first locus antigens, excluding the supertypic specificities.

Three structural forms of C7 have been distinguished by isoelectric focusing. They are the products of three co-dominantly expressed alleles at an autosomal locus. The C7 locus is close to that for C6, but is not close to the HLA complex.

A test is reported which detects alloantibody, absorbed onto the surface of human lymphocytes from multiparous antisera, by means of a red cell rosette assay. The red cells, trypsinised ox, are coupled with anti-immunoglobulin using chromic chloride. The antiglobulin used is rabbit anti-human IgG (Fc), chosen to avoid reaction with the surface immunoglobulin naturally present on human B lymphocytes. The reaction is termed the Indirect Anti-immunoglobulin Rosetting Reaction (IARR). The IARR is shown to be specific in the following ways: anti-immunoglobulin coupled ox cells do not react with normal human lymphocytes nor with lymphocytes treated with non-reactive serum. Red cells coupled with normal rabbit IgG do not react with normal or alloantibody coated lymphocytes. Multiparous sera (reactive with other individuals) do not react with cells of the serum donor in the IARR. Finally, the coupled red cells do not usually react with lymphocytes which have absorbed immune complexes onto their Fc receptors. The IARR is shown to be more sensitive than a standard cytotoxic test for detection of alloantibody. Several possible applications of the IARR are discussed.