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endogenous mediator is one of the activities ascribed to the cytokine or family of cytokines known as interleukin 1. In this study we have examined the ability of circulating blood leucocytes from patients with rheumatic diseases to produce this mediator in vitro. Leucocytic endogenous mediator production was found to be significantly decreased below normal values (mean 107 units, s.e.m.± 25) in systemic sclerosis (-6 units ±18), systemic lupus erythematosus ( - 25 units ± 13), rheumatoid arthritis ( - 3 units ± 13) and mixed connective tissue disease ( - 4 units ±40). A control group of ill patients with cancer produced 57 units ± 8. [ABSTRACT FROM AUTHOR]

Multiple urinary Bence-Jones proteins and scrum paraproteins were found in a child with type I dysgammaglobulinaemia (Seligmann et al., 1968). These showed a continually evolving pattern over a period of 4 months in relation to systemic infections and with no evidence of underlying malignancy. [ABSTRACT FROM AUTHOR]

Serum levels of the complement proteins C3, C4, C1 inhibitor (C1 INH), factor I (C3b inactivator) and factor H (BIH) and plasma levels of cleavage products of C3 (C3c) and factor B were measured in 26 patients with acute pancreatitis. Breakdown of C3 occurred in 19 patients, as shown by a reduction in C3 level and the presence of C3c. C4 levels, however, did not fall and factor B breakdown products were not detected, thus suggesting that enzymatic cleavage of C3 occurred without significant involvement of either the early classical pathway or the alternative pathway. C1 INH and factor H both showed increases, presumably reflecting an acute phase response. Factor I showed an initial fall followed by a rise. There was no correlation between the presence or extent of C3 breakdown and the clinical condition of the patients. It is concluded that C3 cleavage in pancreatitis probably results from tryptic activity and that the measurement of complement components has no part to play in the management of the disease. [ABSTRACT FROM PUBLISHER]

Paraproteinaemia may be associated with xanthomatous skin deposits and these can arise in the absence of elevated lipid levels. Two cases of benign monoclonal gammopathy with diffuse plane xanthomatosis are reported. Case i exhibited hypolipidaemia and a functional deficiency of C1 esterase inhibitor. Case 2 showed a normal lipoprotein profile, abnormal platelet aggregation, and a cutaneous vasculitis with evidence of complement consumption via the classical pathway. The significance of these abnormalities is discussed. [ABSTRACT FROM AUTHOR]

The methods currently in use for the detection and quantitation of complement activation products are slow and time consuming. We describe a method utilising immunofixation after agarose or cellulose acetate membrane electrophoresis which allows large batches of samples to be screened rapidly for the presence of activation products of C3 and factor B. Further, after immunofixation on agarose the conversion product may be quantitated by densitometry. This method gives similar results to those obtained by crossed immunoelectrophoresis. Using both this technique and crossed immunoelectrophoresis we have been able to confirm that C4 activation occurs during electrophoresis in the absence of EDTA and that in the presence of EDTA it is not demonstrable even in patients with active immune complex disease. [ABSTRACT FROM PUBLISHER]

The first two cases of alpha chain disease from Central Africa are reported from Nigeria. Both patients show the classical features of the disease with diffuse involvement of the small bowel and malabsorption. The patients were lost to follow-up but died soon after diagnosis. [ABSTRACT FROM PUBLISHER]

A patient is described with myeloma without paraproteinaemia or Bence Jones proteinuria in whom the tumour cells have been shown to contain monoclonal immunoglobulin. The use of immunoelectrophoresis and polyacrylamide gel electrophoresis has established, apparently for the first time, that the immunoglobulin components are present in the form of intact molecules and free light chains. [ABSTRACT FROM PUBLISHER]

Parotid saliva was collected from 32 patients with rheumatoid arthritis, 10 with systemic lupus erythematosus, three with mixed connective tissue disease, 12 with progressive systemic sclerosis, two with primary Sjögren's syndrome, and four with Raynaud's syndrome. Tissue kallikreins were measured by radioimmunoassay, and saliva samples were subjected to isoelectric focusing followed by immunoblotting or silver staining. The results showed that the saliva of patients with connective tissue diseases contained increased amounts of immunoreactive tissue kallikrein. In addition, there was an increase in the multiple forms of anionic tissue kallikreins, resulting mainly from a shift in their distribution towards that of higher sialic acid content and lower isoelectric point. These changes were most obvious in patients with systemic lupus erythematosus. Novel or unusual glycosylation may explain the occurrence of increased amounts of anionic salivary proteins in connective tissue diseases. [ABSTRACT FROM PUBLISHER]

The production of a systemic inflammatory response to intradermal monosodium urate crystal injection is described. A transient, self-limiting local response is associated with a systemic response detectable by a rise in the white cell count and serum amyloid A protein. The white cell change parallels the evolution of the local response, whereas the serum amyloid A response lags behind the local lesion, peaking after the local lesion is resolving. Intradermal monosodium urate injection is proposed as a possible inflammatory stimulus to explore the acute phase protein response in different disease states. [ABSTRACT FROM PUBLISHER]

Activation of serum C3 by monosodium urate monohydrate (MSU) crystals and other particles was determined by immunofixation following electrophoretic separation of C3 and its activation products. Densitometry allowed quantitation of results. MSU, hydroxyapatite, brushite, and calcium pyrophosphate dihydrate crystals split C3 under conditions which demonstrate activation via the alternative pathway (AP). Quantitatively similar results were obtained in immunoglobulin deficient serum. Activation was crystal specific and was reduced by heating, grinding, sonication, and aging of crystals. Other inflammatory particles (e.g., blackthorn) activated C3 via the AP: noninflammatory particles (e.g., diamond) caused insignificant activation. It is suggested that particle-induced activation of the alternative pathway of complement may be important in the initiation of crystal-induced synovitis. [ABSTRACT FROM PUBLISHER]

A nephelometric assay of concanavalin-A binding of serum acute phase proteins (con-A binding) has been used in cross-sectional and sequential studies of disease activity in rheumatoid arthritis (RA). Con-A binding correlated well with blood viscosity, C-reactive protein, and other individual acute phase reactants in patients with active RA. Twenty-four patients were treated for 6 months with D-penicillamine and assessed clinically and seriologically. Clinical improvement was accompanied by significant falls in both C-reactive protein and con-A binding, although the serological changes did not always occur in parallel in individual patients. The advantages of this simple, cheap assay of acute phase proteins are discussed. [ABSTRACT FROM AUTHOR]

C reactive protein (CRP) and serum amyloid A protein (SAA) are sensitive and rapid acute phase reactants, and their measurement for monitoring inflammatory disease and assessing the prognosis in secondary amyloidosis is gaining widespread acceptance. The changes in these proteins in eight subjects suffering from natural colds, 15 subjects with experimentally induced colds (rhinoviruses E1, 3, 9, 14, or 31), and eight with experimentally induced influenza (A/Eng/40/83) were studied. SAA concentration increased in 21 of the 23 subjects with natural or experimental rhinovirus colds (mean increase 95 mg/l); CRP concentration increased in 11 (mean increase 11 mg/l). All subjects with influenza showed pronounced increases in SAA concentrations (mean increase 642 mg/l) while six showed increases in CRP concentration (mean increase 22 mg/l). All these increases were highly significant (p less than 0.001). Asymptomatic excretors of both rhinovirus and influenza virus showed significant increases in SAA concentration (p = 0.015 for rhinovirus and p less than 0.001 for influenza virus) but not in CRP concentration. No changes in SAA or CRP values were seen in 12 volunteers after challenge with saline. These observations suggest that caution is required in the interpretation of estimations of SAA concentration and that it may be too sensitive an acute phase protein for clinical use as its concentration may be raised in both trivial and asymptomatic viral infections. [ABSTRACT FROM PUBLISHER]

In a series of pregnant women with iron deficiency anaemia treated by a total dose infusion of iron dextran, the non-haem iron content of the placenta at term was studied histochemically and by chemical analysis. Within a few days of the infusion the Prussian blue reaction on the placenta was very strong, but was negative by ten days after the infusion. Chemical analysis showed that both the water-insoluble fraction (haemosiderin) and the water-soluble fraction (ferritin) of the non-haem iron were increased soon after the infusion, but three weeks after the infusion they were almost the same as in untreated controls. Pinocytosis of iron dextran by the trophoblast and increased transport of transferrin-bound iron to the placenta are considered as possible causes for this large uptake of iron by the placenta. [ABSTRACT FROM PUBLISHER]