ABSTRACT
This study investigated the role of perceived daily stress as a potential moderator in the relation between a set of predictors (disease activity, education, pain) and psychological status (anxiety, depression) of 31 patients with rheumatoid arthritis. Psychological measures served as dependent variables in hierarchical regression analyses testing for potential interaction effects of daily stress upon relationships between predictors and dependent measures. No predictors predicted directly scores on depression and anxiety; however, daily stress directly predicted scores on depression and anxiety, even after having separately controlled for each of the predictors. Increased disease activity had significantly stronger associations with increased psychological morbidity only among patients reporting high scores on daily stress, suggesting a potential moderating role for stress.
Subject(s)
Arthritis, Rheumatoid/psychology , Psychophysiologic Disorders/psychology , Stress, Psychological/complications , Adaptation, Psychological , Adult , Aged , Anxiety/diagnosis , Anxiety/psychology , Arthritis, Rheumatoid/diagnosis , Cohort Studies , Depression/diagnosis , Depression/psychology , Female , Humans , Male , Middle Aged , Pain Measurement , Personality Inventory , Psychophysiologic Disorders/diagnosisABSTRACT
Sera from twenty-one patients with systemic lupus erythematosus (SLE) were analysed for the presence of circulating soluble immune complexes by a sensitive and quantitative radioimmunoassay employing radioiodinated human Clq (Clq-deviation test). In twenty-five normal individuals the percentage of Clq inhibition was 2-64 +/- 4-45%. Eleven of the SLE patients had significantly elevated values, and the mean value for the group was 20-38 +/- 20-64%. The seven patients with renal disease had somewhat higher levels (24-14 +/- 18-70%) than those without kidney involvement (19-00 +/- 21-84%), and elevated levels of antibodies to native DNA also were associated with high levels of percentage of Clq inhibition. Both intermediate (7S-19S) and large (greater than 19S) complexes were present in the sera, and digestions with DNase and RNase indicated that antibodies to DNA and RNA accounted for only some of them. Serial studies in individual patients demonstrated the assocation of circulating complexes with, and often preceding, falling complement levels during disease activation.
Subject(s)
Antigen-Antibody Complex , Lupus Erythematosus, Systemic/immunology , Adolescent , Adult , Antibodies, Anti-Idiotypic/analysis , Antigens/analysis , Complement C1 Inactivator Proteins , DNA/immunology , Female , Humans , Middle AgedABSTRACT
In a group of 69 patients receiving levamisole the drug had to be discontinued in 15 (21-7%) because of intolerable but reversible side-effects including gastrointestinal upset, "flu-like" syndrome, central nervous system disturbances, and skin rash. Reversible agranulocytosis with life-threatening sepsis occurred in a patient receiving levamisole immunotherapy for colonic carcinoma. Neutrophils and platelets were both severely affected. Levamisole-dependent leucoagglutinins appeared with circulating immune complexes during the acute phase of the illness, suggesting an immune drug reaction.
Subject(s)
Drug Hypersensitivity , Immunotherapy/adverse effects , Levamisole/adverse effects , Neoplasms/therapy , Adult , Aged , Agglutination Tests , Agranulocytosis/chemically induced , Antigen-Antibody Complex , Centrifugation, Density Gradient , Complement C1/analysis , Drug Hypersensitivity/diagnosis , Female , Gastrointestinal Diseases/chemically induced , Humans , Joint Diseases/chemically induced , Male , Middle Aged , Muscular Diseases/chemically induced , Neutropenia/chemically induced , Pain/chemically induced , Thrombocytopenia/chemically induced , Urticaria/chemically inducedABSTRACT
Sera from forty-nine patients with atopic allergy were tested for the presence of circulating immune complexes by the sensitive, quantitative Clq assay. Compared to twenty-five normal individuals the atopic patients had significantly higher mean values of Clq reactive material, expressed as Clq inhibition values. The highest mean values were seen in the group (twenty-one patients) who had been on long term maintenance immunotherapy for 5 or more years. When positive sera were fractionated by ultracentrifugation on sucrose density gradients, the Clq reactive material was found in intermediate (7S-19S) and heavy (greater than 19S) regions. The heavy material contained both IgM and IgG. It is suggested that the IgG antibodies known to be produced by chronic hyposensitization procedures in allergic individuals may circulate in the serum as antibody-allergen immune complexes, and could carry out their blocking action in this form.
Subject(s)
Antigen-Antibody Complex , Hypersensitivity, Immediate/immunology , Centrifugation, Density Gradient , Complement Fixation Tests , Desensitization, Immunologic , Humans , Hypersensitivity, Immediate/therapy , UltracentrifugationABSTRACT
Circulating immune complexes were detected in 62 individuals with malignant melanoma by precipitation with isolated human C1q and polyclonal rheumatoid factors. In 56 patients the C1q deviation assay showed low to moderate levels of complexes, with increased amounts with advancing stage of disease. Both heavy (greater than 19S) and intermediate (7S to 19S) varieties were present, and complexes containing tumor antigen-antibody or antibody-anti-antibody were identified. Complexes were found in the kidneys of one patient with malignancy and the nephrotic syndrome and in two further patients with melanoma in whom there were no clinical manifestations of nephrosis. Serial determinations in 51 patients showed slow cyclic variations in the levels of complexes and fluctuations in response to therapy. The coexistence of anti-antibodies, immune complex disease, and anergy in melanoma patients may indicate a deranged immune regulation consequent to chronic antigenic stimulation by the tumor.
Subject(s)
Antigen-Antibody Complex , Melanoma/immunology , Adult , Aged , Antibodies, Neoplasm/analysis , Antigens, Neoplasm/analysis , Chemical Precipitation , Complement C1 , Female , Humans , Immunity, Cellular , Kidney/immunology , Kidney/ultrastructure , Male , Melanoma/ultrastructure , Middle Aged , Neoplasm Metastasis , Rheumatoid FactorABSTRACT
Circulating immune complexes in Graves' disease sera were detected by the 125I Clq deviation test. High titers of immune complexes were detected and correlated significantly with the microsomal antibody but not with the thyroglobulin antibody titer nor with serum thyroxine levels. Serum fractionation studies in a patient with high titer of immune complexes revealed these to be heterogeneous in size, sedimenting in 19S, intermediate and 7S regions. The data suggest a role for immune complexes in the pathogenesis of Graves' disease.
