Pigeon breeders' lung: pigeon intestinal mucin, an antigen distinct from pigeon IgA.

Antigens identified by indirect immunofluorescence staining and specific for sera from patients with pigeon breeders' lung or healthy pigeon breeders, have been isolated from pigeon intestinal mucus. Two antigenic peaks, one pigeon intestinal mucin and the other IgA, were separated by equilibrium centrifugation of water-soluble mucus in a caesium chloride density gradient. Antigenic positive material was identified by a modified double-sandwich ELISA, by inhibition of haemagglutination of turkey erythrocytes and by gel diffusion. Antigenic-positive material co-fractionated on gel-filtration with purified intact and papain digested pigeon mucin, both free of IgA. These studies demonstrate antibodies to two quite different antigens are associated specifically with sera from pigeon breeders, a novel antigen pigeon intestinal mucin and the previously documented pigeon IgA.

The dependence of size and functional properties of pig gastric mucus on the isolation method used.

The size of isolated gastric mucin is substantially larger if proteolysis is rigorously excluded during the isolation procedure by inclusion of proteinase inhibitors with or without guanidinium chloride. Pig gastric mucin isolated in 0.2 M NaCl (without proteinase inhibitors) so25,w, 33S, Mr approximately 2 x 10(6) has consistent physical and chemical properties, retains the gel-forming properties of the native mucus secretion and is readily susceptible to proteolysis although it has undergone proteolytic "nicking" during isolation. Gastric mucins isolated in proteinase inhibitors with guanidinium chloride are of larger size so25,w, 41-110S but precipitate from solution at gel-forming concentrations. Reduction of all these gastric mucin preparations with either 0.2 M mercaptoethanol or 10 mM dithiothreitol produced subunits of size in the region of Mr approximately 5 x 10(5). Gel filtration studies also showed that reduced mucin subunits prepared from gastric mucins isolated in guanidinium chloride could reassociate to form larger subunits of size approximately Mr approximately 2 x 10(6). The dependence of gastric mucin size on the isolation procedure is discussed.

Pepsins and the mucus barrier in peptic ulcer disease.

Studies show that the gastroduodenal mucosal barrier is damaged by pepsin under conditions in which it is resistant to acid alone. The continuous layer of adherent mucus gel provides a diffusion barrier to luminal pepsin, preventing its access to the underlying epithelium. Pepsin has mucolytic activity and will progressively digest the adherent mucus layer at its luminal surface, although normally this is balanced by secretion of new mucus to maintain a continuous barrier. In peptic ulcer disease the proportion of peptic activity in gastric juice attributable to pepsin type 1 is significantly raised (four to five-fold). Pepsin 1 has increased mucolytic activity compared with the major component, pepsin 3, both at the optimal pH of 2 (twofold increase in activity) and at higher pH values up to pH 5 (sixfold increase in activity at pH 4). Structural studies show that the gel forming polymeric mucin of the antral adherent mucus barrier is deficient in peptic ulcer disease. This breakdown of the mucus barrier in peptic ulcer patients can be attributed to the increased pepsin activity of gastric juice seen in this disease, although other explanations are also possible. The increased pepsin activity of gastric juice in peptic ulcer patients is compatible with the concept 'no acid, no pepsin, no ulcer'.

The acupuncture treatment of neck pain: a randomized controlled study.

Thirty patients with cervical spine pain syndromes persisting a mean of 8 years were assigned randomly into equal treatment and control groups. After 12 weeks, 12 of 15 (80%) of the treated group felt improved, some dramatically, with a mean 40% reduction of pain score, 54% reduction of pain pills, 68% reduction of pain hours per day and 32% less limitation of activity. Two of 15 (13%) of the control group reported slight improvement after 12.8 weeks. The control group had a mean 2% worsening of the pain score, 10% reduction in pain pills, no lessening of pain hours and 12% less limitation of activity.

The acupuncture treatment of low back pain: a randomized controlled study.

The acupuncture treatment situation was beneficial to the majority of people with low back pain. This was shown by the use of short-term controls and long-term controls, although the latter were not intended in the study design. After acupuncture, there was a 51% pain reduction in the average pain score in the Immediate Treatment Group. The short-term controls, the Delayed Treatment Group, had no reduction whatsoever in their pain scores at the comparable followup period. Later, the Delayed Treatment Group bere also treated by acupuncturists, and reported 62% less pain. When these two treatment groups were compared at 40 weeks with long-term controls (Inadequate Treatment Group), the Inadequate Treatment Group still had the same pain scores, on the average, as when they enrolled in the study. Both treatment groups, on the average, had 30% lower pain scores. Furthermore, 58% of the treatment groups felt that they were definitely improved at 40 weeks, while only 11% of the Inadequate Treatment Group felt definitely improved at 40 weeks.