Evaluation of a semiautomated prestandardized immunofluorescence test system for detection of anti-native deoxyribonucleic acid antibodies.

An immunofluorescence-native deoxyribonucleic acid (nDNA) antibody test system (Zeus Scientific, Inc.) was compared with a radioimmunoassay procedure (FARR assay) for detecting anti-nDNA antibodies in human serum. Double-blind studies of split samples obtained from 236 patients showed an 80% correlation between the immunofluorescence-nDNA antibody test system and the radioimmunoassay procedure. Studies of sera from patients with known diagnoses showed positive nDNA antibody findings in biopsy-prove n systemic lupus erythematosus only. The immunofluorescence-nDNA antibody test system provides a reliable, simple, and economically feasible alternative method for detecting nDNA antibodies that can be employed in any laboratory equipped with a fluorescence microscope.

Anticipation of renal transplant failure by postanastomosis biopsy and immunofluorescence.

Ninety-six pre- and postanastomosis allograft biopsies from 48 transplant recipients were studied employing the direct fluorescent antibody procedure. Of the 48 transplants studied, 26 postanastomosis biopsies showed significant blood vessel wall deposits consisting predominantly of 2-4+ staining IgM and C3 deposits. The corresponding preanastomosis biopsies showed only patchy intimal surface staining. All but two of the grafts with positive biopsies had been preserved by the pulsatile perfusion method for various periods of time. Twenty-three of the twenty-six grafts with positive findings failed within 1 month while only 2 of the 19 negative postanastomosis biopsies failed within the 1-month period. Based on these findings actual graft failure occurred in 89% of the patients with postanastomosis transplant biopsies with positive findings. Although crossmatch studies were negative in all cases, further immunologic studies of eluates obtained from positive postanastomosis biopsies revealed the presence of lymphocytotoxic IgM antibodies in three of five cases studied. These findings suggest that rapid deposition of undetected preformed lymphocytotoxic antibodies accumulate in the vessel walls following anastomosis and contribute to transplant failure.

Treponemal antigen in immunopathogenesis of syphilitic glomerulonephritis.

A patient with syphilitic glomerulonephritis had a renal biopsy and was treated for secondary syphilis. Light, electron, and immunofluorescence microscopic studies revealed an acute proliferative glomerulonephritis with subepithelial, intramembranous, and subendothelial immune complex deposits containing IgG, IgA, IgM, C4, and C3. Similar local deposits containing predominantly IgM were noted in areas of mesangial proliferation. Indirect fluorescent antibody studies employing rabbit treponemal antibody and sheep antirabbit globulin conjugate revealed the presence of treponemal antigen in the glomerular deposits. This finding provides strong evidence for the immunopathogenesis of the glomerular lesion as well as a causal link with Treponema pallidum.

The human secretory immunoglobulin system: immunohistoligical localization of gamma A, secretory "piece," and lactoferrin in normal human tissues.

The immunohistological localization of gammaA, secretory "piece" (SP), and lactoferrin (LF) in the mucosae of a variety of normal human tissues was investigated using specific fluoresceinated antisera. gammaA staining was localized in the apical portion of the mucosal epithelium, intercellular spaces, basement membrane area, and plasma cells of the interstitium or lamina propria of a number of normal human tissues. SP was ubiquitous in the mucosal epithelium of all tissues studied which included parotid and submaxillary glands, bronchi, pancreas, GI tract, sweat glands, kidney, and gall bladder. In addition, SP staining was localized in the intercellular spaces and on the surface of the epithelial cells lining the lumen of the secretory glands. No SP staining was observed in the plasma cells of the interstitium or lamina propria surrounding the secretory glands in these tissues, and no SP staining was observed in sections of normal spleen or lymph node tissue. SP staining was observed in the sweat glands, pancreas, and kidney in the absence of gammaA staining. LF was much less ubiquitous in the epithelial cells of the various tissues studied and appeared to be restricted primarily to the acinar epithelium of the bronchial mucosae, parotid, and submaxillary salivary glands, and was also found in renal tubular cells. A hypothetical model for the transport of gammaA and SP across mucosal membrane epithelium is presented.