IgM class antibodies to intercellular substance in massive cutaneous hyalinosis: occurrence and relation to antigluten and antihyalin antibodies.

High levels of circulating IgM class antibodies to intercellular substance were found in massive cutaneous hyalinosis, a systemic kappa light chain disease characterized by hyalin deposits in skin and gut. A strong humoral immune response to the accumulating mannose-rich hyalin glycoprotein and to wheat gluten was also demonstrated. Both gluten and the hyalin protein, when added to serum, abolished the immunofluorescence staining of the intercellular cement, suggesting that there may exist common antigenic sites in the hyalin protein, gluten, and intercellular substance.

Immunological aspects of asbestosis: patients' neurological signs and asbestosis progression.

This study is a component of a long-term, follow-up study aimed at evaluation of immunological and neurological findings with regard to the early detection of malignancies among patients at high risk of developing cancer. One hundred fifteen patients with diagnosed asbestosis were examined neurologically and immunologically (rheumatoid factor, antinuclear antibodies, C3 and C4 and circulating immune complexes). Patients with nervous system involvement (63 cases; 55%) revealed no significant immunological differences when compared with the other patients except for a more common presence of antinuclear antibodies among patients without nervous system involvement (21% vs 6%, p less than .05). Significantly increased Wa-Ro titers (greater than 1/128) were found for 3-4% of the patients whose asbestosis was either progressive or not as to radiological fibrosis, whereas only 0.4% of the blood donors had a significantly increased Wa-Ro titer. The respective figures of latex agglutination (greater than 1/32) were found for 14-19% of the asbestosis patients whereas in 0.8% of the blood donors. The mean level of C3 was higher among progressive than nonprogressive asbestosis cases (1.48 vs 1.34, p less than .05). Patients with radiographic progression of asbestosis had higher IgG-antinuclear antibody titers than the patients without progression.

Evaluation of six tests for circulating IgG complexes with special reference to IgM rheumatoid factors: analysis of systemic lupus erythematosus and rheumatoid arthritis series.

Six tests for circulating immune complexes (CIC) developed in four laboratories and representing four main principles [affinity of human platelets, Clq, of RF for aggregated IgG, and of conglutinin (Kg) for complex-bound C3] were evaluated on series of SLE and definite RA. All tests detected human model complexes in the presence of NHS and discriminated the patient series from the blood donor series, most powerful being the PIPA (platelet test). The high correlation between the RF-binding inhibition tests (RFbI) and the RF-latex test suggested interference due to intrinsic RFs. This received further support from experimental analyses in which RA sera mixed with varying doses of heat-aggregated IgG were assayed by the pRFbI test.

Asbestos exposure as a cause of immunological stimulation.

Twenty immunological parameters were determined for 37 asbestos-exposed workers with no radiographic pulmonary fibrosis and 132 asbestosis patients, 37 of whom formed a matched referent group for the non-diseased workers. No clear differences between the matched groups were found for the autoantibodies tested, but the prevalence of autoantibodies was increased in both groups in comparison with the prevalence among Finnish blood donor candidates. This phenomenon may reflect a general immunological activity caused by asbestos dust, and this immunological activity may act as an adjuvant in immunisation. The patients revealed a high level of IgA, C3, C4 and alpha-1-antitrypsin. This result indicates that these factors may be related to the development of asbestosis, and could therefore be utilized in the evaluation of diffuse pulmonary fibrosis among workers with asbestos exposure.

Clinical correlations and significance of orceinpositivity in chronic active hepatitis and primary biliary cirrhosis.

Clinical, biochemical and immunological variables were analyzed in 30 patients with orcein-negative (ON) chronic active hepatitis (CAH), 4 patients with ON primary biliary cirrhosis (PBC), 8 patients with orcein-positive (OP; intracellular copper-binding protein seen histologically in liver biopsy specimens) CAH and 15 patients with OP-PBC. A marked elevation of serum bile acids, alkaline phosphatase, leusine aminopeptidase, gammaglutamyl transpeptidase and cholesterol concentrations, and highly pathological BSP Tm values were characteristic for OP-cases. In addition the faecal fat level was increased and bile acids decreased in OP-cases. Serum levels of IgG or IgM and the occurrence of smooth muscle, mitochondrial or glomerular antibodies were identical in ON- and OP-CAH as well as also in ON- and OP-PBC. 49 patients were treated with a combination of prednisone and azathioprine from 4 to 72 months (mean 22). 26 patients with ON-CAH responded biochemically and morphologically to the treatment. No treatment failures were found in ON-CAH. In contrast treatment failure was confirmed in every treated OP-PBC or OP-CAH. The results suggest that orcein-positivity indicates a poor response to prednisone-azathioprine treatment of CAH.

Immunological parameters, viral antibodies, and biochemical and histological findings in relatives of patients with chronic active hepatitis and primary biliary cirrhosis.

The familial occurrence of immunological, virological, biochemical and histopathological abnormalities has been studied in 39 first degree relatives of patients with primary biliary cirrhosis (PBC) and in 58 first degree relatives of patients with chronic active hepatitis (CAH). Tissue antibodies were more frequent in relatives than in age- and sex-matched controls. Abnormal immunoglobulin levels were demonstrated in about half of the relatives. Very high antibody titres to measles and rubella occurred only in the relatives of the patients with CAH. Moreover the raised titres tended to be clustered in a few families in which also the propositi had very high viral antibody titres. Liver biopsy was performed only on the relatives with biochemical abnormalities. Unspecific inflammatory changes were observed in 5 relatives of the patients with CAH and in 4 relatives of the patients with PBC. An active liver disease was detected in two relatives of the PBC-group and in one of the CAH-group. A marked accumulation of various immunological and histopathological abnormalities in four families was observed.