Application of immunofluorescent method for diagnosis of immune thrombocytopenic purpura.
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Biomedical subjects
Publications and source records attributed to H M Bhatia.
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Immune dysfunction seems to be more common in lymphoproliferative disorders wherein the malignant cells originate from the immune system itself. The reaction of Dinitrochlorobenzene (DNCB) and six recall antigens were found to be diminished in patients with non-Hodgkin's lymphomas as compared to control subjects (P less than 0.005). The skin reactivity was lost in increasing order in well differentiated, poorly differentiated, and histiocytic types. The depression in delayed hypersensitivity was greater with generalized as compared to localized disease. In angioimmunoblastic lymphadenopathy (AIL), skin tests also showed negative response in 7 of 8 patients. This T-cell dysfunction in a preneoplastic condition (AIL) suggests early appearance of immunodeficiency and probably a prerequisite for the development of a lymphoma. The serum immunoglobulin levels failed to show any relation with respect to histology or extent of disease. Presumably, the alteration of IgG is secondary to a malignancy.
One-hundred-and-fifty-four tetanus patients and 118 normal persons were typed for 27 HLA antigens of A and B loci. There was no significant difference in the frequency of any of these antigens between the normal controls and the tetanus patients. Classification of the patients into mild, moderate and severe also did not show any significant deviation in the frequency of HLA antigens from the controls. Percentage E-rosettes in normal individuals showed lower values among a low socioeconomic group. The values for E-rosettes among tetanus patients were similar to those observed in low socioeconomic normal individuals. The distribution of ABO and Rho (D) groups among the tetanus patients were not significantly different from the frequencies in the normal population.
To determine whether tetanus toxoid given during pregnancy increases the risk of haemolytic disease of the new-born, 818 group O pregnant women were given one to three doses of tetanus toxoid during the third trimester. There was a significant increase in the incidence of neonatal jaundice among the ABO-incompatible infants of women given toxoid, compared to a control group. Comparative studies were also done at two hospitals: tetanus toxoid was not given during pregnancy at one hospital and was used routinely at the other. More of the mothers given toxoid had high titres of IgG anti-A or anti-B and more of their ABO-incompatible infants became jaundiced. Thus these studies suggest an increased risk of haemolytic disease of the new-born due to ABO imcompatibility when tetanus toxoid injections are given during pregnancy.
The frequency of the Ina antigen was determined in population samples from Thailand and Indonesia as well as in Arabs, Chinese, Iranians and Parsis. It was found to be polymorphic in Arabs (11.8%) and Iranians (10.6%) while it was absent in the other population groups.
55 cases of autoimmune haemolytic anaemia with positive direct Coombs' test were investigated for the nature of autoantibodies. The studies involved characterization of the autoantibodies on the basis of their thermal amplitude, serological specificity, nature of immunoglobulin and light chain specificity. The findings showed that the autoantibodies could be classified as cold autoantibody (18 cases), warm autoantibody (5 cases) and biphasic autoantibody which reacted at 37 degrees C as well as at 6 degrees C (32 cases). Further classification of these cases was made on the basis of antibody specificity to blood groups, immunoglobulin type in relation to the optimum temperature of their reaction.
H and I substances are present in the plasma and the saliva. In the plasma there is no quantitative relationship between H and I substances, whereas in the saliva only non-secretors produce I substance [shown by anti-Is serum, (Sti.)]. The study of I and H substances in the plasma and the saliva of H and I deficient subjects gives a better understanding and enables the completion of the classification of these rare phenotypes. The results also allow the proposal of a synthetic scheme of Is and H substances in the saliva.
Anti-Ina antibodies have been observed in 30 of the 41 anti-Rh donors hyperimmunised with group O Ror In(a+) blood. They have also been found in four of 60 Rh immunised women. In three of these the husbands and previous children were In(a+). However, there was no evidence of haemolytic disease of the newborn due to anti-Ina antibodies alone. The Ina antigen is developed at birth though it is weaker than in adults. The strength of the Ina antigen decreases during pregnancy and returns to the previous level three months afer termination of pregnancy. The Ina antigen is affected by papain, trypsin, bromelin and neuraminidase. The antibodies in all the donors, even though their sera were preserved for more than 10 years at -20 degrees C, reacted in saline and albumin milieux and in the indirect antiglobulin procedure using anti-IgG reagents. These antibodies are complement binding as shown by the two-stage complement binding test. Treatment with 2-mercaptoethanol and DEAE-column chromatography suggested the anti-Ina antibodies were of the IgG class. Anti-Ina antibodies could possibly cause a transfusion reaction since In(a+) red cells when transfused into individuals possessing anti-Ina antibodies are eliminated from the circulation within 20 minutes.
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