The immune system: its development and functions.
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Biomedical subjects
Publications and source records attributed to J O Nysather.
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Interest in tumor immunology grew out of the study of host response to microbial infections during the second half of the 19th century. However, the growth of interest in transplantation during the 1950s and 1960s is largely responsible for the great surge of scientific investigation into tumor immunobiology which we are experiencing today. Tumor cells possess certain abnormal antigens in addition to their normal complement of transplantation antigens. These abnormal antigens evoke an immune response in the host, which involves both the humoral and the cell-mediated systems. Though the cell-mediated (thymus derived) system is generally conceded the most important role in tumor cell destruction, the humoral (bursal-equivalent derived) system also plays a role in host response which is presently less clearly understood. Certain aspects of the humoral response (blocking factors) actually appear to inhibit the host response against a tumor. This complex system of host immune response to tumor has been termed the immunosurveillance system.
A great deal of investigation is presently underway to develop methods of effectively assessing the status of an individual patient's immune system. Such methods might provide a means of early detection of tumor or of indicating prognosis so that treatment modalities may be tailored to individual patient needs. The cell-mediated response may be monitored using intradermal skin tests and in vitro lymphocyte stimulation and cytotoxicity tests. Humoral responses have been monitored using assays for antibodies against tumor specific as well as tumor associated antigens. Assays have been developed which are capable of detecting circulating fetal antigens in very small concentrations. Thus far no one assay technique has proven to be sufficiently sensitive nor specific to be clinically useful. However, by utilizing a battery of tests before, during and after treatment, it is possible to determine a great deal about individual patient response to treatment and prognosis. With so many investigators focusing upon this problem, it seems likely that more effective methods of immunodetection will soon be developed.
It is apparent that development of consistently effective methods of immunotherapy must await a more thorough understanding of the immune response to cancer. However, even those forms of immunotherapy which have been developed to date indicate a tremendous potential. It appears that immunotherapy may be most useful as an adjuvant to established forms of treatment. Surgery, radiation therapy and/or chemotherapy are used to remove all of the gross tumor, with immune therapy then employed to destroy the small foci of tumor which remain. As methods are developed which are effective in counteracting the immunosuppression of tumors, other means of immunotherapy may be found which are capable of destroying tumor cells while not affecting the adjacent normal tissue. Thus, the future of immune therapy holds great promise. As more is learned about the immune response to cancer, advances in therapy will certainly follow.
Serum immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) levels were determined on 245 patients with carcinoma of the head and neck and on 92 controls. Ratios of these levels were calculated for each subject. The patients with cancer demonstrated elevated serum IgA levels (P less than .0001) and elevated IgA/IgM and IgA/IgG ratios (P less than .05). No differences were noted when the IgM/IgG ratios were compared between the cancer and the control groups. These observations are offered as evidence that previously reported elevations of serum IgA levels in patients with carcinoma of the head and neck are not merely an index of nonspecific increased immunoglobulin production in these patients.
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