Anaphylactoid reaction to suxamethonium.
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Biomedical subjects
Publications and source records attributed to R Clancy.
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The time course of appearance of sensitised lymphocytes was studied in rabbits fed 0.1% bovine serum albumin (BSA). Antigen reactive cells (ARC) were detected in Peyer's patches at 1 week, prior to both the appearance of primed cells in the spleen and the detection of circulating anti-BSA antibody. Systemic immunisation with 2 mg BSA induced sensitised cells in the spleen and Peyer's patches. No evidence of an early appearance of sensitised cells in the mucosal cell population was found. These data support the postulates that the initial lymphocyte sensitisation to ingested soluble antigen occurs in Peyer's patches, that this lymphoid tissue provides a significant contribution to systemic immunity following oral and parenteral immunisation, and that the mucosal lymphocyte population is not involved in the early phase of sensitisation to ingested antigen.
A patient with primary amyloidosis is described with extensive vital organ involvement including infiltration of the liver, kidney and myocardium. Treatment with intermittent melphalan and prednisone resulted in improved hepatic and renal function, a reduction in liver size and arrested amyloid deposition in the myocardium. These observations suggest that chemotherapy can halt tissue amyloid deposition, and improve the prognosis of primary amyloidosis.
Lymphocytes have been isolated from human rectal biopsies in numbers sufficient for microassay procedures. No antibody-dependent cell-mediated cytotoxic (ADCC) activity could be detected in normal or inflamed human gut mucosa, using two assay systems which detect predominantly K cell activity. The tissue localisation and circulation characteristics of K cells require definition before establishing their role as an efferent immunological mechanism.
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A patient with Whipple's disease has been studied to examine the effect of antibiotic therapy on the immune status of the patient, and the specific immune response to a cell wall deficient form of an alpha-haemolytic streptococcus (alpha HS) isolated from this patient. T lymphocyte numbers were reduced, and cutaneous anergy was present. Autoantibodies directed against smooth muscle and mitochondria were detected. These abnormal parameters became normal following antibiotic therapy. The specific immune response to the alphaHS was characterised by IgA antibody and lymphocyte sensitisation. The latter was detected as antigen-inducedd lymphocyte stimulation and antigen-induced leucocyte inhibition factor (LIF) production. Antibiotic therapy was associated with a fall in antibody titre and reduced LIF production. No defect in neutrophil function was found. These results are most consistent with the postulates that (i) immunological abnormalities in Whipple's disease are secondary to infection and (ii) the primary abnormality is an unusual pathogenic bacterium.
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Cells from rabbit spleens, bronchial washings (BW) and bronchus-associated lymphoid tissues (BALT) were examined for their ability to lyse cells infected with herpes simplex virus (HSV). Specific lysis of HSV-infected cells was mediated by BW cells as early as 4 days after intratracheal infection of the rabbits with the virus whereas lysis by spleen cells and BALT cells was not detected until 7 or more days after infection. Lysis by spleen cells was initially detected 7 days after intraperitoneal injection of the virus but lysis by BW and BALT cells was not observed until 14 days after infection. Although spleen, BW, and BALT cells could lyse antibody-coated target cells, antibodies detectable by antibody-dependent cellular cytotoxicity could not be detected in bronchial washings until 7 or more days after infection. The data suggest that cells capable of direct cytotoxicity of virus-infected cells appear within the bronchus after local infection by the virus.
Functional studies of Peyer's patch and gut mucosa lymphocytes were performed in mixed lymphocyte culture reaction (MLC), an in vitro measure of the capacity of T cells to recognize and respond to cell surface alloantigens. The data demonstrate the functional effectiveness of both these mucosal lymphocyte populations in one-way MLC, both as responding as well as stimulating cells. Both the responding and stimulating capacities of these cells in MLC were almost the same as observed for lymphocytes obtained from either spleen or thymus. We conclude that functional T cells exist in both rabbit gut lamina propria and Peyer's patches with approximately the same quantitative capacity to respond in the MLC.
Single cell suspensions of lymphocytes have been prepared from human gut mucosa, and short-term culture used to characterize the kinetics of DNA synthesis of mucosal lymphocytes. High rates of DNA synthesis were found in 72-hr cultures of Crohn's disease mucosal lymphocytes, compared with normal subjects. These high rates correlated with the appearance of numerous transformed blast cells in terminated cultures. Lymphocytes from normal and abnormal human gut mucosa were stimulated by phytohemagglutinin-P, except in some patients with Crohn's disease with high rates of "spontaneous" DNA synthesis. The isolation and culture of human gut mucosal lymphocytes by a simple preparative technique will enable the direct study of lymphocyte function in both normal and diseased gut mucosa.
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Platelet function has been studied in 16 patients with uncomplicated infectious mononucleosis. Some abnormality of platelet aggregation and/or release of platelet factor III or platelet factor IV was found in all patients. Six patients with platelet defects were retested after three to four months and were found to have normal platelet function and appreciably higher platelet counts. Abnormal platelet function may reflect a platelet defect which predisposes to premature platelet destruction. Recent viral illness should be excluded before attributing abnormal platelet function to other factors or to a congenital disorder.
Lymphocytes were isolated from rectal biopsies and resected gut specimens through a simple mechanical technique, and assayed for T-cell quantitation and mitogenic response to PHA and PPD. T-cells were found in considerable numbers in gut mucosa of all groups, but in each case their percentage was lower than that of the autologous peripheral blood. The mitogenic response to PHA was found in general to be lower in the mucosal lymphocytes compared to those in blood, with the exception of the polyposis group which responded highly. No response of mucosal cells to PPD was seen. Inhibition studies done by means of mixed cultures revealed the presence of a suppressor activity in many mucosal lymphocytes, especially in the inflamed mucosa group, which may partly account for some low responses observed with mucosal lymphocytes. Further studies are under way to better define these quantitative and functional differences seen in gut mucosal cells, and to correlate differences with disease states.