Commercial antiserums for immunologic tests.
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Primary biliary cirrhosis (PBC) has been classified as an autoimmune disease. It is characterized by a multitude of immune-mediated symptoms and phenomena. Humoral autoimmunity directed against mitochondrial auto-antigens or structures cross-reactive with these proteins represents the basis of one of the most specific tests in any autoimmune disease: the detection of auto-antibodies against pyruvate dehydrogenase. The molecular cloning and expression of antigens of the ketoacid dehydrogenase complex has led to the establishment of highly specific and reliable testing systems for anti-mitochondrial antibodies (AMA). The characterization of specific antinuclear auto-antibodies has contributed to the diagnosis of AMA-negative PBC and is an important marker in overlap syndromes of PBC and other autoimmune liver diseases.
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One-hundred-and-one patients referred because of Raynaud's phenomenon (RP) were prospectively followed for a mean period of 42 months. At presentation they were screened for signs and symptoms of connective tissue disease (CTD) according to a detailed protocol. At presentation 37 patients had primary RP (PRP), nine had RP in combination with vascular occlusive disease (RP-VOD), 25 had one symptom of a CTD (questionable PRP), 13 had two or more symptoms (undifferentiated CTD, UCTD) and 17 had definite CTD. Progression from one of these groups to another was seen in 24 patients and from PRP, RP-VOD or questionable PRP towards a (U)CTD was seen in 19 patients. Patients with one sign of CTD showed a high tendency (56%) to develop CTD. The presence of ANA as detected by immunofluorescence and by immunoblotting at the start of the study was associated with the future development of symptoms of CTD; positive predictive value 65% and 71% and negative predictive value 93% and 83%, respectively. ANA-testing by immunoblotting was of special help in predicting the development of scleroderma, the CREST syndrome and mixed connective tissue disease. In conclusion, testing for ANA by indirect immunofluorescence helps to discriminate between patients with persisting PRP and those who will develop a CTD, while testing for ANA by the immunoblotting technique helps to predict the development of a specific CTD.
294 serum samples from five Norwegian reindeer herds were examined for antibodies against Hypoderma tarandi L. The first and second larval instars of H. tarandi were tested as antigens in immunodiffusion tests, passive haemagglutination and an Enzyme-Linked Immunosorbent Assay (ELISA). The latter technique, using first instar antigens, produced the best results. A significant difference (P less than 0.1%) was observed between the antibody value of naive reindeer bred in France and those from infected Norwegian herds. No correlation was observed between the antibody titre and the number of warbles recovered at necropsy from the 294 Norwegian reindeer.
The comparative sensitivity and specificity of three immunodiagnostic tests for hydatid disease--the latex agglutination (LA) test, the indirect haemagglutination (IHA) test and the counterimmunoelectrophoresis (CIEP) test--were studied. The results of the IHA test were evaluated using three positivity criteria. Antigen from the same source--hydatid cyst fluid pool of ovine origin--was utilized for the three tests. A total of 123 sera were studied; 30 preoperative sera from patients with other parasitic and infectious diseases, 30 sera from patients with non-parasitic diseases and 30 sera from normal blood donors. The results of the three tests were correlated to the immunoelectrophoresis (IEP) test based on the presence of arc 5. The same sensitivity (86.7%) and specificity (99%) was obtained in LA, CIEP and IHA tests when the minimum cross-reactivity titre criterion was employed for the latter. Non-specificity was relatively high (13%) in the IHA test when only serological reactivity was considered. The sensitivity of the IHA test decreased (83.3%) using the diagnostic titre criterion and non-specific reactions were eliminated. All three tests correlated well with the IEP test.
Traditional Chinese medicines (TCM) have been used to treat bronchial asthma for several centuries and a certain degree of clinical benefit has been observed; however, scientific substantiation is lacking. A multicenter, double-blind and placebo-controlled study was therefore conducted to evaluate the clinical efficacy in terms of symptom score, medication score, morning and evening PEFRs, and changes of immunoregulatory function, such as distribution of lymphocyte subsets and in vivo and in vitro production of lymphokines (IFN-gamma and IL-4) and inflammatory mediators (histamine, PGE2 and LTC4). Furthermore, the protective effect of TCM on the late asthmatic reaction (LAR) was evaluated by using asthmatic guinea pigs. Three hundred and three asthmatic children were classified by Chinese doctors, according to a standardized questionnaire designed on the basis of basic logic of Chinese medicine, into three groups of specific constitution (group A, B and C). Group A consisted of 32 herb A-treated patients and 34 placebo-treated; group B, 74 herb B-treated and 64 placebo-treated; and group C, 55 herb C-treated and 44 placebo-treated. The study period was six months. The results were: 1) Both treatment group and placebo group showed an improvement in all clinical parameters, thus demonstrating a placebo effect. However, the improvement was usually greater in the former than the latter, although only the difference in PEFR was significant; 2) Herb A could increase total T cell and decrease B cell; 3) Herb A and B enhanced production of PGE2 but not LTC4, IFN-gamma and IL-4; 4) There was a general tendency for in vivo and in vitro production of histamine to decrease at the end of study in both treatment group and placebo group; however, the decrease was significantly greater in the former than the latter; 5) In asthmatic guinea pigs, 10-day's pretreatment with Chinese herbs could reverse the decrease of sGaw, suppress eosinophilia in bronchoalveolar lavage fluid (BALF), prevent the eosinophil infiltration of airways, increase PGE2 production and decrease LTC4 production in serum and BALF. Thus, traditional Chinese medicines did show a certain degree of clinical efficacy. The decreased production of histamine and LTC4, increased production of PGE2 that were found in both asthmatic children and asthmatic guinea pigs, and prevention of occurrence of LAR by suppressing eosinophil infiltration of airways and preserving airway conductance that were observed in asthmatic guinea pigs after allergen challenge might be used to account partly for the effectiveness.
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A study to determine the reliability of a recently described test, the faecal human haemoglobin test (FHH), specific for human blood, in the detection of colorectal neoplasia, is reported. All of nineteen patients with proven cancers studied were shown to have detectable blood in the stools. Three of five patients with polyps in this series also had detectable blood in the stools by this test. Although three of nineteen control subjects had positive tests, two of these were subsequently found to have bleeding sites, and the third was normal on follow up some weeks later. The findings are discussed in relation to the Hemoccult II (H-O) test results obtained in these subjects, and the implications for the possible future role for this test in screening for colorectal neoplasia.
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We compared the Testpack Strep A plus (TPSAP) enzyme-linked immunosorbent assay test for group A beta-hemolytic streptococcal (GAS) antigen rapid detection with blood agar culture in 454 pediatric patients with clinical pharyngitis. Of the 454 patients, 118 (25.9%) had positive oropharyngeal cultures for GAS. TPSAP sensitivity was 89.9% (106 of 118) and specificity was 95.8% (322 of 336). We conclude that the TPSAP is specific enough to indicate treatment for a patient with a positive test but that a negative test should be confirmed by culture.
BACKGROUND AND PURPOSE: The aims of this prospective and multicenter study were to determine the frequency of anticardiolipin and antinuclear antibodies in an unselected ischemic and hemorrhagic stroke population and to evaluate the clinical significance of these autoantibodies. METHODS: Over a 1-year period, we collected plasma from 481 consecutive patients with ischemic or hemorrhagic stroke attending four different hospitals. Blood (10 mL) was drawn from each subject into a citrated glass tube. Plasma was obtained immediately by centrifugation and was stored at -70 degrees C until use. Concentrations of IgM and IgG anticardiolipin antibodies were measured at room temperature in normal (not heat-treated) plasma by standardized enzyme-linked immunosorbent assay. All sera were treated by indirect immunofluorescence on mouse liver and kidney sections for antinuclear antibodies. RESULTS: A total of 481 patients (325 men, 156 women) 16 to 90 years in age (mean age, 61 years) were studied. Anticardiolipin antibodies were present in 5 of 481 (1.04%) patients. One patient was IgG positive and four patients were IgM positive. Of 481 patients, 35 (7.2%) were positive for antinuclear antibodies. Anti-DNA antibodies were not demonstrable in any patient. CONCLUSIONS: The frequency of anticardiolipin antibodies in a heterogeneous stroke population is possibly lower than reported. The routine screening of anticardiolipin and antinuclear antibodies in a stroke population is of questionable value.
Numbers and percentages of T and B cells in peripheral blood; blastogenic responses to PHA, Con A, and PWM; and serum levels of albumin, total protein, and IgA were assessed in patients with stages I to III operable squamous cell carcinoma of the upper aerodigestive passageways in the head and neck. The patients were categorized into two groups: those who remained tumor free and those in whom cancer recurred. It was found that pretreatment PHA- and Con A-induced blastogenesis was often depressed in patients in whom clinically apparent recurrences developed regardless of stage or nodal involvement. This point is consistent with the idea that cellular immune function (blastogenesis) can identify, within the clinical staging system (TN), subpopulations of patients who are less likely to survive after conventional therapy.