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Are blood group isoantigens lost from malignant prostatic epithelium? Immunohistochemical support for the preservation of the H isoantigen.

Previous studies while demonstrating the presence of blood group isoantigens on normal prostatic epithelium have failed to identify such antigens on malignant prostatic tissue. Using a series of blood group specific monoclonal antibodies directed towards the A, B, H and Y antigens we have reinvestigated blood group isoantigen expression in both benign prostatic hypertrophy and prostatic adenocarcinoma. Results obtained from areas of benign prostatic hypertrophy are in broad agreement with those published however though we were unable to detect either A or B blood group isoantigens Type 2H and Y isoantigens were identified in 10 of the 12 tumours. These findings, while differing from previously reported results, lend support to the suggested connection between ontogenesis, oncogenesis and blood group isoantigen expression and also support the proposed link between Type 2 structures and malignant transformation.

ABO Blood-Group System↗

Thyroid blood group isoantigen expression: a parallel with ABH isoantigen expression in the distal colon.

An interesting and not previously reported parallel has been observed between the known pattern of ABO (H) blood group isoantigen expression in normal and neoplastic colonic epithelium and that in the thyroid. Epithelial expression of blood group isoantigens was not observed in 16 specimens of normal or non-neoplastic thyroid tissue. This contrasts with the progressive re-expression of these antigens in neoplastic thyroid tissue. Blood group isoantigens were detected in two of eight papillary adenomas and 13 of 17 papillary carcinomas. Antigen expression was in part related to differentiation, and stained cells were less readily detected in follicular tumours, only one of five adenomas and two of seven carcinomas displaying blood group antigens while three medullary and two anaplastic carcinomas were antigen-deficient.

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IMMUNOGLOBULIN ISOANTIGENS (ALLOTYPES) IN THE MOUSE. I. GENETICS AND CROSS-REACTIONS OF THE 7S GAMMA-2A-ISOANTIGENS CONTROLLED BY ALLELES AT THE IG-1 LOCUS.

Eight antigens of 7S gamma(2)-immunoglobulins controlled by alleles at a single locus Ig-1, have been identified in mice. This locus has previously been shown to determine antigenic specificities on the F fragments of 7S gamma(2a)-globulins. The reactions of these antigens with various isoantisera have shown that the antigens all cross react with one another. New methods for the analysis of antigenic specificities of soluble proteins are presented in detail. A sensitive method for detecting in the order of 0.01 microg of these isoantigens has been developed, based on the quantitative inhibition of precipitation of I(125)-labeled antigen. Cross-reactions of the antigens were analysed in inhibition assays and the data is compatible with the existence of a minimum of eight antigenic specificities. Each of the antigens is composed of different combinations of these specificities, with only one antigen having a specificity not present in any other. Sixty-eight mouse strains have been tested with specific isoantisera, and on the basis of the results, have been placed into the eight allele groups. Evidence for close genetic linkage of the Ig-1 locus and 11 chromosome markers has been sought and not found.

Alleles↗

[Significance of isoantigen in the management of the urinary bladder tumor--a basic study of ABO isoantigen in step sections of the entire bladder].

Twenty cases of bladder cancer which had been treated by radical cystectomy were investigated, five out of these twenty were rendered to a specific red cell adherence test (SRCA test) using step section of entire bladder and for the other 15 cases malignant lesions and surrounding non-malignant lesions, which had been determined by histological mapping, were compared using the SRCA test. The SRCA test positive and negative lesions could coexist within the same tumor. Thus in the case of a large tumor, multiple biopsies were required to evaluate the results of the SRCA test. Since multiple bladder cancer lesions of the same patient revealed different results of the SRCA test, each lesion should be evaluated individually. Some dysplasia, down growth and squamous metaplasia were SRCA test negative and this phenomenon was frequently observed in the surrounding tissue of the bladder cancer. Histologically normal bladder epithelium and hyperplasia showed SRCA test positive by 100%. All the CIS showed SRCA test negative. Positive percentage of SRCA test in grade II and grade III tumors were 40% and 23.1% respectively. There was no relationship between the pathological stage and the results of SRCA test. There was no relationship between the existence of the intramural lymphatic invasion and/or the intramural venous invasion and the result of the SRCA test. From these results, we conclude that the SRCA test is a useful tool to predict the malignant potential of the bladder cancer, but when we utilize this test for the bladder biopsy specimens we found its reliability limited.

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Expression of A and B tissue isoantigens in benign and malignant lesions of the breast.

AB isoantigens are widely distributed in human tissues and loss of AB isoantigen expression has been shown to be an early marker for carcinomatous transformation in some tissues. We therefore applied the Specific Red Cell Adherence Reaction (SRCA) for detection and localization of AB isoantigens in tissue to the study of benign and malignant proliferative lesions of the breast. Twenty-nine lesions in 19 patients were studied. AB isoantigen expression in normal breast tissue was found to be largely confined to the mammary duct system. Loss of AB isoantigen expression was a consistent feature of intraductal carcinoma (3 of 3 cases). Proliferative lesions associated with fibrocystic disease also demonstrated varying degrees of isoantigen loss (simple cystic disease, 3 of 8 cases; intraductal hyperplasia, 6 of 7 cases; sclerosing adenosis, 4 of 4 cases; and intraductal papillomatosis, 7 of 7 cases negative for isoantigen). In contrast to other systems, loss of AB isoantigen expression in the breast appears to be a consistent marker of apparently benign proliferative duct lesions associated with fibrocystic disease, as well as duct carcinoma. The early loss of AB isoantigen expression in these histologically benign lesions supports a possible link between fibrocystic disease and mammary carcinoma. In contrast to other tissues, loss of AB isoantigen expression in proliferative breast lesions is not necessarily evidence of malignancy.

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Monoclonal antibody localization of A and B isoantigens in normal and malignant fixed human tissues.

The expression of human blood group A and B isoantigens in normal and malignant tissues from stomach, colon, and pancreas was analyzed in an immunoperoxidase assay using monoclonal antibodies specific for these isoantigens. Appropriate isoantigen expression was demonstrated in the normal epithelium from the stomach, pancreas, and proximal but not distal colon of blood group A, AB, or B patients. Half of all gastric carcinomas and of proximal colon carcinomas showed complete loss of isoantigen, whereas the adjacent mucosa in these cases continued to express appropriate isoantigen. Isoantigen expression was completely lost in only 13% of pancreatic carcinomas tested. Neither A nor B isoantigen was detected in normal epithelium from the distal colon. By contrast, 85% of carcinomas derived from this site showed reexpression of isoantigen. Inappropriate expression of A isoantigen was detected in pancreatic carcinomas (2/5) but not in gastric or colon carcinomas (0/21). Inappropriate expression of B substance was not detected in any tissue (0/38). Interestingly, differential binding of antibodies to Type 1 versus Type 2 and/or difucosyl versus monofucosyl blood group B substances was manifested by differences in intensity of staining for endothelium and red blood cells.

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Human blood group isoantigen expression on normal and malignant gastric epithelium studied with anti-A and anti-B monoclonal antibodies.

Variation in human blood group isoantigen expression on normal and malignant gastric epithelium was demonstrated with monoclonal antibodies to blood groups A and B in an indirect immunoperoxidase technique. The expected isoantigen expression was demonstrated on endoscopic biopsy specimens of normal gastric mucosa from 11 patients. Of 17 patients with gastric carcinoma (blood group A, 15; blood group AB, 2), complete loss of isoantigen expression was noted in 6 (35%). In these 6 patients, blood group isoantigen remained both in the adjacent uninvolved mucosa and at the margin of resection. The loss of isoantigen did not appear to be related to the degree of differentiation within the tumor, to the secretor status of the patient, or to the blood subgroup. Lymph node metastases reflected the isoantigen status of the primary tumor, being positive in 5 of 6 expression in all 17 patients or in an additional 15 patients studied with blood group O. These findings were discussed in the light of previously reported work on the localization of blood group isoantigens on malignant and nonmalignant gastric epithelium with the use of conventional antisera and a variety of immunohistologic techniques.

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ABH isoantigens, histology and DNA ploidy in 36 consecutive patients with transitional cell bladder cancer. Status of tumor and biopsies taken from visually normal urothelium.

Tumors and biopsies from visibly normal urothelium in 36 consecutive patients with transitional cell bladder carcinoma were analysed for histological pathology, DNA ploidy and ABH isoantigens. Tumor isoantigen deletion correlated strongly with malignant histology (p = 0.016) and aneuploidy (p = 0.005). In 4/12 patients with ABH isoantigens present on the tumor, and in 6/8 with isoantigens absent, isoantigen changes were found in normal looking urothelium, usually with normal histology and ploidy. It was concluded that the ABH isoantigen change was an early event in bladder carcinoma.

ABO Blood-Group System↗

Isoantigen status in condyloma acuminata of the uterine cervix: an immunoperoxidase study.

The immunoperoxidase technic was used to investigate the blood isoantigen status in condyloma acuminata, which is regarded as being caused by the human papillomavirus (HPV). Since HPV is associated with epithelial atypias and intra-epithelial neoplasia, and since epithelial malignant transformation is associated with isoantigen loss, the purpose of the study was to determine if koilocytotic atypias are associated with isoantigen loss. Complete isoantigen loss was seen in 33% of cases, partial loss in 47%, and retention in 20%. The significance of this study lies in being able to recognize those lesions that may be associated with malignant transformation (80%) as indicated by isoantigen loss. Isoantigen retention may identify those epithelial atypias that undergo spontaneous regression. Long range follow-up of such patients will help further elucidate the role of HPV in neoplastic transformation of condylomatous lesions. The immunoperoxidase technic can be used in retrospective studies of condylomata of the cervix.

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Visualization of urothelial blood group isoantigens A and B using direct biotin-labeled antibodies and avidin-biotin-peroxidase complex.

The loss of blood group isoantigens from the surface of bladder tumor cells has been correlated with the potential invasiveness of the tumor. Development of simple and reliable methods for detection of these isoantigens should facilitate the general clinical use of this test for predicting malignant potential in low grade, low stage cancer of the bladder. We now report a direct peroxidase technique for the detection of isoantigens A and B by utilizing the specific interaction between biotin and avidin, and the capability of labeling a single antibody with multiple biotin molecules. Antibodies specific to the isoantigens A and B were purified from human antisera by affinity chromatography using an immunoabsorbent containing chemically synthesized antigenic determinants. The purified antibodies were directly labeled with biotin. An avidin-biotin-peroxidase complex was used to bind the biotinylated antibody for the peroxidase staining reaction of the isoantigens on tissue section. Application of this technique to formalin-fixed, paraffin-embedded bladder tissue and tumor sections yielded specific and strong stainings of the isoantigens with low background staining. The potential clinical application of this method requires further evaluation.

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[Correlation of the expression of A, B isoantigens with its precursor H antigen in transitional cell carcinoma and the clinical signification of the expression].

The expression of ABO (H) isoantigens in tumors from 96 patients with transitional cell carcinomas (TCC) and the precursor H antigen of A or B antigens were studied by using immunohistochemical technique (ABC method). In our series ABO(H)isoantigens were demonstrated in 57 of 96(59.4%), grade I 76.5%, II 69.4% and III 33.3% respectively. The deletion of ABO(H) isoantigens was related statistically with the histologic grade of TCC (P less than 0.01) and the recurrence of the tumors (P less than 0.05). The results showed that the expression of the precursor H substance was very well related with the expression of A or B isoantigen (r = 0.99, P less than 0.001). The deletion of precursor H substance could more reliably predict the clinical course of the subsequent recurrence and mortality in A, B or AB type blood patients with TCC than that of A or B isoantigen. Detecting H substance can substitute completely detecting A or B isoantigen in tumors of A, B or AB type blood patients, and has more practical value clinically.

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Clinical significance of A, B, H isoantigen deletion of urothelial cells in bladder carcinoma.

The occurrence and/or deletion of A, B, H isoantigens in cytologic specimens was compared to a number of other clinical parameters commonly used for prediction of prognosis or monitoring of bladder carcinoma. Isoantigens were better preserved by our preparation for cytologic than for histologic specimens. Patients with isoantigen present on urothelial cells were more likely to have small or no visible tumors than large tumors. A strong correlation was found between isoantigen status and cytologic diagnosis (P less than 0.001), but not with ploidy (P = 0.059). For short-term prognosis of recurrence, tumor size appeared to be highly significant, whereas A, B, H isoantigen determinations had no predictive value. Intravesical chemotherapy did not per se influence expression/deletion of isoantigens.

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ABH cell surface isoantigens in invasive bladder carcinoma associated with schistosomiasis.

The immunoperoxidase technique for demonstrating blood group ABH isoantigens was used to compare 33 patients with invasive stages T2 and T3 bladder carcinoma with (18) and without (15) schistosomiasis. Of the 18 patients with schistosomiasis 11 (61 per cent) had cell surface antigens present (9 with squamous cell carcinoma and 2 with transitional cell carcinoma and areas of squamous metaplasia), while isoantigens were absent in the remaining 7 (1 with well differentiated squamous cell, 2 with moderately to poorly differentiated squamous cell and 4 with transitional cell carcinoma). Cell surface isoantigens were present in only 3 of the 15 patients (20 per cent) without schistosomiasis (2 with squamous cell and 1 with transitional cell carcinoma) and absent in the remaining 12 with transitional cell carcinoma. This preliminary study shows that a significant percentage of patients with schistosomiasis-associated invasive bladder carcinoma maintain the blood group isoantigens, in contrast to those with bladder carcinoma not associated with schistosomiasis. The better prognosis of schistosomiasis-associated carcinoma could be linked conceivably to isoantigen maintenance. If this speculation is supported by further studies the determination of blood group isoantigens in these patients would be of prognostic value.

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Use of monoclonal antibodies for the localization of tissue isoantigens A and B in transitional cell carcinoma of the upper urinary tract.

Employing the indirect immunoperoxidase technique, monoclonal antisera against blood group antigens A and B were used to localize the corresponding tissue isoantigens in normal ureter and transitional cell carcinoma of the ureter and renal pelvis in 29 patients. All five cases of normal ureters showed positive staining of tissue isoantigens within the transitional epithelium, and all twelve cases of noninvasive transitional cell carcinoma showed similar staining in tumor cells. Of the remaining twelve cases who had invasive tumor, eight lacked tissue isoantigens, while four cases exhibited positive staining. These results support the earlier findings that normal urothelium and noninvasive transitional cell carcinoma of the urinary tract possess ABO tissue isoantigens, while these isoantigens are most frequently absent in invasive tumors. In addition, this study also demonstrates that invasive transitional cell carcinoma of ureters and renal pelvis may continue to possess tissue isoantigens when studied by this sensitive, specific method.

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