Circulating immune complexes were examined in patients with hemophilia or von Willebrand's disease in order to determine the immediate or long-term side effects after transfusion. The conglutinin binding assay which allows quantitation of C3bi-bearing immune complexes was used for 82 patients with hemophilia A. Immune complexes were detected in 37 (45%) of these cases prior to transfusion. Immune complexes also were detected in four of 11 patients with hemophilia A and factor VIII inhibitors, in five of 11 patients with hemophilia B, and in three of 10 patients with von Willebrand's disease. The levels of circulating immune complexes in 21 patients with hemophilia A and seven with von Willebrand's disease significantly increased 24 hours after concentrate or cryoprecipitate transfusions. Purified immune complexes from three patients with hemophilia A were shown to contain IgG, IgM, and complement components. No factor VIII coagulant or antigenic protein or fibrinogen was identified in the immune complexes using specific antisera. Side effects immediately after transfusion were not associated with immune complexes. The levels of factor VIII or IX after transfusion were not particularly decreased in relation to the presence of immune complexes. Finally, the presence of circulating immune complexes in the patients studied did not correlate with the number of transfusions, the units of concentrates injected, the presence of HBsAg or HbsAb, the levels of plasma aspartate transferase, or the presence of rheumatoid factor. Proteinuria was absent in all the patients studied.

Antigen-Antibody Complex↗

PubMedDate not supplied

Evaluation of human monocyte function in vitro.

Mononuclear phagocytes play a role in immunologic phenomena as well as in defence reactions of the organism. It is therefore important that clinicians have possibilities of evaluating their functions. A combination of simple and reproducible methods was set up to make this evaluation possible. The tests described in this paper are performed using peripheral blood monocytes and include: (1) phagocytic capacity of Staphylococcus aureus and 51Cr-labelled sheep erythrocytes, (2) bactericidal capacity with S. aureus and (3) handling of 51Cr-labelled sheep erythrocytes after 18 h in culture. They explore both the afferent limb of the immune response and the capacity to remove and destroy foreign material. The results obtained from 45 normal subjects are reported.

Adult↗

PubMedDate not supplied

[Activation of the alternative complement pathway in pleural fluid of patients with pneumonia].

It has been reported that the opsonic activity of pleural fluid is decreased in patients with pneumonia complicated by infected effusions (empyema) compared to those with sterile (metapneumonic) effusions. In this paper some parameters of complement activity in 12 patients with empyema and in 13 patients with metapneumonic effusions were compared. The hemolytic activity of the alternative pathway and of Factor B in empyemas (15 +/- 10% and 25+15%, respectively) was less than that measured in metapneumonic effusions (55 +/- 38% and 71 +/- 21%; p less than 0.01). Both parameters showed a significant correlation (r=0.76; p less than 0.01). The Ba fragment, a catabolic product of Factor B, was increased in empyema (125 +/- 59%) compared to that in metapneumonic effusions (49 +/- 24%; p less than 0.01). The levels of C3, protein of both, alternative and classical pathways, were decreased in empyema (17 +/- 29%) when compared with the levels in metapneumonic pleural effusion (42 +/- 20%; p less than 0.01). The levels of this protein were correlated with the activity of alternative complement pathway (r=0.68; p less than 0.01), as well as with those of Factor B (r=0.75; p less than 0.01). Finally, the hemolytic activity of C4, as a representative element of the classical pathway, has also shown to be decreased in empyema (6 +/- 6%) compared to metapneumonic fluids (27 +/- 28%; p less than 0.01). Significant correlations between the hemolytic activity of C4 and levels of C3 (r=0.75; p less than 0.01), the hemolytic activity of the alternative pathway (r=0.63; p less than 0.01) and the levels of Factor B (r=0.73; p less than 0.01) were demonstrated. This last suggest a simultaneous activation of both, classical and alternative pathways of complement. The complement decrease and particularly, the activation of the alternative pathway in patients with empyema could be a determinant factor of the deficient bacterial opsonization. This can explain the survival of bacteria in an empyema despite the large number of neutrophils present.

Complement Activation↗

PubMedDate not supplied

In vitro phagocytosis and catabolism of opsonized erythrocytes by human monocytes.

Mononuclear phagocytes play a role in immunologic phenomena as well as in the defense reactions of the organism. Therefore, clinicians should have at their disposal methods of evaluating their function. A simple and reproducible method was set up to evaluate mononuclear phagocytosis and catabolism. The test described in this paper is performed using peripheral monocytes. Mononuclear phagocytes were incubated with opsonized Cr51-labelled sheep erythrocytes. The mononuclear cells phagocytosed the opsonized erythrocytes, and any remaining red cells were lysed. The degree of phagocytosis was determined by the intensity of radioactivity within the monocytes. Catabolism was determined by measuring the amount of radioactive waste excreted by the phagocyte after 18 hours incubation. Thus, this method evaluates the afferent limb of the immune response, as well as the capacity of mononuclear phagocytes to remove and destroy foreign material. Levels of phagocyte catabolism, measured in 30 normal subjects, did not vary appreciably neither in the autologous or homologous serum, nor in the presence or absence of complement.

Adult↗