Histocompatibility antigens.
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Biomedical subjects
Publications and source records attributed to E V Mackay.
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Immune complexes with C1q-fixing properties and those precipitable by polyethylene glycol (PEG) were detected in ascitic fluid from patients with advanced ovarian cancer. The ascitic fluid from 42 of 58 patients (72%) contained these complexes. A positive result with the C1q assay was obtained in 41% of patients, whilst with the PEG assay a positive result was obtained in 59% (50% in the IgM, 36% in the IgG, and 14% in the IgA fraction). The highest mean level of PEG-precipitable complexes was in the IgG fraction (11.4 mg/100 ml) and lowest in the IgA fraction (3.3 mg/100 ml). These results indicate that gram quantities of the immune complexes may be isolated from the large volumes of ascitic fluid usually present in ovarian cancer. Further studies of ascitic fluid may thus provide data on the nature of the immune responses in these patients.
Samples of malignant ascitic fluid from 30 patients with advanced ovarian carcinoma were examined for the presence of IgM antibodies to CEA and PEG-precipitable proteins binding to 125I-CEA. The IgM antibodies to CEA were measured by a solid-phase radioimmunoassay using ovarian CEA. There was no correlation between the level of IgM antibodies to CEA and that of total IgM in the fluid. In 11 of 30 (37%) samples tested, significant amounts of IgM antibodies to CEA were found. The CEA-binding proteins were measured by the ability of ascitic fluid to incorporate 125I-colonic-CEA into PEG-precipitable complexes. In 9 of 39 (30%) samples, the precipitation was significant. There was no association between antibodies to the ABO and Lewis blood group factors and these antibodies to CEA. An inverse relationship was observed between the level of CEA and that of CEA-binding proteins shown by the two assays. When 125I-CEA was incubated with these "positive" samples, a high molecular weight fraction was demonstrated by chromatography. By contrast, in the "negative" samples, there was no incorporation of 125I-CEA. These findings would indicate the presence of CEA-reactive proteins possibly existing as immune-complex-like material in ascitic fluid of some patients.
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The first part of the reversal immune surveillance hypothesis (RISH. I) describes the conceptual framework of the immune system as a homoeostatic mechanism for the control of cell differentiation and replication. The thymic dependent lymphocytes (T-cells) are considered to be tissue specific and identify aberrations in the cell surface pattern (antigens), that represent that particular cell type. The T-cells may then recruit antibody forming B-lymphocytes (B-cells) to produce antibodies (humoral response) to the cell surface antigens in order to return the cell surface pattern to its correct state. The antigens may also be removed from the cell surface as immune complexes by the complement system, which under normal conditions does not cause cell lysis. The cellular arm of the immune system, that of killer cells or activated macrophages are considered to be primarily involved with tissue remodelling. Whether or not the humoral or cellular arm of the immune system is activated depends upon the antigens displayed by the stimulating cell. The proposed system, which is self monitoring, is considered to have evolved from the invertebrates through to the vertebrates to become more complex in the mammals. Therefore the immune system is considered to be based on the identification of self and self-foreignness, rather than on foreignness per se.
In view of the reported disagreement in the physicochemical properties of ovarian carcinoembryonic antigen (CEA), this study was undertaken to compare the properties of CEA obtained from extracts of ovarian tumour tissue, ascitic fluid and cyst fluid. On the basis of molecular weight estimation and binding properties with Concanavalin A and wheat germ lectin, ovarian CEA from these three sources appeared similar, and also possessed similar properties to those of colonic CEA. On isoelectric focusing, however, it was found that the isoelectric point of CEA from tumour tissue and cyst fluid differed from that from ascitic fluid. It is most likely that this is due to a loss of sialic acid from the CEA released into ascitic fluid.
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The proposed reveral immune surveillance hypothesis is based on the identification primarily of self and secondarily of foreignness, unlike the original hypothesis that is based on the identification of foreignness per se. The proposed system is considered to have evolved from the invertebrates through to the vertebrates to become more complex in the mammals, and involves the identification of cell types by lymphocytes through the cell type surface pattern and major histocompatibility antigens. The identification of self and associated foreignness by the immune system is required for the regulation of cell differentiation and replication, and because of this design, the ability of the immune system to destroy foreignness can be regarded as a natural consequence. The reversal immune surveillance hypothesis explains why spontaneously occurring tumours may not be antigenic, in the sense of eliciting their own destruction, and is consistent with the destruction of tumour cells that display significant amounts of viral antigens or gross antigenic changes induced by carcinogenic agents. It is also able to explain the stimulation and inhibition of tumour development.
Alpha-fetoprotein (AFP) concentrations were measured by radioimmunoassay in serum from women with normal and pre-eclamptic pregnancies. An analysis of the results obtained in normal pregnancy was made using arithmetic and semi-logarithmic scales, and a statistical conversion of the AFP values in relation to gestational age was introduced to allow an easier interpretation of results. In pre-eclampsia, significantly lower mean AFP values were obtained, with the majority of individual values being lower than the mean for normal pregnancy. These low levels were not associated with fetal death, but appeared to be related to the severity of disease. The significance of these findings remains to be evaluated.
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Recent and significant developments in the field of fertility control are reviewed. Consideration is given to new aspects of existing methods, recent modifications to steroidal formulations and Intrauterine devices, increased utilization of older methods (abortion and sterilization) and evaluation of new fields (postcoital contraception, prostaglandins and immunological techniques). There is an increasing demand for better application of newly developed methods and a rational decision in the selection of appropriate methods.
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