Assay of soluble immune complexes using radiolabeled rheumatoid factor.
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Biomedical subjects
Publications and source records attributed to J Barratt.
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Serial studies of circulating immune complexes, serum complement, proteinuria and renal histology and immunofluorescence have been undertaken in infective endocarditis glomerulonephritis in rabbits. Eighteen of 24 rabbits developed evidence of glomerulonephritis and 13 of 18 had circulating immune complexes. Gel filtration studies showed the immune complexes to have a size range of ca 4.10(6)--3.10(5) daltons. Direct immunofluorescence staining of glomeruli showed that IgM was the predominant immunoglobulin present and that antiglobulin activity was associated with IgM deposition. Intraglomerular localization of antiglobulin was closely associated with evidence of glomerulonephritis. Streptococcal antigen(s) were not demonstrable in glomeruli, even after acid elution of sections.
A simple assay for circulating immune complexes has been developed and the optimal conditions for reaction defined. Partially purified radiolabelled polyclonal or monoclonal rheumatoid factor was incubated with aggregated IgG or soluble immune complexes and the resultant macromolecule precipitated with 3% polyethylene glycol. Monoclonal rheumatoid factor was much the better reagent, allowing the detection of approx. 0.35microgram/ml or more of aggregated IgG. Soluble immune complexes formed in vitro at between x2--x20 antigen excess were detectable over a wide range of molecular size. Clinical studies indicated that the assay is a useful addition to the currently available techniques for measuring circulating immune complexes.
Five of twenty-three patients with paraproteinaemia (two IgM, three IgG) have been shown to exhibit marked classical pathway complement activation. The mechanisms of hypocomplementaemia proposed for the five patients are cryoglobulinaemia in one and in vivo immunoglobulin aggregation in the other four. Three further patients had a low C1q and three a low C3 unassociated with any other complement abnormality. No association with any particular IgG subclass or obvious clinical abnormality existed in association with hypocomplementaemia.
A new, specific haemolytic assay for C2 is described using EAC43 (Antrypol) cells and serum deficient in C4 and C2 from a patient with hereditary angio-oedema. The method is simple and the results in pathological and normal sera correlate well with those obtained using the EA and C2-deficient serum method.
A case of gonadal dysgenesis in a phenotypic female with XY genotype associated with ovarian gonadoblastoma is reported. Endocrinologic studies suggest that the normal female secondary sex characteristics could be due to estrogen production from luteal intersitial cells.
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The attention given to the nutritional needs of older adults receiving hospital care has been the subject of research over recent years. It has been suggested that older people are suffering from malnutrition as a result of poor nursing care. Those involved in care of persons with dementia are faced with considerable difficulty when trying to respond to their nutritional care needs and there is concern that there may come a time when the care team will withdraw food and fluid. However, in Southern Derbyshire we believe that we now have a set of standards for nutritional care of older adults with dementia that can ensure adequate and good nutrition despite the numerous and complex problems posed by dementia. This article discusses the progress of a sample of 20 residents of a long-stay ward over a period of 6 years and shows how a multidisciplinary team accessed, developed and applied an evidence base to practice to the benefit of the sample group. The outcomes show that malnutrition can be reversed, and that people who are considered to be in the final stages of dementia can improve their nutritional status.
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