Biomedical subjects
Publications and source records attributed to J Brostoff.
Twenty-seven per cent of atopic patients initially presenting with infantile eczema or hay fever were defective for yeast opsonization and 18% had low levels of C2; these deficiencies were mutually exclusive, suggesting that they are primary. Both defects were associated with each of four different atopic syndromes, some of which were related to certain HLA haplotypes.
Evidence of circulating high-molecular-weight forms of IgE was found in 16 patients with hayfever and/or atopic eczema. This finding of what appears to be complexed IgE in the serum of atopic patients may help to elucidate the aetiology of atopy.
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Of 26 patients with intrinsic asthma, 21 (81%) were homozygous for the histocompatibility antigen HLA-W6. Also, half the patients had complement defects, in particular low levels of C2. This is the first indication of a strong genetic component in intrinsic asthma, apart from that already known from family studies. These findings suggest that intrinsic asthma may be a recessive disease.
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In order to determine the phagocytosis of human anti-D coated red cells we adopted a quantitative technique for its measurement using human erythrocytes labelled with 51Cr-chromate to support the assumption that erythrophagocytosis is one of the main mechanisms by which IgG-anti-D-antibody coated red cells are destroyed.
A high incidence of unexpected metal sensitivity was found in patients with metal-to-metal (McKee) hip arthroplasties. Patients with metal-to-plastic (Charnley) prostheses had no greater incidence of metal sensitivity than a control group awaiting operation. If metal sensitivity does occur loosening of the prosthesis may be a complication.
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A group of patients with allergic rhinitis had a clinical history strongly suggestive of house-dust-mite (Dermatophagoides pteronyssinus) allergy but negative skin reactions when prick tested with D. pteronyssinus extracts. These patients were proved to be clinically allergic by nasal provocation with this allergen. Although radioallergosorbent tests showed that these patients lacked specific IgE antibodies in their serum, they did have specific antibodies in their nasal secretions. These findings indicate that these patients had allergic rhinitis mediated by the local production of IgE antibodies.
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A group of thirty-six patients of whom fourteen were being treated with methotrexate, were studied in order to assess T-lymphocyte function by in vitro techniques. Circulating T-lymphocytes in aliqots of blood were assessed by the rosetting technique. No differences were found in psoriatics, whether on methotrexate or not, compared with fifteen control subjects. Lymphocyte counts and lymphocyte transformation to phytohaemagglutinin (PHA) tended to be lower in the psoriatic group as a whole than in the controls, but the differences were not statistically significant, However, a significant inverse relationship was found between the extent of the skin lesions and lymphocyte transformation to PHA, i.e. the smaller the area of skin affected the higher the lymphocyte transformation. Psoriatics treated with methotrexate had fewer skin lesions and higher lymphocyte transformation to PHA than psoriatics not so treated, probably reflecting this inverse relationship. The reason why the presence of extensive psoriasis is associated with depressed lymphocyte transformation is not understood. No evidence was found that methotrexate depressed cell-mediated immunity as judged by these in vitro tests.
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