Plasma exchange in myasthenia gravis.
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Biomedical subjects
Publications and source records attributed to R Finn.
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A hypothesis is put forward to account for the non-rejection of the fetal allograft, based on shared surface-repellent molecules (S.R.M.s) which prevent close apposition of maternal and fetal immunocompetent cells. This hypothesis is shown to be compatible with the major theoretical requirements of the immune system. Thus it provides possible explanations for the self/not-self recognition process, tolerance to organ transplants, the development of autoimmune disease, and high and low zone tolerance. It is also argued that the recognition of self is important with reference to cellular antigens, but may not be essential for humoral antigens.
The mechanism by which Rh immunization is prevented by IgG anti-D was investigated by studying the specificity of immunosuppression. 62 D-negative Kell(K)-negative male volunteers were given two successive stimuli of 1 ml D-positive K-positive red cells. Thirty-one of the volunteers were also given 13-14 mug of IgG anti-K immediately after each stimulus, the others acting as controls. Anti-D developed in 11 of the 31 controls and in one of the 31 volunteers who had received anti-K. This marked suppression of the anti-D response by IgG anti-K was accompanied by the rapid clearance of the injected red cells to the spleen. This shows that the predominant mechanism that must be operating when IgG anti-D prevents Rh immunization is not antigen specific but is one that must involve the whole red cell, probably through destruction within splenic macrophages.
Eight out of ten of patients with analgesic nephropathy were regular and usually heavy laxative takers compared with 12 out of 200 controls from the general population and four out of 70 patients attending a renal clinic. The finding that regular laxative taking was greatly increased in patients with analgesic nephropathy suggests that this condition may often be due to the combined abuse of both laxatives and analgesics. In a series of 40 patients with rheumatoid arthritis all were found to have normal renal function and no patient took laxatives regularly. This finding would explain why analgesic nephropathy is so uncommon in patients with rheumatoid arthritis despite the fact that they are regular and heavy analgesic takers.
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Lymphocytes from pregnant women and non-pregnant individuals were cultured under the stimulus of phytohaemagglutinin in the presence of their own and heterologous (allogeneic) sera. The results indicate that heterologous sera have an inhibitory effect on the lymphocyte transformation rate and suggest that the inhibitory property is more powerful in pregnant and fetal sera. Conversely, the addition of heterologous non-pregnant sera to cultures of pregnant lymphocytes increases their transformation rate. These findings suggest that there is a serum inhibitor in pregnancy and this finding may be relevant to the survival of the fetal allograft.
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Immunological responses were studied in pregnant women and controls using as tests phytohaemagglutinin-induced lymphocyte transformation and the tuberculin reaction. Significantly reduced responses were found to both tests in the pregnant women. These results suggest that a reduction in T-cell activity during pregnancy may help protect the fetus from rejection by its mother's immunological mechanisms.