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A quantitative analysis of the interactions of antipneumococcal antibody and complement in experimental pneumococcal bacteremia.

The mechanism of protection of type-specific antipneumococcal antibody and complement in bacteremia was investigated with purified rabbit antibody and a guinea pig model of pneumococcal bacteremia. IgG and IgM were isolated from the sera of rabbits immunized with type 7 pneumococci (Pn), and their binding to Pn was quantitated. The number of antibody-binding sites on the pnuemococcal capsule was also determined. Pn were incubated with various amounts of the immunoglobulin preparations before intravenous injection into nonimmune guinea pigs. Whereas 120 molecules of IgM per Pn were sufficient to enhance bloodstream clearance of Pn, 1,400 molecules of IgG per bacterium were required to produce this effect. As the amount of either IgG or IgM added to the Pn was increased, the rate of bloodstream clearance accelerated. In striking contrast, greater than 1,000 molecules of IgM had no effect on the rate of clearance in C4-deficient guinea pigs, which cannot activate complement via the classic pathway. Similarly, 5,000 molecules of IgG had only minimal effect in C4-deficient guinea pigs, and 24,000 molecules of IgG had no effect in guinea pigs depleted of complement by cobra venom factor. Thus, the in vivo opsonic effects of both IgG and IgM anticapsular antibody are mediated via their ability to activate complement. IgG anti-pneumococcal cell wall antibody, raised by intravenous injection of rabbits with unencapsulated Pn, had no effect on the rate of bloodstream clearance of Pn or on the polymorphonuclear leukocyte killing of type 7 Pn in an in vitro bacterial assay. Because the opsonic effects of anticapsular antibody required complement activation, the ability of anticell wall IgG to activate complement was compared with the two classes of anticapsular antibody. As judged by depletion of C3 and C4 from guinea pig serum, as well as by the fixation of radiolabeled C3 to Pn, IgM anticapsular antibody was the best complement activator. However, anticell wall IgG was somewhat more active than anticapsular IgG in each of these tests of complement activation and fixation. When equivalent amounts of C3 were fixed to Pn by each of the three antibodies, Pn sensitized with IgG and IgM anticapsular antibodies caused immune adherence, whereas Pn sensitized with anticell wall IgG did not. This may explain the failure of anticell wall antibody of mediate complement-dependent phagocytosis of Pn in vivo or in vitro. Although anticell wall IgG is capable of activating complement and fixing C3 to Pn, it is not opsonic; the most likely reason is that the nonopsonic antibody mediates C3 deposition in sites on the Pn that cannot interact efficiently with phagocytic cell C3 receptors.

Animals↗

Microcomputer-based technique for 3-D reconstruction and volume measurement of computed tomographic images. Part 2: Anaplastic primary brain tumors.

Serial computed tomography (CT) plays an integral part in monitoring effects of therapy for primary anaplastic brain tumors. Despite advances in CT technology, clinicians often cannot obtain accurate quantitative volume information to complement the qualitative assessment of tumor change. This paper presents a microcomputer-based method that provides both quantitative volume measurements and 3-D reconstructions of primary anaplastic brain tumors based on their hard copy CT or magnetic resonance imaging studies. The findings of this study demonstrate that planimetry is feasible for routine clinical use and is superior in accuracy to the spherical geometric model, which is shown to significantly overestimate tumor volume. The findings of 62 quantitative tumor studies (17 patients) showed a direct relationship between the total tumor volume and the volume of the hypodense intratumor core. There was no evidence of a relationship between the total tumor volume and the amount of peritumor low density (edema).

Astrocytoma↗

Quantitative variations of the C3b/C4b receptor (CR1) in human erythrocytes are controlled by genes within the regulator of complement activation (RCA) gene cluster.

The genetic relationships of quantitative and structural variations of the C3b/C4b receptor (CR1) in human erythrocytes have been analyzed in informative families. Our results demonstrate the existence of multiple discrete quantitative variations of CR1 controlled by a locus, C3bRQ, closely linked to the CR1 structural locus, C3bR. Since the amounts of CR1 produced by each C3bR allele are shown to be independently regulated, we propose that a cis-acting genetic mechanism controls the level of expression of the C3bR alleles, and that this quantitative control plays a major, if not the sole, role in determining the total amounts of CR1 on normal human erythrocytes.

Alleles↗

Bactericidal and opsonizing effects of normal serum on mutant strains of Salmonella typhimurium.

The bactericidal and opsonizing effects of normal human serum on six strains of Salmonella typhimurium LT-2 having different lipopolysaccharide (LPS) composition were demonstrated through five indices. Complement activity in the presence of antibody was important for the opsonization of all six strains and for the bactericidal effect on rough mutants. Complement activity, either in the presence or absence of antibody, was involved in the ingestion strains of SL 901 (SR) and SL 1032 (Rd1) by human neutrophils. Strain SH 5014 (Rb2) was avidly ingested by neutrophils and totally dependent on complement activity in the presence of antibody. The ingestion of strain SH 2201 (S) was also mediated exclusively by complement activity in the presence of antibody but not as efficiently as were rough mutants. Antibody, as demonstrated by quantitative fluorescence, enhanced the complement activity on the ingestion of the S, SR, and Rb2 strains by neutrophils. The intracellular killing of six strains was enhanced significantly by complement activity in the presence of antibody. The overall survival in the presence of serum and neutrophils decreased as the LPS became shorter. Complement activity in the presence of antibody enhanced extracellular killing only for strains SL 901 (SR) and his 515 (Ra). It was shown that there was no difference between SR and Ra strains in all five indices, suggesting that the one additional O-antigen side chain does not make the SR strain more resistant than the Ra strain. Although resistance by S. typhimurium to host defense mechanisms increases as the LPS chain length increases, the specific LPS structure appears to be of greater importance, especially with respect to opsonization.

Antibodies↗

The complement-mediated binding of soluble antibody/dsDNA immune complexes to human neutrophils.

The complement-mediated binding of soluble antibody/3H-dsDNA immune complexes (prepared in vitro) to human polymorphonuclear leukocytes (PMN) has been investigated quantitatively. Studies with isolated complement components in conjunction with experiments on the binding of these complexes to human red blood cells suggest that the binding to both cell types is mediated predominantly by CR1 (C4b-C3b) receptors but that CR3 (iC3b or C3d-g) receptors may play a role in binding to PMN but probably not to RBC. Our results also indicate that under the standard conditions of these assays (37 degrees C, 20 to 40 min incubations) there is no significant internalization of the soluble antibody/dsDNA immune complexes after they are bound by the PMN.

Antigen-Antibody Complex↗

Inhibition of complement by gold sodium thiomalate.

The effect of gold sodium thiomalate on C3 and factor B activation by monosodium urate monohydrate (MSUM) and zymosan was studied using a quantitative immunoelectrophoretic assay for complement activation. C3 and factor B conversion by the classical pathway activator MSUM, was inhibited 50% and 100% by 3.2 x 10(-4)M and 10(-3)M gold sodium thiomalate, respectively. C3 and factor B conversion by the alternative pathway activator, zymosan, was much less susceptible to inhibition by gold. Gold at 10(-3)M, inhibited alternative pathway activation by only 30%. A 50% inhibition would have required 10(-2)M gold. There was no significant inhibition of complement activation through either pathway by less than 10(-4)M gold. Sodium thiomalate alone showed no inhibition. Studies using other crystals and immune complexes were confirmatory. Thus, there was no appreciable inhibition of the complement system at concentrations of gold attainable in the serum of patients receiving chrysotherapy. The in vivo significance of these findings is unknown.

Complement C3↗

[Perimembranous glomulonephritis in heapatitis associated with hepatitis B antigen (author's transl)].

Hepatitis B (HB) antigen was persistently found in two children with perimembranous glomerulonephritis. Soluble immune complexes were demonstrated in both instances. These circulating immune complexes were found only in serum fractions enriched with HB antigen. Immunohistology of sections of kidney demonstrated immune complexes in a granular pattern in the subepithelial regions of the glomerular capillary walls. Fluorescent HB antigen was found in the same region. HB antigen was also detectable in urine. Participation of the complement system in the progress of the disease was demonstrated quantitatively by a decrease in complement factors C1q, C4 and C3 in peripheral blood. Histological, including electromicroscopic, studies in both cases revealed diffuse thickening of the glomerular basement membrane with dense deposits of different extent, and spikes of the basment membrane. These studies strongly suggest an interrelationship between hepatitis with HB antigen and glomerulonephritis.

Adolescent↗

Immunochemical determination of ganglioside GM2, by inhibition of complement-dependent liposome lysis.

Immunochemical quantitative determination of a lipid antigen, ganglioside GM2, has been developed, based on the inhibition of the immune lysis of liposomes containing the antigen in their lipid bilayer. It has been shown that the full expression of the antigenicity of the competing lipid requires its dispersion in accessory lipids. The assay of inhibition of liposome lysis can be used also for the establishment of the antigenic similarity of structurally related lipid antigens.

Animals↗

Judging the 'weight of evidence' in systematic reviews: introducing rigour into the qualitative overview stage by assessing Signal and Noise.

The 'weight of evidence' in a topic area can be judged by assessing the 'Signal' from available research publications and tempering the importance attached by the level of 'Noise' (the inverse of methodological quality). This assessment process has validity and reliability and can be applied to the 'qualitative overview' stage of systematic reviews. This enables the important themes and areas of relevance to the research question to be identified. Important findings from individual papers may also be identified providing further information which may not be evident from quantitative analysis. The findings from these more qualitative stages of analysis complement, but do not replace, quantitative analysis.

Data Interpretation, Statistical↗

Preliminary reports on hyperbaric oxygen therapy in multiple sclerosis.

Preliminary clinical examinations comprised 16 patients suffering from multiple sclerosis, the mean duration of the disease 9.33 years, of the manifestations at different stages of the development--evaluated on the basis of Kurtzke scale. The patients were subjected exclusively to the treatment with oxygen hyperbary--all in all 25-30 exposures, with the intervals of 24 hours, under the O2 pressure of 2 ata. The qualification for the purposes of treatment and the classification of the symptoms present were carried out according to Fisher, the results obtained were evaluated in conformity with standard version of the Disability Status Scale of Kurtzke. Apart from the routine clinical and laboratory tests the programme of the examinations included also a quantitative determination of immunoglobulins level, complement activity as well as the determination of T and B lymphocytes. An eminent change for the better was found in 14 afflicted persons, in one patient after 15 exposures a worsening was observed and the treatment was arrested. As to the immunological parameters investigated, a general decrease of IgG, IgM, IgA in serum, increase of the complement fraction and its 50% hemolysis determined activity were observed, whereas quantitatively investigated T and B lymphocytes did not show any typical changes. The authors discuss the results.

Adolescent↗

A simple alternative pathway for hemolytic assay of human complement component C3 using methylamine-treated plasma.

A quantitative, alternative pathway (AP) hemolytic assay for human complement component C3 has been developed. This AP-C3 assay is inexpensive, rapid, simple, reproducible and insensitive to C3 degradation products. The AP-C3 assay uses rabbit erythrocytes as complement activator and methylamine-treated plasma, depleted of C3 and C4, as complement source. Rabbit erythrocyte sensitivity varies little from batch to batch, and remains unaltered for at least one month in Alsever's solution. Methylamine plasma may be stored at -20 degrees C for 3 months. AP-C3 lysis of 5-25% of erythrocytes is complete in 20 min and does not change subsequently. The AP-C3 assay is optimally stable at 2 mM Mg2+, 5 mM EGTA and at 5 X 10(7) erythrocytes/ml, yet insensitive to at least 20% deviation in these concentrations. The AP-C3 assay is specific to functional C3 and well suited for determination in plasma samples and during C3 preparation. Adding excessive amounts of C3c or plasma components other than C3 does not change the hemolytic response. The level of native C3 in plasma from 14 donors relative to a reference plasma pool ranged from 0.78 to 1.23. The standard deviation of relative C3 determinations did not exceed 2%.

Animals↗

Quantitation of C3 subcomponents on red cells coated with complement in vitro.

In order further to characterise and evaluate the reproducibility of human red cells coated with complement in vitro, the number of molecules of C3 subcomponents/red cell were determined by Scatchard analysis of equilibrium concentrations of bound and free antibody using (125)I-labelled goat anti-rabbit IgG. A 1:1 combining ratio was assumed. Red cells coated via the classical pathway had twice as much bound C3b and C3d as alternative pathway-coated cells. Assays using different anti-C3d sera gave different amounts of bound antigen, but results with any one antiserum versus one cell type were reproducible. Anti-C3d sera raised to C3d-tryp and to C3d-KAF detected significantly different amounts of bound C3d on the same cells. Both trypsinisation and serum KAF treatment of classical pathway-coated cells resulted in marked reduction of C3b molecules/cell (over 90% in both cases). Similar reduction in bound C3b was seen after trypsinisation of alternative pathway-coated cells, but serum KAF treatment of such cells had no significant effect. K(0) values were lower with anti-C3c than with anti-C3d. Anti-C3d K(0) values with the various cells coated with complement in vitro were not statistically different (approximately 10(7) litres/mol), with the exception of trypsinised alternative pathway-coated cells (approximately 10(8) litres/mol, the same order of magnitude observed with cells coated with C3d in vivo). A non-linear relationship between antiglobulin titre and antigen strength was observed. The minimal number of C3d molecules/red cell detectable by agglutination with the various anti-C3d sera ranged from 200 to 670 molecules. The minimal number of C3b molecules detectable by agglutination was approximately 9000 molecules/cell.

Animals↗

Myasthenia gravis: quantitative immunocytochemical analysis of inflammatory cells and detection of complement membrane attack complex at the end-plate in 30 patients.

To clarify the role of cell-mediated versus humoral immune effector responses in myasthenia gravis (MG), we examined the occurrence of inflammatory cells in muscle from 30 patients with MG, determined the site of accumulation of the cells (at or remote from end-plates), enumerated and immunophenotyped those cells at the end-plate, and evaluated the frequency of deposition of the complement membrane attack complex (MAC) at the end-plate. Seven of 30 patients had well-defined collections of mononuclear cells in muscle (lymphorrhages), but these were not topographically related to the end-plates. Twenty of 30 patients had inflammatory cells (mostly macrophages and T cells) at or near end-plates, but these cells were present at less than 10% of the end-plates, and only seldom was there more than one cell at any end-plate. None of the inflammatory cells penetrated the muscle fiber near the end-plate. All end-plates of all patients immunostained for MAC. The findings reconfirm that the predominant immune effector response in MG is humorally mediated. The lymphorrhages in muscle and other tissues are probably a nonspecific indicator of disturbed immune regulation in MG.

Adolescent↗