[DETERMINATION OF CHORIONIC GONADOTROPINS IN THE COURSE OF PHYSIOLOGIC PREGNANCY WITH AN IMMUNOLOGIC TEST].
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A variety of immunologic approaches may be potentially useful for the immunodiagnosis of cancer. These sensitive procedures might assist in the initial detection, diagnosis, and localization of tumors, and might also be used in determining prognosis and for monitoring cancer patients for recurrence of disease after therapy. The types of approaches and some of the available information regarding their clinical usefulness are reviewed. The main emphasis with potential immunodiagnostic tests has been placed on detection of circulating tumor-associated markers. However, the detection of tumor markers in tissue cells might help in the discrimination between tumor cells and nonneoplastic cells, and also might help in the categorization of the type of cancer. Detection of depressed immunologic competence or in a subpopulation of lymphoid cells may be useful in diagnosis. Humoral or cell-mediated immune responses to tumor-associated antigens have the potential of being very sensitive, specific indicators of neoplastic disease, but most of the tests for these responses are difficult and none has yet been established for use in practical clinical situations.
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Thirteen patients with oral erythema multiforme were assessed immunologically by skin testing and in vitro tests (lymphocyte transformation and rosettes). The results suggested a possible defect in cell-mediated immunity for most patients in this group.
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The aim of this study has been to clarify the immunopathogenesis and diagnosis of cow milk allergy (CMA). Thirty-four children with symptoms suggestive of CMA had a challenge test with cow milk (CM) and an estimation of their immunological response. Nineteen of the 34 children reacted to CM challenge test. We measured serum levels of immunoglobulins G, A, M and E, complement fractions 3 and 4, class specific CM antibodies as well as the numbers of the different lymphocyte subsets and the responses of lymphocytes in whole blood to stimulation by phytohemagglutinin (PHA), concanavalin A (ConA) and beta-lactoglobulin (BLG). Twelve (63%) of the children who reacted had high levels of IgE CM-specific antibodies; they had lower mean levels of serum IgA and lower lymphocyte stimulation indices with BLG and PHA than the rest of the children (37%) who reacted on CM, but were without IgE antibodies. Of these seven children, five gave elevated responses to stimulation with BLG, and in three of six the helper/suppressor lymphocyte ratio rose during the challenge test. Most (10) of 15 children who showed no reaction when challenged with CM at hospital, had earlier had cutaneous symptoms closely related to CM formula feeding. No single laboratory method was sufficient to discriminate between the children who reacted to CM and those who did not. The best combination of tests was measurements of CM-specific IgE and the index of lymphocyte stimulation with BLG. This combination had a sensitivity of 88% and specificity of 67% for predicting a clinical reaction.
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