Synthesis and secretion of gamma-globulin by lymph node cells. II. The intracellular segregation of amino acid-labeled and carbohydrate-labeled gamma-globulin.
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Both synthetic and catabolic processes determine the serum gamma-globulin level. The rate of gamma-globulin synthesis appears to be the primary factor determining the amount of serum gamma-globulin. Increase of gamma-globulin synthesis (as may occur following immunization or development of plasma cell tumor) elevates the serum gamma-globulin level. This, in turn, accelerates the fractional rate of gamma-globulin catabolism. The change in catabolic rate reduces the dimensions of the serum change from that which would occur if synthesis alone determined the serum gamma-globulin level. The present studies indicate the existence of a homeostatic mechanism controlling the rate of gamma-globulin catabolism. The mechanisms of gamma-globulin catabolism are specific and selective. Marked serum increase of other immunoglobulin components (beta(2A)-globulins and gamma(1)-macroglobulins) do not accelerate gamma-globulin catabolism. Similarly, serum albumin increases do not influence gamma-globulin catabolism. The site determining gamma-globulin catabolism is restricted to a part of the gamma-globulin molecule; i.e., on the F piece obtained by papain digestion and, by inference, on the H chains obtained by reduction and alkylation of gamma-globulin molecules.
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We compared the efficacy of intravenous gamma globulin plus aspirin with that of aspirin alone in reducing the frequency of coronary-artery abnormalities in children with acute Kawasaki syndrome in a multicenter, randomized trial. Children randomly assigned to the gamma globulin group received intravenous gamma globulin, 400 mg per kilogram of body weight per day, for four consecutive days; both treatment groups received aspirin, 100 mg per kilogram per day, through the 14th day of illness, then 3 to 5 mg per kilogram per day. Two-dimensional echocardiograms were interpreted blindly and independently by two or more readers. Two weeks after enrollment, coronary-artery abnormalities were present in 18 of 78 children (23 percent) in the aspirin group, as compared with 6 of 75 (8 percent) in the gamma globulin group (P = 0.01). Seven weeks after enrollment, abnormalities were present in 14 of 79 children (18 percent) in the aspirin group and in 3 of 79 (4 percent) in the gamma globulin group (P = 0.005). No child had serious adverse effects from receiving gamma globulin. We conclude that high-dose intravenous gamma globulin is safe and effective in reducing the prevalence of coronary-artery abnormalities when administered early in the course of Kawasaki syndrome.
1. Gamma globulin metabolism and distribution were studied employing rabbit gamma globulin (RGG)I(131) 24 times in 13 control rabbits. Similar studies were performed before and during the ananmestic response in 4 rabbits previously sensitized with a polyvalent pneumococcal vaccine. 2. During the ananmestic response, gamma-globulin levels increased from 1.0 to 6.0 gm/100 ml, and the gamma-globulin pool increased from 0.7 to 4.7 gm/kg. There was no change in the intravascular-extravascular partition of gamma globulin. 3. Gamma globulin degradation increased from 0.06 to 0.33 gm/kg/day during the 28 days of the immunization period while gamma globulin synthesis increased even further to average 0.47 gm/kg/day. Following the attainment of elevated gamma globulin levels the fractional rate of RGG-I(131) turnover increased from 8.0 to 12.5 per cent/day. 4. No differences were noted in the metabolism of homologous or autologous gamma globulin regardless of the allotypic specificities.
Administration of anti-cytomegalovirus gamma globulin has been reported to prevent acute human cytomegalovirus (HCMV) infection in immunocompromised patients. Most likely the gamma globulin acts by its neutralizing activity. However, the antibody titer to HCMV in hyperimmune gamma globulin is usually detected by an enzyme immunoassay (ELISA). We, therefore, compared the ELISA titres with the neutralizing antibody titres in the sera of blood donors and in hyperimmune gamma globulins. A poor correlation between both titres was found. Gamma globulin preparations with identical ELISA titres clearly differed in the neutralizing titre. If neutralization is the important mechanism by which the hyperimmune gamma globulins work, our results would favour a routine testing of the neutralizing antibody titre in HCMV hyperimmune gamma globulins.
Various preparations of gamma-globulin homogeneous in the ultracentrifuge showed a similar content of hexose, hexosamine, fucose, and sialic acid. Subfractionation of Fr. II gamma-globulin by zone electrophoresis revealed multiple components of different mean mobilities but containing similar amounts of carbohydrate. Gamma globulin isolated directly from normal serum by zone electrophoresis showed a heavy component in addition to the usual 7 S material. The heavy component (s(20, w) = 19 S) concentrated by preparative ultracentrifugation was found to be considerably richer in carbohydrate than the rest of the gamma-globulin and accounted for small differences in carbohydrate content between different preparations of gamma-globulin. Pathological sera with marked elevation in gamma-globulin showed a carbohydrate-protein ratio for the gamma-globulin similar to that found for the corresponding 7 S fraction in normal serum. This was only partially true of the myeloma proteins with a mobility in the gamma-globulin region. Certain of these proteins showed slight but significant differences. The myeloma proteins of faster mobility (beta-myelomas) contained considerably more carbohydrate. The possible role of these carbohydrates in accounting for some of the mobility and immunological differences in the myeloma proteins is discussed. The pathological proteins found in two cases of macroglobulinemia showed a high carbohydrate content similar to but slightly lower than the normal 19 S component of gamma-globulin.
The effects of serum proteins on the in vitro hydroxylation pathways of mephenytoin (CYP2C19) and debrisoquine (CYP2D6) were studied to enhance the predictability of in vivo drug metabolism from in vitro assays. Both CYP substrates are known to be weakly bound to albumin and the applicability of the free drug hypothesis was further appraised. Since bovine serum albumin (BSA) is used widely in in vitro assays, a comparison between human and bovine proteins was made. Four major serum proteins were studied: albumin, alpha1-acid glycoprotein (AGP), alpha- and gamma-globulins. Human serum albumin (HSA) inhibited both CYP activities about 20% more than BSA. The addition of human alpha-globulins, but not the bovine protein, resulted in marked reduction of 86% and 41% in CYP2C19 and CYP2D6 activities, respectively. This reduction of activity was strikingly greater than the fraction bound (14 and 22%, respectively). The inhibition was of the competitive type and the Ki values of human alpha-globulins on CYP2C19 and CYP2D6 were found to be 0.45% (4.5 mg/ml) and 3.5% (35 mg/ml), respectively. The effect of both human and bovine gamma-globulins on CYP isoforms was negligible. The Ki values of human and bovine AGP for CYP2C19 were 1.84% (420 microM) and 0.93% (210 microM), respectively. For HSA, human alpha-globulins and human and bovine AGP, the strongly decreased CYP activities in vitro cannot be explained by the free drug hypothesis. A direct interaction of these serum proteins with CYP enzymes is postulated. Differential effects of bovine and human serum proteins and CYP specific inhibition were observed.
To estimate the efficacy of intravenous gamma globulin adjunct therapy on the course of severe neonatal group B streptococcal (GBS) disease, the hospital records of 67 confirmed cases of early-onset GBS sepsis associated with neutropenia were reviewed. Among the 33 infants who had received antibiotic agents without gamma globulin, 13 (39%) died. Among the 34 who had received antibiotic agents plus gamma globulin, 6 (18%) died (p < 0.05). Among 52 low birth weight infants, 5 (20%) of the 25 given gamma globulin died compared with 13 (48%) of the 27 not given gamma globulin (p < 0.03). Neutrophil counts rose more rapidly among survivors who received gamma globulin than among those who did not. This retrospective study suggests that intravenous gamma globulin adjunct therapy for neonatal GBS disease associated with neutropenia promotes a more rapid increase in neutrophil count and improves survival.
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Studied were 15 series of normal bovine gamma-globulin, 5 series of normal swine gamma-globulin, 7 series of Aujeszky gamma-globulin, 6 series of specific gamma-globulin against edema disease of pigs, 4 series of specific gamma-globulin against paratyphus, 5 series of Mixoglobulin-70, and one series of swine poly-globulin. All series of gamma-globulin preparations were studied for the presence of antibodies against Mixovirus parainfluenza-3 through the hemagglutinationinhibition reaction, antibodies against adenoviruses through the precipitation reaction in agar gel, and antibodies against the virus of Aujeszky's disease through the virus-neutralization reaction in tissue cultures.
This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.