Treatment of upper lip wrinkles: a comparison of the 950 microsec dwell time carbon dioxide laser to manual tumescent dermabrasion.

BACKGROUND: High-energy pulsed or computer-scanned continuous-wave carbon dioxide (CO2) laser resurfacing has gained popularity as a wrinkle treatment because of its minimal thermal injury and precise control of tissue vaporization depth. Manual tumescent dermabrasion has also been effective for treating facial wrinkles. This is, to our knowledge, the first study comparing the use of CO2 laser to manual tumescent dermabrasion for the treatment of wrinkles on the upper lip. OBJECTIVE: To compare prospectively the clinical efficacy of the 950 microsec dwell time CO2 laser to that of manual tumescent dermabrasion in the treatment of upper lip wrinkles. METHODS: Twenty female subjects with moderate to severe upper lip wrinkles were randomly treated with the 950 microsec dwell time CO2 laser on one side of the upper lip and manual tumescent dermabrasion on the other. RESULTS: The average upper lip laser-treated wrinkle score (0 = none to 5 = severe) decreased from 4.3 +/- 0.2 before treatment to 1.8 +/- 0.3 at 6 months after treatment. The average upper lip dermabrasion-treated wrinkle score decreased from 4.4 +/- 0.2 to 1.5 +/- 0.3. The degree to which the wrinkle score improved after laser treatment compared with that after dermabrasion was not statistically significant (P =.216). CONCLUSION: Manual tumescent dermabrasion and 950 microsec dwell time CO2 laser resurfacing are equally effective for the treatment of upper lip wrinkles.

Treatment of upper lip wrinkles: a comparison of 950 microsec dwell time carbon dioxide laser with unoccluded Baker's phenol chemical peel.

BACKGROUND: The high energy, pulsed, or computer-scanned continuous wave carbon dioxide laser (CO2 laser) has gained popularity as a wrinkle treatment because of its minimal thermal injury and precise control of tissue vaporization depth. Chemical peels such as phenol have also been effective in treating facial wrinkles. This is, to our knowledge, the first study comparing the use of CO2 laser to phenol for treatment of wrinkles on the upper lip. OBJECTIVE: To compare the effectiveness and side effect profile of the 950 microsec dwell time CO2 laser to that of unoccluded Baker's phenol chemical peel in the treatment of upper lip wrinkles. METHODS: Twenty female subjects with moderate to severe upper lip wrinkles were randomly treated with Baker's phenol on one side of the upper lip and the 950 microsec dwell time CO2 laser on the other side. RESULTS: The average upper lip laser-treated wrinkle score (0 = none to 5 = severe) decreased from 4.30+/-0.20 before treatment to 1.11+/-0.28 at 6 months after treatment. The average upper lip phenol-treated wrinkle score decreased from 4.20+/-0.20 to 0.47+/-0.12. The degree in which the wrinkle score improved after phenol treatment compared with that after laser treatment was statistically significant (p<0.03). CONCLUSION: Treatment of upper lip wrinkles with Baker's phenol resulted in greater improvement than treatment with the 950 microsec dwell time CO2 laser.

A mutation in a non-MHC murine cell surface antigen detectable by cytotoxic T lymphocytes.

During the course of screening new T-H-2 region congenic strains of mice constructed from the C57BL/6 and B6-H-2k strains, a new cell surface polymorphism, designated dtc-1, was identified by cell-mediated lympholysis techniques. The dtc-1 antigen can be found on both Con A- and LPS-stimulated lymphoblasts, peritoneal macrophages, and SV40-transformed mouse embryo fibroblasts. Lysis of dtc-1+ targets by CTL is H-2Dk restricted. All inbred strains tested are dtc-1+, with the exception of the B6-H-2k strain, which is dtc-1-, and several congenic strains directly derived from B6-H-2k. Because B6/Boy and AKR/Boy, the parents of the B6-H-2k strain, are dtc-1+, the dtc-1- phenotype may be the result of mutation in the locus specifying the cell surface molecule that carries this antigen. Segregation analysis of the dtc-1+/dtc-1- polymorphism demonstrated that this locus is not linked to T or H-2. The dtc-1 antigen thus identifies yet another cell surface polymorphism and adds another immunologically defined genetic marker to the murine genome. Furthermore, the dtc-1 system indicates the need for reevaluation and restandardization of congenic strains of mice derived from the B6-H-2k congenic strain.

H-2 antigens of certain t and non-t mice react with the same monoclonal antibody.

Monoclonal antibody 212.i.4.2 mediated complement-dependent lysis of spleen and lymph node cells carrying the tw1 , tw12 , tw71 , t6, tw73 , and tLub1 haplotypes, while cells from mice carrying 11 other t haplotypes were not lysed. The antibody also detected an epitope controlled by genes in the H-2Dd region of non-t mice. A molecule of 46,000 molecular weight was immunoprecipitated by 212.i.4.2 from detergent extracts of 125I-labelled spleen cells of +/ tw12 and B10.D2 mice. The H- 2dm2 mutation did not alter the expression of the epitope recognized by 212.i.4.2. However, the H- 2dm1 mutation decreased the reactivity of lymphoid cells with the antibody in cytotoxicity tests, and 212.i.4.2 immunoprecipitated little or no protein from extracts of B10.D2( R106 ) spleen cells which carry the H- 2dm1 mutation.

HLA-DR7-specific monoclonal antibodies and a chimpanzee anti-DR7 serum detect different epitopes on the same molecule.

We describe here two monoclonal antibodies with HLA-DR7 serologic specificity. The antibodies, SFR16-DR7M, a cytotoxic rat IgM antibody of high affinity, and SFR16-DR7G, a noncytotoxic antibody of the rat IgG 2a class, react with only DR7-positive cells in radioimmunoassay. The cytotoxic activity of SFR16-DR7M correlates completely with the presence of the DR7 specificity, and segregates with the DR7-bearing haplotype in a family. SFR16-DR7M precipitates a class II molecule with the electrophoretic characteristics of DR molecules from LG-10, an HLA-DR7 homozygous cell line. SFR16-DR7G completely inhibits the cytotoxicity of SFR16-DR7M, but only partially inhibits the cytotoxicity of a chimpanzee antiserum with DR7 specificity, Gay/Swei. In binding-inhibition studies, binding of SFR16-DR7M to LG-10 cells is only partially inhibited by the chimpanzee antiserum and vice versa. Both SFR16-DR7M and Gay/Swei reciprocally deplete the same class II molecules from a 35S-methionine-labeled detergent-solubilized membrane preparation of the LG-10 cell line. The chimpanzee serum Gay contains antibodies reactive with epitopes on separated DR7 beta chains, while both SFR16-DR7M and SFR16-DR7G bind only to DR7 alpha-beta complexes. These data suggest that at least two allogenic epitopes exist which result in the same serologic specificity, and that these epitopes differ in their requirement for alpha-beta complex formation.

SFR3-DR5, a monoclonal antibody with HLA-DR5 specificity.

We have developed a monoclonal antibody with HLA-DR5 serologic specificity. The antibody, SFR3-DR5, binds specifically to DR5-positive lymphoblastoid cell lines, and immunoprecipitates alpha- and beta-chains characteristic of DR antigens from them. Cytotoxic activity of the antibody segregates with the DR5-bearing haplotype in a family. The antibody reacted with the cells of 16 of 17 DR5 individuals and was negative on all DR5-negative cells tested. SFR3-DR5 reacted weakly with PWM-activated cells of the single DR5 individual whose B lymphocytes were unreactive with the monoclonal antibody by cytotoxicity. Possible interpretations of these results are discussed.

Ra3 skin test response and HLA-A2, antigen E, and IgE: evidence of interactions between antigen E and HLA.

A positive association of Ra3 skin test responses with HLA-A2 has previously been reported to be evident in individuals with low IgE levels and to a greater extent in these individuals than those with high IgE levels. We give evidence based on an analysis of data from 133 individuals that Ra3 response is positively correlated with HLA-A2 among individuals with low Antigen E response and negatively associated with HLA-A2 among individuals with high Antigen E response. Furthermore, we have evidence that any observed interaction between Ra3, IgE, and HLA-A2 can be explained by the correlation between IgE and Antigen E response, and that it is Antigen E response which interacts in the relationship between HLA-A2 and Ra3 skin test response.

Paired H-2-specific monoclonal antibodies react differently to red cells and lymphocytes.

Two hybrid clones from a fusion of C57BL/6 anti-DBA/2 spleen cells and the myeloma line Sp2/0 secrete antibodies reactive with a product of the murine major histocompatibility complex (MHC). The two antibodies are provisionally designated S13.11 and S13.29. Both react in rabbit-complement-mediated cytotoxicity with spleen cells of H-2d, H-2f, H-2r, and H-2p strains. In addition, both antibodies hemagglutinate red blood cells from these strains. S13.11 is also cytotoxic for H-2a, H-2k, H-2u, and H-2v spleen cells but does not hemagglutinate red blood cells from mice bearing these haplotypes. With the exception of H-2v, this strain pattern mimics the public specificity H-28. Quantitative absorption of S13.11 shows that H-2d cells are twice as efficient as H-2k cells in their ability to remove the S13.11 antibody. S13.29 reacts weakly in cytotoxicity with H-2k spleen cells and does not react with cells from H-2u or H-2v. Blocking studies indicate that S13.11 and S13.29 react with the same or a closely related molecule on the cell surface.

Natural killing and antibody-dependent cellular cytotoxicity in specific-pathogen-free miniature swine and germ-free piglets. II. Ontogenic development development of NK and ADCC.

The ontogenic development of natural killing (NK) and antibody-dependent cellular cytotoxicity (ADCC) in germ-free and specific-pathogen-fee (SPF) miniature swine were compared. Activities of NK and ADCC were tested by a short-term (2.5 to 4 h) 51Cr-labelled human myeloid cell line K562 and TNP-conjugated human B-cell line SB as target cells for NK and ADCC, respectively. Animals obtained by aseptic hysterectomy 3-5 days prior to term showed ADCC activities similar to adult levels but lacked NK activity. Hysterectomy-derived piglets which were colostrum-deprived and maintained in germ-free isolators developed NK activity at 3-4 weeks of age. In comparison, naturally-farrowed, colostrum-fed piglets maintained in our SPF facility developed NK activity at 2-3 weeks of age. Thereafter, there was no significant difference in the levels of either NK or ADCC between germ-free and SPF animals. This suggests that microbial flora and environment do not affect the development of effector cells for ADCC but do play some role in the maturation of NK cells during ontogeny. The difference in ontogeny of NK an ADCC further support our previous suggestion that the effector cells for NK and ADCC in swine are distinct sub-populations.

HLA antigens and immunoglobulin allotypes in patients with malignant melanoma.

HLA antigens and Gm, A2m, and Km allotypes were examined in Caucasian patients with malignant melanoma. No significant associations were found for any of the HLA antigens tested. Significant association was found with Gm(2), and the relative risk for individuals with this marker was calculated at 1.9. The data indicate that Caucasians positive for Gm(2) are almost twice as likely to develop malignant melanoma as those without this marker.

Interaction of cytotoxic T lymphocytes with target cells. I. Specific inhibition by detergent-solubilized, partially purified mouse histocompatibility antigens.

H-2 antigens from EL4 (H-2b) and RLmale 1 (H-2d) leukemias were solubilized with deoxycholate and partially purified based on their adherence to a Lens culinaris hemagglutinin column. In double reciprocal experiments we have shown that these preparations specifically inhibit conjugate formation between target cells and alloimmune peritoneal lymphocytes, a preparation rich in cytotoxic T lymphocytes.

Viral infection-homograft interactions in a murine model.

The effects on some host defenses of murine cytomegalovirus (MCMV) and(or) EL(4), a mouse ascites homograft, were studied in mice. Assays of cellular and humoral immunity in response to either or both of these perturbations were carried out by quantitation of various immune activities.Limited studies demonstrated no effect of EL(4) inoculation on the host response to MCMV by organ viral titer, duration of viral persistence, or anti MCMV complement-fixing antibody titer. Prior infection with MCMV, however, resulted in greatly reduced numbers of splenocytes, the source in this study of immune effector cells. Residual splenocytes demonstrated less response to both phyto-hemagglutinin and lipopolysaccharide, particularly in the 2-3-wk interval after infection. Similarly, responder cells in mixed lymphocyte cultures were less reactive when derived from infected animals. Lymphocyte-mediated cytolysis of EL(4) was significantly less in mice infected on the day of and 7, 14, and 21 days before the tumor homograft with a return to control levels by 28 days. 90% of the cell-mediated cytolysis could be eliminated by treatment with anti-theta serum. Serum-mediated cytolysis of EL(4) was also reduced in infected animals. No suppressor cells or serum inhibitory factors could be identified in infected animals. Although alternative explanations exist, this study suggests that in infected animals there is a significant reduction in both the number and function of bone marrow-derived and thymus-derived cells directed against the alloantigens in EL(4).

Target antigens of cell-mediated lympholysis discrimination of HLA subtypes by cytotoxic lymphocytes.

The evolution of HLA specificities has been toward ever-increasing refinement; one example is a subdivision of HLA-B5, the supertype specificity originally defined as 4a. HLA-B5 can now be further subdivided into Bw51 amd Bw52 by serologic means. Whereas the specificity Bw51 can be detected by specific sera, the identification of Bw52 must frequently be deduced from knowledge of B5 and Bw51, although serology has progressed rapidly. There has been no comparable development in identifying fine specificities by cellular cytotoxicity in populations. We have now found that cytotoxic effectors of exquisite specificity can be generated against Bw52 by sensitization of cells from a Bw51 donor and vice versa; Bw51 and Bw52 can in this way be recognized with equal ease. This may set a precedent for recognizing fine specificities of other HLA antigens that cannot yet be identified serologically or can be identified only imprecisely. These fine distinctions may have great relevance in allotransplantation and in understanding disease susceptibility.

Natural killing and antibody-dependent cellular cytotoxicity are independent immune functions in the Minnesota miniature swine.

Peripheral blood lymphocytes from Minnesota miniature pigs were tested for natural killing (NK) and antibody-dependent cellular cytotoxicity (ADCC) in a 2- to 4-hr 51Cr release assay against human myeloid and lymphoid tumor target cells. Adult specific pathogen-free and germfree animals exhibited normal levels of activity in both assays. In addition, the NK and ADCC activities of peripheral blood lymphocytes from colostrum-deprived newborn piglets were examined. These animals were obtained by hysterectomy and previously shown to be immunologically "virgin." We found that these newborn piglets exhibited normal ADCC but lacked NK activity. The differences in the ontogeny of the two activities suggest that they are distinct. Preliminary effector cell characterization studies suggest that: (i) NK and ADCC in the pig are physically not separable; (ii) the majority of the cytotoxic activity on a cell-per-cell basis is mediated by the non-T lymphocyte fraction; and (iii) the rosetted T cells, which account for about 60% of the total pig peripheral blood lymphocytes, have low but demonstrable cytotoxic activity as well.

Induction of allogeneic unresponsiveness in adult dogs. Role of non-DLA histocompatibility variables in conditioning the outcome of bone marrow, kidney, and skin transplantation in radiation chimeras.

Exposure to supralethal total body irradiation and transplantation of bone marrow from a DLA- and pedigree-identical donor have regularly produced successful engraftment and the establishment of stable long-term chimerism in beagles of the Cooperstown colony. Bone marrow allografts performed in pairs of dogs bearing identical DLA haplotypes derived from different pedigree origins (i.e., different classes of the same haplotype) yielded two different results. Depending upon the particular haplotype pedigree combination used, such transplants either led to long-term chimerism or to failures of engraftment, secondary disease, and death of the recipients (i.e., pedigree-incompatible combinations). Radiation chimeras given bone marrow from a DLA-and pedigree-identical donor were challenged within 8-12 h after marrow transplantation with a renal allograft obtained from another DLA- and pedigree-identical donor. The recipients have remained unresponsive to such renal allografts and have survived indefinitely with normal renal function. In contrast, renal allografts obtained from donors bearing the same DLA haplotypes derived from pedigree-incompatible sources were rejected within 25-50 days after transplantation. The long-term surviving recipients have also been unresponsive to skin allografts obtained from their donor of marrow and the kidney donor. Skin grafts obtained from other DLA- and pedigree-identical dogs were rejected within 13-41 days, and grafts from DLA-incompatible donors survived for 10-25 days. These results highlight the potential importance of genetically controlled histocompatibility determinants other than DLA in conditioning allograft reactivity. The determinants uncovered in the present study appear to be linked to the DLA complex, as demonstrated by the ability of the pedigree origins of DLA haplotypes present in individual dogs to serve as an effective marker system for such non-DLA antigen(s). The results also point to the potential usefulness of the early postirradiation period for the induction of allogeneic unresponsiveness in large adult mammals.

Natural killing in immunodeficient patients.

Natural killing (NK) capacity was evaluated in peripheral blood mononuclear cells from 14 patients with well defined primary immunodeficiency disorders and compared with the activity of those cells in antibody-dependent cell-mediated cytotoxicity (ADCC) assays against antibody-coated erythrocyte (killed primarily by monocytes) and lymphoid or tumor targets (killed exclusively by lymphoid cells). A selective inability to lyse antibody-coated lymphocyte targets was observed with cells from patients with x-linked agammaglobulinemia, suggesting the involvement of either a different lymphocyte subpopulation or membrane receptor for NK and ADCC, or that a different functional susceptibility exists for the two types of killing. The only immunodeficiency state in which lymphocyte NK activity was found to be lacking was severe combined immunodediciency disease.