DNA skin tests in patients with definite or suspected systemic lupus erythematosus and in dermatological control patients. A long-term follow-up study.

This study presents a long-term clinical and immunological follow-up of 62 patients during 1971 and 1973, tested intradermally with DNA derived from calf thymus. The DNA skin test is positive in almost all clear-cut cases of SLE. In addition, the DNA skin test was positive in 16 patients, but the criteria for SLE were not met at the time of testing. During the follow-up, 7 out of these 16 patients developed definite SLE, 2 developed subacute cutaneous LE and 3 developed ANA-negative SLE. This suggests that a positive DNA skin test may precede the development of SLE or some of its subtypes. All our SLE patients with skin test reactivity presented cutaneous disease manifestations suggesting that similar pathogenetic mechanisms may be involved in DNA tests and natural SLE skin lesions. Because the positive DNA skin test showed correlation with ANA, anti-DNA antibodies, cryoglobulins, lupus anticoagulant and depressed C3 and C4 values, humoral factors may be partly responsible. However, DNA skin test reactivity was also positive in ANA-negative SLE, suggesting that other mechanisms may also be involved.

Ligninolytic enzymes of the white-rot fungus Phlebia radiata.

One oxidase (EC 1.10.3.2) and three lignin peroxidases (EC 1.11.1.-) were purified from the culture liquid of the white-rot fungus Phlebia radiata Fr. All the enzymes were glycoproteins. The oxidase had Mr 64,000 and the lignin peroxidases I, II and III had Mr values 42,000, 45,000 and 44,000 respectively. The lignin peroxidases were found to share common antigenic determinants: lignin peroxidases II and III were serologically indistinguishable and lignin peroxidase I was related but distinguishable. The oxidase did not share any immunological properties with the lignin peroxidases. Lignin peroxidases of Phlebia contain protoporphyrin IX as a prosthetic group. In the presence of H2O2 and an electron donor, veratryl alcohol, lignin peroxidases exhibit spectral shifts analogous to those of animal catalase (EC 1.11.1.6). Phlebia enzymes show optimal activity at pH 3-4.5 at 40 degrees C and are stable in the pH range 5-6. They modify Kraft lignin and phenolic compounds containing hydroxy and methoxy groups.

When does rheumatoid disease start?

Stored serum specimens collected in connection with a community-oriented epidemiologic study were available from 30 subjects who later developed seropositive rheumatoid arthritis. In 9 of these pre-rheumatoid specimens, the Rose-Waaler test result was positive, and in 16, the latex fixation test was positive. Two-thirds of the samples were positive when the interval between taking the blood specimen and onset of the disease was less than 4 years, and one-third were positive when the interval was greater than or equal to 4 years. The occurrence of rheumatoid factor preceded the onset of clinical disease more often in males than in females.

Cellobiohydrolase from Trichoderma reesei.

A 1,4-beta-D-glucan cellobiohydrolase (EC 3.2.1.91) was purified from the culture liquid of Trichoderma reesei by using biospecific sorption on amorphous cellulose and immunoaffinity chromatography. A single protein band in polyacrylamide-gel electrophoresis and one arc in immunoelectrophoresis corresponded to the enzyme activity. The Mr was 65 000. The pI was 4.2-3.6. The purified enzyme contained about 10% hexose. The enzyme differs from previously described cellobiohydrolases in being more effective in the hydrolysis of cellulose.

Absence of mutagenic activity of fodder proteins in the Ames Salmonella/microsome test.

The mutagenicities of fodder proteins (Pekilo, L-lysine and Orsan) were tested towards Salmonella typhimurium in the plate-incorporation assay in the presence or absence of metabolic activation with a rat-liver S9 preparation. Filtrates and 2-, 5- and 10-fold-concentrated filtrates of saline- or ethanol-soluble fodder proteins were tested. No mutagenic activity was observed.

Cerebrospinal fluid and acoustic neurinoma specific proteins in perilymph.

White rabbits were immunized with pooled and concentrated cerebro-spinal fluid (CSF) and with tumour homogenate concentrate from specimens taken from five patients with acoustic neurinoma. The absorbed anti-CSF-antitumour antiserum was tested with the micro-immunodiffusion test against normal human serum (NHS), CSF, perilymph and CSF from tumour patients and tumour homogenate. NHS showed no precipitates in any of the tests. One protein band was observed in all the other four reactants. Tumour tissue and perilymph had two proteins in common. Diffusion from the CSF space into the perilymph can thus occur via both the cochlear aqueduct and the internal acoustic meatus.

Immunologic aspects of otitis media.

The cellular immune response in otitis media with effusion consisted of granulocytic cells in the majority (60--70%) of cases, while the monocytic-lymphocytic cells formed the bulk of cells present in 20%. A considerable number (15--20%) of serous, seromucinous and mucoid effusions had sparse cellular populations. T-lymphocytes, marked with alpha-naphthyl-acetate-esterase (ANAE) constituted the majority of lymphocytes and were present in effusion liquids in numbers similar to those in blood. Tests with E-rosettes confirmed the results obtained with ANAE stain. The finding that T-lymphocytes are present in normal numbers may link the mucosal damage to the delayed-type hypersensitivity reaction. Another explanation of mucosal damage may be sought in immune complexes, which have recently been found to be present in many sterile middle ear liquids.

Fluid pathways in temporal bones.

Five temporal bones were serially sectioned and studied concerning spread of erythrocytes and blood-derived precipitate in patients who died from subarachnoid hemorrhage. Erythrocytes followed the natural pathways--the cochlear aqueduct, the cochlear, vestibular, facial and glossopharyngeal nerves, and were demonstrable in the inner ear fluid spaces. The temporal bone marrow spaces were also filled with erythrocytes, particularly in the hypotympanal area. In the microimmunoelectrophoresis, no specific precipitation lines formed between the anti-CSF serum from rabbits and middle ear exudate from human ears with acute otitis media. Although, in animals, middle ear spaces have been shown to be connected to the middle ear space this does not seem to apply to human ears, and CSF fluid components are not involved in the formation of middle ear exudate.

The effect of chemoprophylactic use of rifampin and minocycline on rates of carriage of Neisseria meningitidis in army recruits in Finland.

During an epidemic caused by sulfonamide-resistant group A Neisseria meningitidis (A SuR strain), rifampin (600 mg per day for four days) or minocycline (100 mg every 12 hr for five days) was administered as chemoprophylaxis to 1,540 unvaccinated recruits in the Finnish Armed Forces. Rates of carriage of all strains of N. meningitidis were initially reduced by 78% (from 60% to 13%) in the 389 men receiving rifampin and by 62% (from 70% to 26%) in the 1,151 men receiving minocycline but rose to approximately 30% in both groups four weeks after prophylaxis. The carriage of A SuR strains was similarly reduced. An individual follow-up of 636 trainees demonstrated a high rate of new infections. It is suggested that the long-term inefficiency of rifampin and minocycline is due to their inability to reduce the carriage rates enough to prevent further spread of infection after prophylaxis is descontinued. However, no new cases appeared among the men receiving the prophylaxis. Five strains highly resistant to rifampin were found after the use of rifampin (minimal inhibitory concentration, greater than or equal to 100 microgram/ml), but no minocycline-resistant strains were encountered. No unpleasant side effects were seen in subjects receiving either drug.

Agammaglobulinemia with arthritis and celiac disease developing after infectious mononucleosis. Follow-up study of a case.

A previously healthy 2 1/2-year-old boy from a healthy family developed agammaglobulinemia with arthritis 3 months after infectious mononucleosis (IM). The response of serum immunoglobulins at the initial stage of IM was typical, with greatly elevated IgM and a positive IM-specific heterophil antibody test. A secondary celiac disease was diagnosed one year after IM. Considering the serum immunoglobulin levels and the normal half-lives of IgM and IgG, it seems very probable that the synthesis of immunoglobulins ceased about one month after the onset of IM. The role of suppresor T-cells in the development of acquired secondary agammaglobulinemia is discussed.

A study on the mutagenic activity of styrene and styrene oxide.

Styrene oxide is multagenic, without metabolic activation, to S. typhimurium strains TA 1535 and TA 100, which have been devised to detect mutagens causing base-pair substitutions. Styrene seems to be mutagenic toward the same strains, but only after metabolic activation. The toxicity of both styrene and styrene oxide make the construction of reliable dose-response curves rather difficult. Diethylmaleate and 3,3,3-trichloropropene oxide enhanced the mutagenicity of styrene oxide in the presence of homogenate; this result indicates the participation of epoxide hydratase and glutathione S-oxide transferase in the metabolism of styrene oxide. These two chemicals did not influence the mutagenic activity of styrene. Styrene glycol and 4-tert-butyl-brenzcatechin were not mutagenic to any of the strains studied. Results show that further, more detailed experimental and, possibly, epidemiologic studies are warranted.

Immunosuppressive effect of radiotherapy on patients with lung cancer.

The immunoglobulins A, E, G and M of 25 patients with lung cancer were determined (by radial immunodiffusion) before, during and after radiotherapy. No significant change in any immunoglobulin were noticed overall. In the group with a poor prognosis (survival less than 12 months; 15 patients), there was a significant decrease of IgA and IgM one month after the irradiation. In the group of patients with pulmonary infection (14 patients), the level of IgA, IgG and IgM were lower than in the group without infection throughout the examination period. Cellular immunity measured by the PPD skin test, showed no significant differences between the groups by survival.

Aminotransferases in post-mortem cochlear fluids.

Aspartate and alanine aminotransferase (ASAT, ALAT) activities were measured in human post-mortem sera, cerebrospinal fluid (CSF), perilymph and endolymph. Due to heart and/or liver morbidity during a terminal illness, the ASAT and ALAT serum activities were considerably increased as compared with normal and both were 20--30 times higher (p less than 0.001) than in CSF or inner ear fluids. CSF and inner ear fluids showed mutually similar values.

Penetration of azidocillin into the secretion and tissues in chronic maxillary sinusitis and tonsillitis.

The penetration of azidocillin into the sinus mucosa and secretion as well as into tonsils and adenoids was studied. Altogehter 73 patients were included and they were arranged in four groups according to age, diagnosis and drug dose. The average azidocillin concentration was satisfactory and predictable in all tissues and well over the MIC for most upper respiratory tract pathogens studied. In the maxillary antrum secretion the values were much lower and in many cases under the MIC for hemophilus. This is thought to depend upon the drug's being bound to proteins in the secretions. The clinical results were good in all cases and the contribution of the surgical operation, particularly in providing drainage for the secretion, is obvious.