抗顶体反应人精子单克隆抗体的制备和鉴定

精子从男性生殖道释放后必须经过获能和顶体反应，才能与卵子结合。获能和顶体反应后，精子细胞内和精子表面的许多大分子都会发生改变。利用这些变化，可探索新的避孕方法和男性不育诊断及治疗的新途径。本文将正常人精子于体外在BWW－BSA培养基中获能，用钙离子载体A23187诱导人精子进行顶体反应，以三染和金霉素荧光染色两种方法检测这些精子的顶体反应率为50％左右，然后用这些经顶体反应处理的新鲜人精子（AR sperm）作为抗复，腹腔免疫Balb/C小鼠，利用最近发展起来的半固体培养及普通的液体培养方法制备单抗。分别用未经任何处理的人精子（NT sperm）及上述顶体反应的人精子包被酶标板，用ELISA法检测所得杂交瘤细胞分泌的抗体，得到了近百株阳性杂交瘤，其中已克隆并得到腹水的有23株，并对这些单抗进行了以下鉴定：腹水滴度测定；抗体分类；与人白细胞系U937，Raji和Jurkat的交叉反应；在NT和AR人精子、树（左鼠右句）和小鼠精子上的荧光定位；单抗对人精子的凝集（SA）和制动（SI）试验；免疫印迹测定单抗相应抗原的分子量。主要结果如下：1.单抗与NT和AR精子反应的ELISA结果表明，有12个单抗主要与AR精子抗原发生反应（A组抗体），6个单抗主要与NT精子抗原反应（B组抗体），而另外5个则与这两种精子抗原都呈阳性反应（C组抗体）。2.在得到的23个单抗中，绝大多数（21个）为IgM，只有两个分别是IgC_1和IgG_(2a)。3.23个单抗与白细胞系的交叉反应强度不同。A组单抗的交叉反应有的较强，有的较弱，有的居中；B组单抗的交叉反应为弱阳性或阴性；C组单抗则呈现要么很强、要么很弱的交叉反应。4.所得单抗的荧光定位主要在赤道板和中段，未发现定位于顶体及顶体后的单抗，而国内外其他实验室已获得的单抗，主要定位在顶体。某些单抗在两种不同精子（NT sperm, AR sperm）上有不同的荧光定位。这些结果表明，AR精子的免疫原性是十分特殊的，它明显不同于NT精子。5.有9个单抗显示较强的精子凝集作用，另有9个单抗的凝集作用稍弱，未发现有精子制动效应的单抗。6.免疫印迹结果表明，有9个单抗的靶抗原是蛋白质类物质，其分子量为16－146kDa，其余14个单抗的免疫印迹呈阴性反应。有关这些单抗及其抗原的鉴定仍在进行中。其中10个单抗已送世界卫生组织（WHO），参与WHO的抗人精子抗原的单克隆抗体的研究计划。

抗小鼠乳酸脱氢酶C4（LDH-C4）IgA单克隆抗体的制备及其对精子功能的影响

乳酸脱氢酶C4 （LDH-C4）是一种人和哺乳动物精子特有的乳酸脱氢酶同功酶。用纯化的小鼠LDH-C4 免疫动物，有一定的避孕效果。这种避孕效果与血清特异性抗体水平并不完全一致。这可能是由于受精过程是在生殖道内进行的，而生殖道内又有粘膜免疫因素存在。IgA抗体是生殖道内的主要抗体成分，研究抗LDH-C4 IgA抗体的抗精子作用有助于了解局部分泌性免疫系统在抗精子免疫避孕中的作用。由于足够量的特异性IgA抗体难于从动物或人粘膜分泌液中分离到，为了获得供体内外试验用的该种抗体，直接证明它在抗生育方面的作用，我们采用一种特殊的免疫方法制备了一系列的抗LDH-C4的单克隆抗体，包括6株IgA和9株IgM。这种免疫方法的主要特点是将抗原直接注射到派伊尔氏淋巴小结（PP）或小肠腔内。ELISA检测表明，按这种方法免疫后，分泌IgA的克隆出现的比例明显高于常规免疫的结果。这是因为PP是粘膜免疫的中枢，其中含有大量的IgA前体细胞，直接将抗原注射到PP内有助于刺激IgA前体细胞的分化和增殖，诱导局部分泌性免疫反应。我们用所得到的单克隆抗体研究了LDH-C4在人，小鼠和树鼩精子表面的定位。结果表明，大多数单克隆抗体可以结合到这些精子的表面；不同的单抗在同一物种的精子表面呈现不同的结合区域。这一方面说明来源于人，小鼠和树鼩的LDH-C4的抗原决定簇有很高的同源性；另一方面提示LDH-C4在精子表面不同的区域所暴露的抗原决定簇不同。初步的功能试验表明，某些抗LDH-C4的IgA单克隆抗体可以凝集或制动精子，说明生殖道内的IgA抗体可以通过凝集和制动作用来影响精子的功能，从而影响精子的受精力。

Immunoprotective analysis of VhhP2, a Vibrio harveyi vaccine candidate

VhhP2 is an Outer membrane protein identified in a pathogenic Vibrio harveyi strain, T4, isolated from diseased fish. When used as a Subunit Vaccine, purified recombinant VhhP2 affords high level of protection upon Japanese flounder against V harveyi challenge. Vaccination with VhhP2 induced the expression of a number of immune-related genes, especially those encoding immunoglobulin M (IgM) and major histocompatibility complex (MHC) II alpha. A VhhP2 surface display system, in the form of the fish commensal strain FIR harboring the vhhP2-expressing plasmid pJVP, was constructed. PF3/pJVP is able to produce and present recombinant VhhP2 on cell surface. Vaccination of fish with live PF3/pJVP via intraperitoneal injection elicited Strong immunoprotection. Vaccination of fish orally with live PF3/pJVP embedded in alginate microspheres also induced effective immunoprotection. In addition, a VhhP2-based surface display system was created, in which VhhP2 serves as a carrier for the Surface delivery of a heterologous Edwardsiella tarda immunogen, Et18, that is fused in-frame to VhhP2. DH5 alpha/pJVP18, which expresses and surface-displays the VhhP2-Et18 chimera, proved to be an effective vaccine that call protect fish against infections by V. harveyi and E. tarda to the extents comparable to those produced by vaccination with purified recombinant VhhP2 and Et18, respectively. These data suggest that VhhP2 may be applied as a vaccine and a vaccine carrier against infections by V. harveyi and other pathogens such as F. tarda. (C) 2009 Elsevier Ltd. All rights reserved.

Identification and analysis of a CpG motif that protects turbot (Scophthalmus maximus) against bacterial challenge and enhances vaccine-induced specific immunity

Oligodeoxynucleotides (ODNs) containing unmethylated CpG motifs in certain contexts are known to be immunostimulatory in vertebrate systems. CpG ODNs with immune effects have been identified for many fish species but, to our knowledge, not for turbot. In this study, a turbot-effective CpG ODN, ODN 205, was identified and a plasmid, pCN5, was constructed which contains the CpG motif of ODN 205. When administered into turbot via intraperitoneal (i.p.) injection, both ODN 205 and pCN5 could (i) inhibit bacterial dissemination in blood in dose and time dependent manners, and (ii) protect against lethal bacterial challenge. Immunological analyses showed that in vitro treatment with ODN 205 stimulated peripheral blood leukocyte proliferation, while i.p. injection with ODN 205 enhanced the respiratory burst activity, chemiluminescence response, and acid phosphatase activity of turbot head kidney macrophages. pCN5 treatment-induced immune responses similar to those induced by ODN 205 treatment except that pCN5 could also enhance serum bactericidal activity in a calcium-independent manner. To examine whether ODN 205 and pCN5 had any effect on specific immunity, ODN 205 and pCN5 were co-administered into turbot with a Vibrio harveyi subunit vaccine, DegQ. The results showed that pCN5, but not ODN 205, significantly increased the immunoprotective efficacy of DegQ and enhanced the production of specific serum antibodies in the vaccinated fish. Further analysis indicated that vaccination with DegQ in the presence of pCN5 upregulated the expression of the genes encoding MHC class II alpha, IgM, Mx, and IL-8 receptor. Taken together, these results demonstrate that ODN 205 and pCN5 can stimulate the immune system of turbot and induce protection against bacterial challenge. In addition, pCN5 also possesses adjuvant property and can potentiate vaccine-induced specific immunity. (C) 2010 Elsevier Ltd. All rights reserved.

鱼类疫苗的研究：I: 海水鱼类病原菌乳化口服疫苗的研究；II：迟缓爱德华氏菌和嗜水气单胞菌外膜蛋白疫苗的研究

本论文的目的是研究几种病原菌口服疫苗接种鱼类的免疫效果，并从常见病原菌株中筛选几个具有较好保护效果的蛋白抗原，利用口服免疫的方式，接种养殖动物，并检测免疫效果。 以10号白油为有机溶剂，采用搅拌与均浆方法制备鳗弧菌M3和SMP1的油乳化二价疫苗，用饵料包埋后以口服途径免疫养殖大菱鲆，评价免疫大菱鲆的免疫应答和疫苗的保护效果。结果显示，以油乳化和未油乳化疫苗分别连续口服免疫大菱鲆一周后，在后肠组织，乳化疫苗刺激产生的非特异性活力、特异性抗体水平均高于未乳化疫苗；而在血清，两种疫苗引起的两种酶的活力、SMP1抗体水平没有变化，但在乳化疫苗免疫的大菱鲆检测到明显高于未免疫对照大菱鲆的M3抗体水平。大菱鲆后肠组织原位杂交结果显示，口服免疫的大菱鲆后肠褶皱有IgM抗体的产生和分布。其中，乳化疫苗免疫大菱鲆的IgM抗体的产生和分布水平高于未乳化疫苗免疫的大菱鲆。攻毒实验显示，乳化疫苗免疫的大菱鲆对M3和SMP1的感染分别获得100%和50%的免疫保护率，而未乳化疫苗获得的免疫保护率分别为57.9%和0%，表明乳化疫苗比未乳化疫苗更有效地保护大菱鲆、抵抗病原的感染。在乳化疫苗免疫持续期的研究中，免疫的大菱鲆后肠在免疫后120天仍能检测到抗体效价，在免疫后90天还能观察到一定的免疫保护效果。免疫30天、60天、90天和120天的大菱鲆分别获得100%、66.7%、36.7%和13.3%的免疫保护力。 以鳗弧菌M3和SMP1、链球菌CF、迟缓爱德华菌SMW7作为细菌抗原制备油乳化多价口服疫苗和轮虫携带疫苗，口服途径免疫养殖大菱鲆与大菱鲆初孵仔鱼。结果显示，在免疫大菱鲆后肠可检测到抗M3抗体水平的提高（P<0.05），而在其胆汁、鳃、中肠、体表黏液、前肠与血清中抗体效价变化与对照组没有显示出差异；没有检测到免疫大菱鲆后肠抗SMP1、SMW7、CF抗体效价。M3浸泡攻毒实验显示，口服免疫的大菱鲆获得了100%的免疫保护力；在M3注射攻毒和SMP1、CF、SMW7浸泡攻毒大菱鲆的实验中，在每个攻毒组中，免疫组大菱鲆开始死亡的时间都要比对照组有不同程度的延迟，但攻毒大菱鲆都发生死亡，不能显示出与对照组的差异。轮虫携带免疫的结果显示，免疫的大菱鲆初孵仔鱼并未获得较好的保护效果，与对照大菱鲆没有体现出差异。 从致病性病嗜水气单胞菌（Aeromonas hydrophila）LSA34克隆并表达ahaI基因和gapA基因，从迟缓爱德华菌（Edwardsiella tarda）LSE40克隆并表达eseB，将所得蛋白分别通过腹腔注射途径免疫大菱鲆，检测蛋白的免疫原性和免疫保护。结果在免疫后7天就可以检测到AhaI、GapA蛋白免疫组大菱鲆产生的抗体，至第40天可以检测到明显的保护性抗体，之后抗体效价增加明显，直至第60天时达到最高值。EseB免疫的大菱鲆第一次免疫后15天就有较高的抗体效价产生，明显高于对照组大菱鲆血清抗体效价，到距第一次免疫60天时，抗体效价达到最高值。攻毒实验显示，与对照组相比，AhaI免疫组和GapA免疫组对LSA34感染的免疫保护力分别为80%和100%；AhaI免疫组和GapA免疫组对LSE40感染的免疫保护力分别为30%和10%。，而对照组牙鲆对人工攻毒不具有保护力。以AhaI和GapA作为疫苗免疫大菱鲆，使大菱鲆获得了对嗜水气单胞菌LSA34较高的免疫保护；而对迟缓爱德华氏菌LSE40的交叉保护能力没有明显提高。EseB免疫的大菱鲆在攻毒实验中并没有显示出较好的保护效果，与对照组相比，只是在死亡时间上有所延迟。 以从致病性嗜水气单胞菌中克隆的ahaI和gapA基因表达出的蛋白为蛋白抗原制备油乳化疫苗，用饵料包埋后以口服途径免疫养殖牙鲆，评价免疫牙鲆的免疫应答和疫苗的保护效果。结果显示，以油乳化和未油乳化疫苗分别免疫牙鲆一周后，在后肠组织，AhaI和GapA乳化疫苗免疫组牙鲆检测到抗体，且分别高于AhaI和GapA未乳化疫苗免疫的牙鲆；而在血清，GapA的两种疫苗引起的GapA抗体水平没有变化；但在AhaI乳化疫苗免疫的牙鲆第21天和第35天的血清中检测到高于未免疫对照牙鲆的AhaI抗体水平，AhaI未乳化疫苗免疫牙鲆血清对照组相比没有检测到AhaI抗体水平的变化。

中国对虾病害的免疫防治研究

从不同方面研究了中国对虾免疫系统的组成及作用特点，并研究了天然免疫药物经口服后，对中国对虾免疫系统的作用。从提高对虾的自身免疫力入手，探讨全面有效地防治病害的新途径。用纸片法定量测定了11种天然免疫药物对弧菌的体外抑制效果，结果表明，有5种属高度敏感药物，其效果优于绝大多数抗菌素，可作为高效、低毒的天然抗菌药物应用于对虾养殖。于1994年4-9月，以海捕亲虾和养殖对虾为材料，用单向免疫扩散法（SRID）测定了不同机体状态对虾中的血淋巴因子，并进行了酚氧化酶（PO）活性测定及特性研究。在此基础上，以数种天然药物口服免疫养殖对虾后，运用SRID测定血淋巴免疫因子和运用改进后的方法测定PO活性。结果表明，对虾血淋巴中存在类似IgM样的物质，酚氧化酶在血细胞中以酶原形式存在，而在正常血清中也表现活力。类IgM的SRID测定及血清中PO活性测定可作为衡量对虾免疫功能的定性参考。口服免疫药物对中国对虾的免疫系统有激活作用。于1992年4月以海捕亲虾为材料，对其血淋巴中的抗菌、溶菌活力及PO活力进行了测定，并研究了经注射大肠杆菌、弧菌及酵母聚糖等刺激或感染后，上述活力的变化规律。结果表明，抗菌、溶菌活力变化与对虾免疫功能的增强或减弱呈相关性。可以此作为定量指标，研究对虾的机体状态、抗病机制及免疫药物的作用机理等。于1992年8-9月间，使用复合口服免疫药进行对虾免疫的中间试验，通过现场观测对虾的发病率、生长及增重速度，以及测定对虾体内的抗菌、溶菌活力和PO活力，证实口服免疫可显著提高对虾的抗病防病能力，并具有明显的促生长作用，可应用于大面积养殖。研究和实践表明，可以运用免疫学方法提高对虾的自身免疫力，从而全面有效地防治对虾病害。

心理干预对癌症病人生活质量和免疫功能作用的研究

A set of tools of clinical psychological intervention for cancer patients had been composed for the first time in the form of a manual with three tapes and some pictures. The cancer patients during chemotherapy were treated by psychological intervention via the tools in group and individual therapy. QLQ-C30, POMS-SF and DWI-CI were first recommended and used as indicators for measuring the results of QoL, emotion and coping method in cancer patients in Chinese mainland. NK cell activity and IgG、IgM, IgA were used to measure the immune function. 120 cancer chemotherapy patients were randomly assigned to one of four conditions formed by a 2 (pre-chemotherapy and post-chemotherapy) *2 (experimental and control group) factorial design. The effect of psychological intervention on quality of life and immune function for cancer patients was investigated as well as the mediate role of coping method and personality and their factors. The efficiency of the tools was verified. The major conclusive results drawn out from the study were: 1. After treated by psychological intervention for three months, the status of quality of life and the symptoms of the patients during the chemotherapy was improved accompanying with the increase of immune parameters, especially the NK cell activity. The influential way of the factors, which effected on the effect of psychological intervention on the quality of life, immune parameters and coping methods, was synthetic. There was obvious mutual effects among the factors. 2. The patients of experimental group used more the active behavior, more the active cognition and less the avoidance coping method than those in control group. 3. The results of measurement showed that the personality of the caner patients was of obvious concealing and hiding. 4. Quality of Life Questionnaire-Core 30(QLQ-C30) was suitable for the cancer patients with great efficiency in Chinese mainland although the scale of SF needed to be revised in the light of Chinese culture.

Selective defect of anti-pneumococcal IgG in a patient with persistent polyclonal B cell lymphocytosis.

BACKGROUND: Persistent polyclonal B cell lymphocytosis (PPBL) is a rare condition characterized by increased IgM and large excess of B cells with an IgD(+) CD27(+) phenotype. In normal individuals, these cells play a central role in the defense against pneumococcal infection. So far, few studies have characterized humoral immune responses in PPBL patients. We therefore measured IgG directed against S. pneumoniae antigens in a 51 yr-old woman with PPBL before and after vaccination with a pneumococcal 23-valent polysaccharide vaccine. METHODS: Antibodies against pneumococcal antigens were measured first with an overall immunoassay using microplates coated with the 23-valent pneumococcal vaccine. A serotype-specific test was also performed according to the WHO consensus protocol. RESULTS: Despite a large number of IgD(+) CD27(+) cells, our patient had low baseline titers of IgG directed against pneumococcal antigens and did not significantly respond to a 23-valent polysaccharide vaccine against S. pneumoniae. On the contrary, she had good titers of IgG directed against tetanus toxoid. CONCLUSION: IgM(+) IgD(+) CD27(+) cells which accumulate in this patient with typical PPBL patient failed to perform IgG isotype switch after a polysaccharide vaccine. The potential mechanisms and relationships with the main features of PPBL are discussed. Further studies on a larger number of similar patients are needed.

Evolution of immunoglobulin and mannose binding protein levels after renal transplantation: association with infectious complications.

Hypogammaglobulinemia (hypo-Ig) and low mannose binding protein (MBP) levels might be involved in the infectious risk in renal transplantation. In 152 kidney transplant recipients treated with calcineurin inhibitors (CNI) and mycophenolate mofetil (MMF), during the first year, we prospectively recorded the incidence of hypogammaglobulinemia, and low MBP levels. Their influence on infectious complications was evaluated in 92 patients at 3 and 12 months (T3 and T12). The proportion of deficiency increased significantly: hypo-IgG: 6% (T0), 45% (T3), and 30% (T12) (P < 0.001); hypo-MBP: 5%, 11%, and 12% (P = 0.035). Hypo-IgG at T3 was not associated with an increased incidence of first-year infections. A significantly higher proportion of patients with combined hypogammaglobulinemia [IgG+ (IgA and/or IgM)] at T3 and with isolated hypo-IgG at T0 developed infections until T3 compared with patients free of these deficits (P < 0.05). Low MBP levels at T3 were associated with more sepsis and viral infections. Hypogammaglobulinemia is frequent during the first year after renal transplantation in patients treated with a CNI and MMF. Hypo-IgG at T0 and combined Igs deficts at T3 were associated with more infections. MBP deficiency might emerge as an important determinant of the post-transplant infectious risk.

IL-12 inhibits in vitro immunoglobulin production by human lupus peripheral blood mononuclear cells (PBMC).

Systemic lupus erythematosus (SLE) is a prototypical autoimmune disease characterized by polyclonal B cell activation and by the production of anti-double-stranded (ds) DNA antibodies. Given the inhibitory effects of IL-12 on humoral immune responses, we investigated whether IL-12 displayed such an activity on in vitro immunoglobulin production by SLE PBMC. Spontaneous IgG, IgG1, IgG2, IgG3 and IgM antibody production was dramatically reduced by addition of IL-12. These results were confirmed by Elispot assays detecting IgG- and anti-dsDNA-secreting cells. While IL-6 and TNF titres measured in PBMC supernatants were not modified by addition of IL-12, interferon-gamma (IFN-gamma) titres were up-regulated and IL-10 production down-regulated. Since addition of IFN-gamma did not down-regulate immunoglobulin production and since the inhibitory activity of IL-12 on immunoglobulin synthesis was not suppressed by anti-IFN-gamma antibody, we concluded that the effect of IL-12 on immunoglobulin production was not mediated through IFN-gamma. Our data also argue against the possibility that down-regulation of endogenous IL-10 production was responsible for the effect of IL-12. Thus, inhibition of IL-10 production by IFN-gamma was not accompanied by inhibition of immunoglobulin production, and conversely, restoration of IL-10 production by anti-IFN-gamma antibody did not suppress the inhibitory activity exerted by IL-12 on immunoglobulin production. Taken together, our data indicate that reduction of excessive immunoglobulin and anti-dsDNA antibody production by lupus PBMC can be achieved in vitro by IL-12, independently of IFN-gamma and IL-10 modulation.

Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania.

Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, P = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating.

Costimulation blockade alters germinal center responses and prevents antibody-mediated rejection.

De novo donor-specific antibody (DSA) after organ transplantation promotes antibody-mediated rejection (AMR) and causes late graft loss. Previously, we demonstrated that depletion using anti-CD3 immunotoxin combined with tacrolimus and alefacept (AMR regimen) reliably induced early DSA production with AMR in a nonhuman primate kidney transplant model. Five animals were assigned as positive AMR controls, four received additional belatacept and four received additional anti-CD40 mAb (2C10R4). Notably, production of early de novo DSA was completely attenuated with additional belatacept or 2C10R4 treatment. In accordance with this, while positive controls experienced a decrease in peripheral IgM(+) B cells, bela- and 2C10R4-added groups maintained a predominant population of IgM(+) B cells, potentially indicating decreased isotype switching. Central memory T cells (CD4(+) CD28(+) CD95(+)) as well as PD-1(hi) CD4(+) T cells were decreased in both bela-added and 2C10R4-added groups. In analyzing germinal center (GC) reactions in situ, lymph nodes further revealed a reduction of B cell clonal expansion, GC-follicular helper T (Tfh) cells, and IL-21 production inside GCs with additional belatacept or 2C10R4 treatment. Here we provide evidence that belatacept and 2C10R4 selectively suppresses the humoral response via regulating Tfh cells and prevents AMR in this nonhuman primate model.

Antibody deficiency due to a missense mutation in CD19 demonstrates the importance of the conserved tryptophan 41 in immunoglobulin superfamily domain formation.

Immunoglobulin superfamily (IgSF) domains are conserved structures present in many proteins in eukaryotes and prokaryotes. These domains are well-capable of facilitating sequence variation, which is most clearly illustrated by the variable regions in immunoglobulins (Igs) and T cell receptors (TRs). We studied an antibody-deficient patient suffering from recurrent respiratory infections and with impaired antibody responses to vaccinations. Patient's B cells showed impaired Ca(2+) influx upon stimulation with anti-IgM and lacked detectable CD19 membrane expression. CD19 sequence analysis revealed a homozygous missense mutation resulting in a tryptophan to cystein (W52C) amino acid change. The affected tryptophan is CONSERVED-TRP 41 located on the C-strand of the first extracellular IgSF domain of CD19 and was found to be highly conserved, not only in mammalian CD19 proteins, but in nearly all characterized IgSF domains. Furthermore, the tryptophan is present in all variable domains in Ig and TR and was not mutated in 117 Ig class-switched transcripts of B cells from controls, despite an overall 10% amino acid change frequency. In vitro complementation studies and CD19 western blotting of patient's B cells demonstrated that the mutated protein remained immaturely glycosylated. This first missense mutation resulting in a CD19 deficiency demonstrates the crucial role of a highly conserved tryptophan in proper folding or stability of IgSF domains.

A study of HPV 1, 2 and 4 antibody prevalence in patients presenting for treatment with cutaneous warts to general practitioners in N. Ireland

Three hundred and seventy-six patients attending their general practitioner with cutaneous warts at five health centres in Northern Ireland were screened for human papilloma virus (HPV) types 1 and 2 IgM antibody using an indirect immunofluorescence test. Eight-eight (23.4%) patients were positive for HPV type 1 IgM and 156 (41.5%) for HPV type 2 IgM. HPV 1 IgM antibody was significantly more likely to be associated with plantar warts than warts elsewhere (P less than 0.0001). HPV 2 IgM was present in 45 (34.1%) patients with plantar warts and 99 (45.6%) patients with warts at other sites (P = 0.1). Evidence of multiple infection by HPV types 1 and 2 was demonstrated by the finding of HPV 1 and 2 IgM antibodies in the sera of 16 (4.3%). HPV 4 was found in only 1 out of 30 biopsies and HPV 4 IgM was undetectable in 50 randomly chosen sera.

Monochloroacetic acid and 60% salicylic acid as a treatment for simple plantar warts:effectiveness and mode of action

Monochloroacetic acid crystals and 60% salicylic acid ointment was found to be more effective than placebo as a treatment for simple plantar warts in a double blind study on 57 patients. Nineteen (66%) patients in the active treatment group compared with five (18%) patients in the placebo group were cured after 6 weeks (P = 0.002). The active treatment was associated with a significantly higher cure rate 6 months after entry (P = 0.04). Treatments were well tolerated. IgG or IgM antibodies or both to human papilloma virus (HPV) types 1 or 2 or both were detected significantly more frequently in the actively treated group 6 weeks after entry (P = 0.0005). Twelve (50%) patients considered to be cured had no detectable secondary immune response. Our results suggest that cure does not depend primarily on the humoral system but rather on mechanical destruction of wart tissue, or occurs as a result of cell mediated immunity.