Inhibition of binding of bacteria to amniochorionic membranes by amniotic fluid

The immunological composition of amniotic fluids is shown to be of such a lower order of activity that its role in fetal protection may be limited. Also, amniotic fluids were found not to have classical antibiotic activity. Amniotic fluids (25/31), however, were found to inhibit, by 27.5% to 88.2%, three target bacteria from binding to discs of amniochorionic membranes. This inhibition is also demonstrable with the monosaccharides alpha-D(+)-fucose, D(+)-galactose, alpha-D-glucose, alpha-D-lactose and bovine serum albumin-lactose conjugate, whereas other glycoconjugates enhanced bacterial binding. This demonstrates that the test bacteria bind to the amniochorionic membranes using bacterial lectins. In intraamniotic infection bacterial lectins may be complexed by amniotic fluid glycoconjugates which prevent the bacteria from binding to the amniochorionic membranes. This would explain asymptomatic infection and in the absence or reduced levels of the glycoconjugates the bacteria would bind to the amniochorionic membranes giving rise to symptomatic infection.

Post-irradiation cytology of cervical cancer patients

The accuracy of cervicovaginal cytology following radiotherapy for cervical cancer is compromised by the anatomical and tissue changes resulting from irradiation. Collection of representative samples may be more difficult, and benign radiation changes, post-irradiation dysplasia, and the frequent occurrence of repair cells and active stromal cells in post-irradiation smears may cause diagnostic problems. Nevertheless, cytology is a valuable tool for the detection of locally recurrent cervical cancer. It is simple and economical to perform at the time of clinical follow-up examination, and may detect occult tumour recurrence. Awareness of the cellular changes resulting from irradiation, and the varied composition of post-irradiation smears may lead to more accurate interpretation of the cytological findings.

Immune response: tissue specific T-lymphocytes

The lymphatic system forms a 'blind' plexus of vessels that in general are found in tissue which has an inherently high replicative capacity. It is this system that is responsible for the rapid deployment and circulation of tissue-specific T-lymphocytes for the inspection of cell-surface aberrations within the tissue. The presence of tissue-specific T-lymphocytes explains why 90% of lymphocytes are found outside the lymphatic system and why they migrate in a selective manner. The tissue-specific T-lymphocyte is considered to express a common lymphocyte cell surface pattern, the homotype, and a tissue-specific cell-surface pattern, the histotype which may involve MHCA and mHCA. It is the histotypic pattern that is responsible for the tissue specificity of the tissue-specific T-lymphocyte. The presence of tissue-specific T-lymphocytes does pose problems for the immune system. If different tissue-specific T-lymphocytes met within a particular tissue, 'lost' lymphocytes, an immune response will be generated against the intruder (lost lymphocyte), and the intruder will not be able to recruit other immunocompetent cells in that tissue. This immune reaction is an attempt to change the histotypic pattern of the intruder. This situation would explain the autologous immune response. This response however is suppressed in the systemic system by immunosuppressive compounds from the liver. It is only in the tissues that the tissue-specific T-lymphocytes are released from this suppression, in order to initiate immune reactions against aberrant cell-surface patterns.

Immunology of pregnancy: towards a unifying hypothesis

The variable findings of hormonal-immunoregulation and the variable cellular and humoral immune responses in pregnancy have been considered in relationship to the physiological response. From such considerations it appears that the peripheral blood lymphocyte/leukocyte response in pregnancy is not important, but rather the local uterine immune response at implantation and throughout pregnancy. It is proposed, and evidence is presented, that a normal allogeneic immune response is initiated at the time of implantation of the blastocyst. This immune response regulates the invasive nature of the trophoblast and initiates the first stage of parturition. The initiation and maintenance of this immune response is based on an interplay between maternal and paternal HLA and trophoblast antigens. In the case of HLA-incompatible donor-recipient blastocyst transplants, a more pivotal role for immunoregulation by trophoblast antigens is proposed. This is because it is considered that the local uterine immune response suppresses the expression of allogeneic HLA. This concept is further developed in terms of haploid HLA suppression on maternal and fetal lymphocytes that cross the placenta. This is considered to allow the interaction of these lymphocytes with each other and explains maternal transfer of cell-mediated immunity.

Topical treatment of malignant and premalignant skin lesions by very low concentrations of a standard mixture (BEC) of solasodine glycosides

A cream formulation containing high concentrations (10%) of a standard mixture of solasodine glycosides (BEC) has been shown to be effective in the treatment of malignant and benign human skin tumours. We now report that a preparation (Curaderm) which contains very low concentrations of BEC (0.005%) is effective in the treatment of keratoses, basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin of humans. In an open study, clinical and histological observations indicated that all lesions (56 keratoses, 39 BCCs and 29 SCCs) treated with Curaderm had regressed. A placebo formulation had no effect on a smaller number of treated lesions. Curaderm had no adverse effect on the liver, kidneys or haematopoietic system.

Immune response: self-foreignness

The classical basic concept of the immune system as a defence system per se and immunological surveillance against neoplasia have never been satisfactorily verified experimentally. The reason for this lies in the historic development of immunology in terms of observations of infectious disease and the interpretation of those observations. Thus, based on a complete lack of understanding of immune events, immunization procedures were developed by Pasteur and his contemporaries. The success of some of these immunization methods, influenced by culture and philosophical thoughts, and based on prima facie evidence allowed the next conceptual step to be taken, culminating in the immune surveillance hypothesis. Central to this hypothesis is selection and tolerance to self-antigens. However, immune reactions to self-antigens are evident and clonal selection is not viable because the number of clones required increases as the frequency of chance of a cell belonging to a particular clone decreases. Also, circadian rhythms in the immune response have not been taken into account. In addition, the problems of haemocytopoiesis have not been addressed, in that it is possible for B-lymphocytes to become terminal macrophages and T-lymphocytes to become mast cells, eosinophils and/or basophils constituting 'dead end' cells in an immune response. The initiation of the immune response begins with a tissue-specific T-lymphocyte being stimulated and undergoes replication. This gives rise to a dual functional helper/suppressor cell and a B-lymphocyte. These basic concepts explain the necessity for auto-reactive lymphocytes, that is the autologous mixed lymphocyte reaction (AMR). The AMR is a natural consequence of having tissue-specific lymphocytes to monitor plasma membrane aberrations.

The accuracy of cervicovaginal cytology in the detection of recurrent cervical carcinoma following radiotherapy

The accuracy of cervicovaginal cytology testing in the detection of recurrent cervical carcinoma was investigated by correlating clinical and histology records with cytology smear results for two groups of patients. All patients had been treated with radiotherapy, with or without pelvic surgery, for carcinoma of the uterine cervix. Abnormal cervicovaginal smear results were present for 45.7% (32/70) of patients with histologically diagnosed recurrent cervical carcinoma including a correct prediction of recurrent cervical carcinoma in 32.8% (23/70) of cases. A cytologic diagnosis of recurrent carcinoma was present for 48.9% (23/47) of cases with local recurrence. The positive predictive value for a histologic diagnosis of recurrent cervical carcinoma after a positive cytology report for a group of 61 patients was estimated to be 98.4%. A cytologic diagnosis of locally recurrent cervical carcinoma preceded clinical signs in 15/61 (24.6%) of cases. These results indicate that although cervicovaginal cytology after radiotherapy for cervical cancer does not have high sensitivity it is a reliable test for the diagnosis of local recurrence. Cytologic examination of the vaginal vault or cervix after treatment may thus provide an early diagnosis of tumor recurrence or persistence, in some cases prior to the onset of clinical signs.

Solasodine glycosides. Selective cytotoxicity for cancer cells and inhibition of cytotoxicity by rhamnose in mice with sarcoma 180

BEC, a standard mixture of solasodine glycosides is effective in vivo against murine sarcoma 180 (S180), whereas the aglycone solasodine at equimolar concentrations is ineffective. The efficacy of BEC against S180 in vivo can be inhibited by rhamnose. Mice which are in their terminal stage with S180 can tolerate and become symptom-free of cancer by single dose administration of BEC at concentrations of BEC three times the LD100 for normal mice. These observations suggest that the binding of solasodine glycosides on tumour cells may be mediated through the monosaccharide rhamnose, which forms part of solasonine, solamargine and di-glycosides of solasodine in BEC. Furthermore, these results provide evidence that BEC selectively destroys tumour cells relative to normal cells in vivo.

Solasodine glycosides. In vitro preferential cytotoxicity for human cancer cells

Solamargine [(22R,25R)-spiro-5-en-3 beta-yl-alpha-L-rhamnopyranosyl- (1----2glu)-O-alpha-L-rhamnopyranozyl (1----4glu)-beta-D-glucopyranoze], a glycoside of solasodine preferentially inhibits the uptake of tritiated thymidine by cancer cells. In contrast, solamargine at equivalent concentration, and the mono- and diglycosides of solasodine have a limited effect on the uptake of tritiated thymidine for other cell types, including unstimulated lymphocytes and lymphocytes stimulated with Con A. In contrast the solasodine glycosides do not inhibit the uptake of tritiated thymidine by lymphocytes stimulated with PHA or PWM. The inhibition of tritiated thymidine uptake by solamargine and the mono- and di-glycosides of solasodine are dependent upon their cellular uptake by endogenous endocytic lectins (EELs). The mode of action of the solasodine glycosides, in particular solamargine, appears to be the induction of cell lysis, as determined by morphological examination.

Seminal plasma biochemistry. III: Characterization of coagulum components

Human seminal plasma components involved in coagulum formation have been isolated by liquefaction and reformation of the coagulum in acidic and neutral buffers, respectively. The SDS-PAGE profile of the isolated coagulum (recoagulum) is similar to that reported for the native coagulum immediately following liquefaction. Thus the recoagulum may be considered to represent the native coagulum. Electrophoresis of the recoagulum under non-denaturing conditions reveals the presence of both positively and negatively charged components. These components are sialoglycoproteins that bind copper. Based on these results, a possible mechanism for coagulum formation and liquefaction is discussed.

Seminal plasma biochemistry. IV: Enzymes involved in the liquefaction of human seminal plasma

A significant positive correlation was found between the liquefaction time of human seminal coagula and bound sialic acid. There was also a similar relationship between bound sialic acid and the enzyme sialyl-transferase. This suggests that the degree of sialylation of the components of seminal coagulum are important in determining the liquefaction time of the coagulum. These results support previous findings. The coagulum is considered to be composed of glycoprotein-metal ion complexes, and the initial stage of liquefaction results from the reduction of these metal ions by L-ascorbic acid. The removal of hydrogen peroxide, generated by the oxidation of L-ascorbic acid, requires the presence of glutathione peroxidase and glutathione reductase. These enzymes have been identified in human seminal plasma and their possible physiological importance is discussed.

RISH. VII: Cell surface patterns--association of like cells

Like-cells associate to form various tissues, and it has been demonstrated that this specificity resides in the plasma membrane. Membrane bound tissue specific antigens and enzyme substrate mechanisms have been considered to be involved in this phenomena, but these explanations are incomplete. It is proposed that like-cells identify each other by specific complementary cell-surface patterns. This complementarity results from cell division. That is, when cells divide, they give rise to a mirror image of themselves. These complementary patterns are the result of the association of histocompatibility antigens (HCA) with non-histocompatability components in the plasma membrane. This proposal is based on topographic conjecture in that four colours are sufficient for colouring all maps drawn on a plane or sphere so that regions that share a common boundary are of a different colour. It is further proposed that these specific cell-surface patterns can be classified as four overlapping regions: (i) homotypic--which is generally species specific, (ii) allotypic--which is variable within a species, (iii) idiotypic--which represents variation within an individual or family group, and (iv) embryotypic--which identifies the embryonic origin of the tissue.

RISH. VI: General evolutionary aspects of the immune system

Both the prokaryotic and eukaryotic cells are considered to have arisen from a common progenitor cell. The plasma membrane of the prokaryotic cell became specialized to carry out functions that the eukaryotic cell delegated to cellular organelles. Thus the plasma membrane of the eukaryotic cell remained flexible to evolutionary influences. Thus, provided the structural integrity of the plasma membrane was maintained, alterations within this infrastructure could be tolerated. This gave rise to basic speciation at the cellular level. Such differences in the plasma membrane of these primitive eukaryotic cells were of no importance until the dawn of sexual reproduction, then only like-cells could associate to exchange genetic information. Thus in the protozoa cell-surface, antigens are demonstrable in mating, whereas alloincompatability is intracellular. With the evolution of the Metazoa, in order for like-cells to identify each other, alloincompatability changed from intracellular expression to become expressed on the plasma membrane. Like-cell identification was derived and evolved from the basic feeding mechanism of primitive eukaryotic cells, which involved the induction of lectins that were expressed at the cell-surface. These lectins were induced by the RNA that was complementary to, and complexed with cell surface components of the organisms upon which the eukaryotic cells fed. This RNA was also inserted along with the lectin in the eukaryotic cell plasma membrane, and acted as a template for DNA synthesis. This DNA was then incorporated into the genome of the eukaryotic cell and it became an inheritable characteristic. Thus these lectins could be expressed intracellularly as well as on the plasma membrane. The intracellular expression of these inheritable lectins may have constituted intracellular-alloincompatibility, as well as being used for feeding by agglutination of the organism on the plasma membrane of the eukaryotic cell. With the development of colony formation and the true metazoa, the cell-surface lectins became incorporated into cell-surface components for the identification of like-cells. This represents, in part, the histocompatability antigens of the organisms. At the same time, the lectins were also being increasingly used for the regulation of differentiation, and for what we would classify as immunological reactions.(ABSTRACT TRUNCATED AT 400 WORDS)

The Pap smear revisited

Papanicolaou smear screening for cervical cancer has become an established practice in most developed countries. This is because the cervix is relatively accessible to investigation and treatment, and early stages in the morphogenesis of cervical cancer are both recognizable and easily treated. The Pap smear is a valid test. It is simple, relatively inexpensive, reliable, and free of risk. Although the test has far from perfect sensitivity, it has high specificity, and false-positive results are rare. In most reported series, the majority of false-negative results have been found to be attributable to collection errors rather than laboratory errors. Despite the importance of Pap smear screening, controlled prospective trials have not been undertaken to determine its efficiency in reducing cervical cancer incidence and mortality. However, countries with well-organized programmes, wide population coverage and correct follow-up appear to have had some impact on mortality from cervical cancer. Nevertheless, coverage of high-risk groups, particularly women over 40 years of age, remains the greatest problem. Recommendations on the frequency of testing vary considerably. Statistical models indicate triennial testing may deliver almost all of the effectiveness of annual testing at a substantially reduced cost, but the numerous reports of false-negative results argue strongly in favour of annual screening. It is possible that these problems may be solved in the future by increasing the sensitivity of the test and/or by the use of additional tests.

N-acetylneuraminic acid and hostile mucus infertility

A total of 39 samples of hostile mucus, as defined by postcoital examination, were examined for N-acetylneuraminic acid (NANA) deficiency, as measured by the enzymatic addition of NANA, spermatozoal penetration and immobilization. Only 56.7% of the mucus samples were deficient in NANA and this did not correlate with spermatozoal penetration or immobilization, which were negatively correlated. Thus, as the spermatozoal hostility in the mucus decreases, spermatozoal penetration increases. This finding also applies to hostile mucus not deficient in NANA. In contrast, resialylation of NANA hostile mucus, deficient and not deficient in NANA, although not enhancing spermatozoal penetration, did reduce spermatozoal immobilization. Thus, components of the mucus deficient in NANA and/or the lack of unbound NANA may contribute to mucus hostility, but it is not the only hostile factor. In addition, SEM studies of NANA-deficient mucin before and after resialylation were shown to have similar structures. Hence ultrastructural changes are not apparent in NANA-deficient mucin, and this supports the previous finding that NANA deficiency does not impede spermatozoal penetration. The spermatozoa from the husbands of the infertile couples formed three distinct groups in terms of spermatozoal penetration and immobilization in normal donor mucus. One group demonstrated normal levels of spermatozoal penetration and immobilization in donor mucus. A second group was demonstrable in which spermatozoal penetration was similar to that in the wife's hostile mucus, but had a normal level of spermatozoal immobilization. In the third group, both spermatozoal penetration and immobilization in donor mucus were similar to that in the wife's hostile mucus. The results demonstrate that not all hostile mucus is deficient in NANA, and that other unknown factors are involved. In addition, there are also male factors which may impede spermatozoal penetration and/or result in the inability of the spermatozoa to survive in normal donor mucus.

The packing of spheres in embryogenesis and carcinogenesis

Fertilization of the mammalian ova results in the formation of a compact ball of cells, the morula, which then transforms into a hollow sphere of cells, the blastula. The formation of these structures is considered to be dependent on the number and shape of the cells present and approximates to the problem of maximal sphere packing. Similarly, the shape of organs, to some degree, is considered to be dependent upon the shape of the constituent cells which predetermines their maximal packing densities. Implicit in this concept is that like-cells divide until they reach their maximal packing density and are then inhibited from further replication by three dimensional contact inhibition. In this context, tumour cells may be considered as pleomorphic relative to the tissue in which they arise and form a benign tumour, whereas malignant tumours display pleomorphism within the tumour mass.

Ovarian tumor antigens: preliminary histological investigation

The immunoglobulin IgG was isolated from the immune complexes obtained from the ascitic fluids of patients with ovarian serous cystadenocarcinoma. The IgG isolates did not react in immunoperoxidase staining of normal ovarian, fallopian tube, or endocervical tissue. In contrast, the IgG isolates did react in immunoperoxidase staining of autologous and allogeneic ovarian cancer tissue. However, the staining was variable in terms of areas of positivity and was completely absent in some serial sections. This variability was also evident in control sections of an ovarian mucinous cystadenocarcinoma that was positive for the carcinoembryonic antigen. In addition, it appears that serous and mucinous ovarian cancers may share common antigenic determinants. These results demonstrate the antigenic heterogenous nature of ovarian cancer.

RISH V. Application to monoclonal antibody production

RISH considers that cell surface components involved in like cell identification are not involved in the structure of the plasma membrane per se and are attached to a part of their mRNA. The mRNA then acts as a template for the synthesis of DNA. Thus the component at the cell surface is attached to an RNA/DNA receptor. If there is a conformational change in the component (antigen) this will cause a distortion in its RNA/DNA receptor. This distortion is then detected by a tissue specific T lymphocyte which removes all or part of the RNA/DNA receptor from the aberrant cell and the lymphocyte then undergoes replication. During this process receptor RNA/DNA is incorporated into the daughter lymphocyte which becomes a B lymphocyte/plasma cell producing immunoglobulin. The initial tissue specific T lymphocyte becomes a dual functional helper/suppressor cell. The plasma cell after the initial immune response becomes a circulating memory B cell displaying IgM or IgD. If this cell complexes an antigen with its surface IgM or IgD a humoral immune response will be developed as previously described, but in this case the antibodies produced will be anti-idiotypic antibodies. The anti-idiotypic antibodies will regulate the production of the antibody directed against the antigen per se. The anti-idiotypic antibodies will in turn be regulated by a second anti-idiotypic antibody. In RISH five such anti-idiotypic systems may be involved in regulating the immune response to the initial non-immunoglobulin antigen. Based on the RISH anti-idiotypic mechanism a system is briefly described whereby human memory B cells, to a particular antigen, may be isolated. These B cells may then be activated to secrete immunoglobulin with autologous isolated anti-idiotypic antibodies. These activated cells may then be infected with E.B. virus to establish an immortal cell line of B cells secreting the immunoglobulin of interest.

RISH IV. Immunoglobulin diversity

RISH considers that cell surface components involved in like cell identification are not involved in the structure of the plasma membrane per se and are attached to a part of their mRNA. the mRNA then acts as a template for the synthesis of DNA. Thus the component at the cell surface is attached to an RNA/DNA receptor. If there is a conformational change in the component (antigen) this will cause a distortion in its RNA/DNA receptor. This distortion is then detected by a tissue specific T lymphocyte which removes all or part of the RNA/DNA receptor from the aberrant cell and the lymphocyte then undergoes replication. During this process receptor RNA/DNA is incorporated into the daughter lymphocyte which becomes a B lymphocyte/plasma cell producing immunoglobulin. The initial tissue specific T lymphocyte becomes a dual functional helper/suppressor cell. The B lymphocytes use the RNA from the RNA/DNA receptor to synthesize the variable region of the first antibody, IgM1. This antibody (IgM1) does not react with the antigen, ie. the distorted component, or the receptor RNA, but with receptor DNA. The DNA of the receptor base pairs with its complementary strand in the B lymphocyte, and the complementary DNA acts as a template for mRNA synthesis. This results in the production of IgM2 and IgG that can bind the antigen and receptor RNA. These antibodies (IgM1, IgM2 and IgG) when endocytosed by the stimulating cell will also complex cytoplasmic mRNA and nuclear DNA and prevent the synthesis of the antigen that initiated the immune response. If other classes of antibodies are to be produced they will follow a similar pattern (IgM1, IgA and IgG or IgM1, IgE and IgG). From the codons of the known amino acids, the codons for amino acids from translation of the complementary DNA strand have been calculated. The amino acids derived from the complementary codons are considered to represent sequences of amino acids in the antigen as represented by the DNA of an RNA/DNA receptor. For these sequences of amino acids, each has a complementary amino acid as defined by the normal codon. These complementary amino acids are then used in the synthesis of the variable region of the antibody.

Melphalan-resistant lymphoblastoid cell lines established from patients with ovarian cancer treated with cross-linking agents

Lymphoblastoid cell lines (LCLs) were established from 83 patients with ovarian cancer by transformation of peripheral B lymphocytes with Epstein-Barr virus. Comparing the melphalan resistance of different groups of LCLs using the mean Do obtained from clonogenic survival assays, LCLs from melphalan-treated patients were significantly more resistant than LCLs from patients not treated with this drug. However, prior treatment of the patient with ionizing radiation was not associated with increased in vitro resistance of the LCL to this agent. In melphalan-treated patients where LCLs were established serially, the melphalan Do increased after further melphalan treatment in vivo and decreased when no further treatment was given. No correlation was found between age of donor and LCL resistance to any of the above agents. A group of 15 LCLs previously established from non-tumour donors was less resistant to melphalan than the LCLs from patients with ovarian cancer. In a group of 29 patients with advanced disease in whom the clinical response was known, LCL resistance to melphalan appeared to be associated with poor clinical response to cross-linking agents. These results suggest that B cell populations undergo long term, but not necessarily permanent, increases in resistance to melphalan.

RISH III. Haplotype-sharing in immune responses

A number of hypotheses have been proposed for the reactivity of lymphocytes with allogeneic tissue. However, these hypotheses have not been generally accepted for they cannot accommodate the observation that lymphocytes from chimeras cooperate with each other. Also, only a few percent of lymphocytes react with allogeneic tissue in rejection reactions.

Role of cervical mucus in human infertility

The physiological role of cervical mucus in enhancing spermatozoal penetration at mid-cycle has been established. However, the involvement of cervical mucus in primary infertility is still controversial. Although immunological reactions against spermatozoa in the female have been offered to account for the immobilization of spermatozoa--an observation termed 'hostility' of the mucus--this is not always demonstrable. In addition, there are a number of microbial antigens that are similar to spermatozoal antigens. Antibodies to these antigens are found in the serum of the majority of females and males whose infertility is considered to be immunopathological in origin. There are also naturally-occurring antispermatozoal antibodies in both females and males that in some cases may contribute to immunological infertility. The overall spectrum of 'hostile' mucus reactions becomes more complex when we consider the biochemical structure of cervical mucus and its possible interaction with spermatozoa. This spermatozoa: mucus interaction may involve the transfer of spermatozoal components to 'hostile' mucus that should normally be transferred to the zona pellucida of the ova. In addition, there are also pH changes in some 'hostile' mucus that lead to spermatozoal immobilization. In contrast to the above, the cause of infertility in some cases is the inability of spermatozoa to survive in normal mid-cycle mucus. It is evident therefore that an understanding of the complex nature of 'hostile' cervical mucus will lead to a more objective approach in the treatment of infertility.

Osmolarity of human seminal plasma

Osmolarity of human seminal plasma was found to be higher than that of human blood plasma. No significant relationship was found between osmolarity, spermatozoal concentration and liquefaction time. Osmolarity was shown to correlate with spermatozoal motility and optimum motility was observed between 360 and 380 mOsm.

Immune complexes in ovarian cancer: association between IgM class complexes and antinuclear autoantibodies in ascitic fluid

Samples of ascitic fluid from patients with ovarian cancer were analyzed for autoantibodies to nuclear and cytoplasmic antigens and for immune complexes (ICs) detectable by the Clq deviation and polyethylene glycol (PEG) precipitation (either IgG or IgM class) assays. The predominant autoantibody was antinuclear (ANA); this was detected in 29 of 58 samples (59% showing the homogeneous and 41% the speckled pattern). The antibody was not reactive to saline extractable nuclear antigens. A strong association between this autoantibody and the PEG-precipitated IgM class ICs was shown, suggesting the possible participation of this autoantibody in IgM class ICs formation. The lack of association between C1q-reactive and IgG class ICs and the autoantibodies indicates that the IgG class ICs may be more related to the tumor.

Scanning electron microscopy and histological examination of human seminal plasma coagulum

Human seminal plasma coagulum was examined by S.E.M. and light microscopy using various preparatory techniques. Two types of structures were observed; porous and laminated. A consistent finding using all the preparatory techniques was the presence of the majority of the spermatozoa on the surface of the coagulum as opposed to the interior. Those spermatozoa present in the interior of the coagulum are attributed to the invagination of the surface layer. The presence of spermatozoa on the surface of seminal plasma coagulum plays an important role in concentrating spermatozoa in close proximity to the cervical os. This allows spermatozoa to reach cervical mucus rapidly and minimizes the time they must remain in the unfavourable environment of the vagina.

Affinity chromatography separation of tumor associated antigens from ascitic fluid of ovarian cancer patients

Tumor associated immunoglobulins previously isolated from ovarian cancer ascitic fluid have been used in an affinity chromatography step to purify putative tumor associated antigens from a perchloric acid extract of ascitic fluid. Examination of the affinity chromatography purified proteins revealed 4 bands on electrophoresis. Antisera raised to the affinity chromatography products have been examined by Ouchterlony diffusion as well as a solid-phase radioimmunoassay. Two of thirteen ovarian tumor extracts investigated reacted in Ouchterlony diffusion analysis, whereas all thirteen extracts gave positive results in the more sensitive solid-phase radioimmunoassay.

Types of immune complexes in the ascitic fluid of women with carcinoma of the ovary

Immune complexes with C1q-fixing properties and those precipitable by polyethylene glycol (PEG) were detected in ascitic fluid from patients with advanced ovarian cancer. The ascitic fluid from 42 of 58 patients (72%) contained these complexes. A positive result with the C1q assay was obtained in 41% of patients, whilst with the PEG assay a positive result was obtained in 59% (50% in the IgM, 36% in the IgG, and 14% in the IgA fraction). The highest mean level of PEG-precipitable complexes was in the IgG fraction (11.4 mg/100 ml) and lowest in the IgA fraction (3.3 mg/100 ml). These results indicate that gram quantities of the immune complexes may be isolated from the large volumes of ascitic fluid usually present in ovarian cancer. Further studies of ascitic fluid may thus provide data on the nature of the immune responses in these patients.

Immunoglobulins reactive to carcinoembryonic antigen and their relationship to the antigen in malignant ascitic fluid of ovarian carcinoma

Samples of malignant ascitic fluid from 30 patients with advanced ovarian carcinoma were examined for the presence of IgM antibodies to CEA and PEG-precipitable proteins binding to 125I-CEA. The IgM antibodies to CEA were measured by a solid-phase radioimmunoassay using ovarian CEA. There was no correlation between the level of IgM antibodies to CEA and that of total IgM in the fluid. In 11 of 30 (37%) samples tested, significant amounts of IgM antibodies to CEA were found. The CEA-binding proteins were measured by the ability of ascitic fluid to incorporate 125I-colonic-CEA into PEG-precipitable complexes. In 9 of 39 (30%) samples, the precipitation was significant. There was no association between antibodies to the ABO and Lewis blood group factors and these antibodies to CEA. An inverse relationship was observed between the level of CEA and that of CEA-binding proteins shown by the two assays. When 125I-CEA was incubated with these "positive" samples, a high molecular weight fraction was demonstrated by chromatography. By contrast, in the "negative" samples, there was no incorporation of 125I-CEA. These findings would indicate the presence of CEA-reactive proteins possibly existing as immune-complex-like material in ascitic fluid of some patients.

Infertility: cervical mucus and semen factors

A total of 34 infertile couples whose infertility was considered to be the result of a cervical factor were investigated. The use of pooled human blood plasma was found to significantly stimulate spermatozoal motility relative to that in seminal plasma or tissue culture media. Two additional male factors that may contribute to infertility have been identified, nondirectional spermatozoal motility, and in particular the inability of spermatozoa from some males to survive in normal donor mucus. This is supported by the fact that pregnancies only occurred in those cases (25%) in which the spermatozoa were able to survive in normal donor mucus. These pregnancies were achieved by artificial insemination using the husband's spermatozoa suspended in pooled human blood plasma.

A comparison of the physicochemical properties of carcinoembryonic antigen in extracts of tumour tissue, ascitic and cyst fluid from ovarian cancer

In view of the reported disagreement in the physicochemical properties of ovarian carcinoembryonic antigen (CEA), this study was undertaken to compare the properties of CEA obtained from extracts of ovarian tumour tissue, ascitic fluid and cyst fluid. On the basis of molecular weight estimation and binding properties with Concanavalin A and wheat germ lectin, ovarian CEA from these three sources appeared similar, and also possessed similar properties to those of colonic CEA. On isoelectric focusing, however, it was found that the isoelectric point of CEA from tumour tissue and cyst fluid differed from that from ascitic fluid. It is most likely that this is due to a loss of sialic acid from the CEA released into ascitic fluid.

Seminal plasma biochemistry II: seminal plasma and spermatozoal cytidine monophosphate-sialic acid synthetase and sialyltransferase activities

The zona pellucida receptor for spermatozoa has not been identified and the mechanism by which spermatozoa traverse the zona pellucida has not been elucidated. It is proposed that the zona pellucida receptor is a glycoprotein and the receptor per se is galactosamine or N-acetyl galactosamine. The mechanism by which spermatozoa transverse the zona pellucida may be by its structural modification, by the transfer of spermatozoal sialic acid. In addition, male infertility resulting from oligozoospermia or polyzoospermia, may be due to lack of spermatozoal bound sialyltransferase. A total of 43 semen samples were examined for cytidine monophosphate-sialic acid synthetase and sialyltransferase activities. It was found that both these enzymes are present in seminal plasma and bound to the spermatozoa. The spermatozoal bound enzymes may be derived from the seminal plasma which may be a limiting factor in terms of infertility.

The reversal immune surveillance hypothesis: part II

The first part of the reversal immune surveillance hypothesis (RISH. I) describes the conceptual framework of the immune system as a homoeostatic mechanism for the control of cell differentiation and replication. The thymic dependent lymphocytes (T-cells) are considered to be tissue specific and identify aberrations in the cell surface pattern (antigens), that represent that particular cell type. The T-cells may then recruit antibody forming B-lymphocytes (B-cells) to produce antibodies (humoral response) to the cell surface antigens in order to return the cell surface pattern to its correct state. The antigens may also be removed from the cell surface as immune complexes by the complement system, which under normal conditions does not cause cell lysis. The cellular arm of the immune system, that of killer cells or activated macrophages are considered to be primarily involved with tissue remodelling. Whether or not the humoral or cellular arm of the immune system is activated depends upon the antigens displayed by the stimulating cell. The proposed system, which is self monitoring, is considered to have evolved from the invertebrates through to the vertebrates to become more complex in the mammals. Therefore the immune system is considered to be based on the identification of self and self-foreignness, rather than on foreignness per se.

Seminal plasma biochemistry. I. Preliminary report: a possible mechanism for the liquefaction of human seminal plasma and its relationship to spermatozoal motility

Based on indirect evidence it has been suggested that the liquefaction of human seminal plasma involves fibrinolytic and proteolytic enzymes and that the coagulum is formed by proteins. In this preliminary investigation evidence is presented for the involvement of seminal plasma sialyltransferase in liquefaction which suggests that the coagulum may be composed of glycoproteins. It is proposed that the glycoproteins form a polymer by the chelation of divalent metal ions via the carboxylic acid moieties of the sialic acid groups of the glycoproteins. The glycoprotein polymer may then be dismantled by the reduction of the meal ions by the oxidation of L-ascorbic acid, possibly allowing enzymes to complete the liquefaction process. A total of 100 semen samples from 30 male subjects whose semen profiles were considered "normal" by an independent assessor, were examined for the following: (i) liquefaction time of the seminal plasma; (ii) seminal plasma sialyltransferase activity; (iii) spermatozoal motility, defined as directional or nondirectional; (iv) spermatozoal count, and (v) seminal plasma content of free L-ascorbic acid, dehydroascorbic acid and glutathione. Linear regression analysis showed a significant correlation between sialyltransferase activity and the liquefaction time for seminal plasma. Similarly, multilinear regression analysis of the data showed that as the seminal plasma levels of L-ascorbic acid, total dehydroascorbic acid and glutathione increase, there is a decrease in spermatozoal motility and a decrease in the liquefaction time of the seminal plasma. The possible metabolic relationship of seminal plasma L-ascorbic acid and glutathione is discussed and a metabolic pathway is suggested.

The beta-subunit of chorionic gonadotrophin as a tumour marker in gestational trophoblastic disease

The clinical usefulness of the serum level of the beta subunit by radioimmunoassay was evaluated in 96 patients with gestational trophoblastic disease. The measurement of the hormone-specific beta subunit has allowed a better understanding of the activity of the various types of disease, with a correlation between the initial serum levels and the different subtypes of hydatidiform mole, and the ability to predict the development of malignant sequelae. The phenomenon of trophoblastic persistence after uterine evacuation was confirmed: although the half-life of the beta subunit was 4 days during the early phase, there was an average period of 8 weeks before levels fell to negative and 12 weeks was the limit for spontaneous regression. The serial beta subunit levels were found to provide an accurate indication of the clinical course of the disease in untreated and treated patients, and treatment could be withheld after 3 consecutive weekly negative values.

The reversal immune surveillance hypothesis

The proposed reveral immune surveillance hypothesis is based on the identification primarily of self and secondarily of foreignness, unlike the original hypothesis that is based on the identification of foreignness per se. The proposed system is considered to have evolved from the invertebrates through to the vertebrates to become more complex in the mammals, and involves the identification of cell types by lymphocytes through the cell type surface pattern and major histocompatibility antigens. The identification of self and associated foreignness by the immune system is required for the regulation of cell differentiation and replication, and because of this design, the ability of the immune system to destroy foreignness can be regarded as a natural consequence. The reversal immune surveillance hypothesis explains why spontaneously occurring tumours may not be antigenic, in the sense of eliciting their own destruction, and is consistent with the destruction of tumour cells that display significant amounts of viral antigens or gross antigenic changes induced by carcinogenic agents. It is also able to explain the stimulation and inhibition of tumour development.