To determine the chemical characteristic of the immunosuppressive factor in the culture supernatants from decidual cells, serial biochemical methods were applied. The suppressor factor was obtained in the fraction with a molecular weight between 43, 000 and 67, 000 after a gel filtration of the supernatants, and showed four major peaks on an anion exchange chromatography. Of the four peaks, only the second peak with an ion strength of 0.3 M had immunosuppressive activity on mixed lymphocyte reaction (MLR). The following study on a Lentil-Lectin affinity chromatography showed that the suppressor factor had no affinity to Lentil-Lectin. An isoelectric focusing of the purified suppressor factor showed four bands, protein isoelectric point (PI) of which was between 6.85 and 7.50.
To elucidate how the suppressor factor mediate an immunosuppressive activity, effects of the suppressor factor on lymphokine production and lymphocyte activation of periferal blood lymphocytes (PBL) stimulated with 0.05% PHA were investigated. The purified suppressor factor inhibited not only lymphokine production (IL-2: 61.2% inhibition, γ-IFN: 32.6% inhibition, BSF-2: 33.1%) of PBL, but also the expression of activated surface markers on lymphocytes (IL-2 receptor: 33.8%, transferrin receptor: 33.7% inhibition) at a concentration of 5μg/ml.
These results clearly demonstrate that the suppressor factor from human decidual cells, which is protein but not glycoprotein and PI of which is between 6.85 and 7.50, mediate a nonspecific immunosuppressive activity by inhibiting lymphokine production and lymphocyte activation.

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We have experienced 26 cases with anti-thyroid hormone autoantibodies. Clinical features, evaluation of the results of thyroid function tests and whether or not the thyroid hormone resistance is present in these patients were evaluated. Thyroid hormone values measured by a double antibody RIA, a solid phase RIA, or an analog method RIA showed apparently high values, whereas those measured by a single antibody RIA showed apparent low values compared with the clinical manifestations, respectively. It was concluded that measurement of serum FT₃ and FT₄ after 12.5% PEG treatment as well as the measurement of serum TSH values is useful in the evaluation of real thyroid function in patients with anti-thyroid hormone antibodies.
From the supplemental dose of T₄ or T₃ to maintain hypothyroid patients due to Hashimoto's thyroiditis in euthyroidism, it was concluded that there is no thyroid hormone resistance in such patients.

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We studied 5 infants born to 4 women who had anti-SSA/Ro autoantibodies. Four infants had cutaneous lupus lesions, or transient elevated liver enzyme levels, or both. No infants had congenital heart block, but one had complex structural cardiac defects. No anti-SSA/Ro positive mothers had exacerbation or precipitation of systemic lupus erythematosus during the period of gestation and puerperium.
Taken together, these findings confirm the association of anti-SSA/Ro antibodies with neonatal lupus and indicate that structural cardiac defects might be an infrequent but life-threatening symptom of neonatal lupus syndrome.

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A possible involvement of major histocompatibility complex (MHC) antigens in lysis of target cells by autologous lymphokine-activated killer (LAK) cells was studied in human systems. LAK cells that were generated by 7-day culture of peripheral blood lymphocytes with recombinant interleukin 2 (IL 2) killed autologous phytohemagglutinin (PHA)-induced T blasts in a 4-h ⁵¹Cr release assay. NK type LAK cells expressing CD 16 antigen showed higher cytotoxicity against autologous T blasts that were depleted of MHC class I antigens by citric acid treatment, with little reaction recorded against MHC class I positive targets. By contrast, CTL type LAK cells with CD3 antigens on their surface preferentially killed autologous T blasts that were induced to express higher amounts of MHC class I antigens by recombinant interferon-gamma treatment. On the other hand, class II antigens were not involved in LAK-mediated lysis of autologous T blasts. In kinetics the NK type LAK cells appeared on day 3 of IL 2 treatment, the activity of which peaked on day 5 and then declined on day 7. By contrast, the CTL type LAK activity was noticeable after 5 day, reaching a maximum on day 7. These results indicate that LAK cells could be classified according to their ability to kill MHC class I positive and negative autologous target cells.

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For assessment of the effects of pregnancy and delivery on SLE activity, its activities during pregnancies were compared with those during 1-year period, with pre-pregnancy and post-pregnancy as control periods in 40 pregnancies of 26 patients. Of these 40 pregnancies, there were 11 full term deliveries, 12 premature deliveries, 13 spontaneous abortions and 4 artificial abortions. SLE activity was scored on the basis of 8 clinical features, 6 items of laboratory data and 4 of renal involvement. During pregnancy, this activity did not exceed that of the control. There were no differences in activity scores between normal and abnormal pregnancies. Renal involvement, however, was exacerbated during pregnancy in approximately 40% of the patients with normal or abnormal pregnancies. The frequency of SLE flare-up during pregnancy also compared with that of the control periods and was found essentially the same with respect to the clinical features and laboratory data. However, renal involvement flare-up during pregnancy occurred more frequently than that during pre-pregnancy or post-pregnancy (p<0.01 and p<0.02, respectively). Frequencies of laboratory data and renal involvement flare-up during pregnancy in patients with premature delivery were higher than those in patients with full term delivery.
Maternal serum complement (C 3) level in SLE patients and healthy controls were studied during pregnancy. The majority of patients with abnormal pregnancy had relatively low C 3 levels from the beginning of pregnancy up to the time of abortion or premature delivery compared with those of SLE patients or healthy controls with normal pregnancy. It is concluded that the monitoring of C 3 levels may provide a means for the prognosis of lupus pregnancies.

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Human B lymphocytes obtained from bone marrow aspirates were infected with Epstein-Barr Virus (EBV) and plated in microwell culture at the density of a single B cell per well along with irradiated autologous bone marrow mononuclear cells as feeder layers. By this procedure, many B cell lines were established effectively. The culture supernatants of 111 cell lines were examined for their secretion of IgM and IgG. Eighty-two cell lines secreted IgM in their supernatants. These immunoglobulines were investigated for their antibody activities against intracellular antigens of methanol fixed human fibroblasts by indirect immunofluorescence, and against surface antigens of human cell lines by radioimmunoassay (RIA) or indirect immunofluorescence. Twenty-one of 82 cell lines (26%) produced autoantibodies reactive with intracellular antigens of fibroblasts such as intermediate filaments, microtubules, mitochondrias, cytoplasmic granules, nuclei and nucleoli. Reactivities with cell surface antigens were not detected by indirect immunofluorescence, but were detectable by RIA in a number of culture supernatants. It is an interesting phenomenon that so many populations of bone marrow B cells are capable of producing autoreactive antibodies. Our system of B cell transformation by EBV is very useful for the exploration of this phenomenon.

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We attempted to evaluate the effect of immunosuppressants on the clinical course of systemic lupus erythematosus (SLE). The subject was 100 patients (10 males and 90 females), who could be followed up from the start of corticosteroid treatment and for more than 6 months after the start of the maintenance therapy (prednisolone 15 mg/day). They were divided into two groups: the one treated with corticosteroid alone (group S) and the other treated with corticosteroid and immunosuppressants for more than 12 weeks (group I).
Although the relapse and motality rate were not significantly different between two groups in both initial and relapse treatment, the period from the start of maintenance therapy to the relapse was longer in group I than in group S in relapse treatment.
Occurrence of severe infection and malignancy was not significantly different between two groups. In 19 patients studied by serial renal biopsies, immunosuppressive treatment could not improve the histological changes and urine protein excretions.
In conclusion, immunosuppressants seems to be significantly effective on the course.

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We studied clinical and immunological association between various immune parameters and SCM test which measured lymphocyte polarization change induced by the stimulation with phytohemagglutinin (PHA). It was found that number of peripheral lymphocytes, diameter of immune cutaneous tests or concentration of serum complements was identical among cancer patients with SCM-R_??_1 and healthy controls with SCM-R<1. It was also found that blastogenesis was higher in lymphocyte samples with SCM-R<1 as compared with those with SCM-R_??_1. Although blastogenesis and change of polarization are the phenomena expressed at different sites in lymphocyte, it is probable that same lymphocyte subpopulation is responsible for these two different phenomena. Lower percentages of B lymphocyte were noted in cell samples with SCM-R_??_1, and it was suggested that interaction between T lymphocyte and B lymphocyte was necessary for the stimulation of lymphocyte with PHA.
Clinically, descrease of SCM-R values was found in cancer patients who received immunotherapy with OK-432 for more than 4 weeks, and short incubation of SCM-R_??_1 lymphocytes in culture fluid containing OK-432 reduced SCM-R values to less than unity. Therefore, it was suggested that direct activation of lymphocyte with OK-432 was clinically responsible for decrease of SCM-R values after immunotherapy.

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A case of systemic lupus erythematosus (SLE) mimicking the features of infective endocarditis (IE) was reported.
A 38-years-old female who had suffered from rheumatic fever in childhood received the first mitral valve replacement for her remnant rheumatic valvular disease in 1967. In 1981, she visited first our hospital complaining of her joint pains and was diagnosed as rheumatoid arthritis. She also had proteinuria and hematuria, therefore renal biopsy was done. Histological diagnosis was IgA nephropathy. The second mitral valve replacement was performed on August in 1985 because of large intraventricular thrombosis. Three months after the second surgery, she developed severe arthralgia, and high spiking fever and dyspnea appeared 6 months later. IE was suspected and large dose of antibiotics was administered. But her symptoms did not improved, she was transfered to our hospital on March in 1986.
The patient had systolic heart murmur and swelling of several joints. Although erythrocyte sedimentation rate, CRP and gamma-globulin were increased, repeating venous and arterial blood cultures revealed no organisms. She had also leukopenia, high titers of anti-nuclear and anti-ds DNA antibodies. She was diagnosed as SLE, however we could not denied IE completely. Combination therapy of antibiotics and prednisolone was started. Her symptoms and laboratory abnormalities improved gradually after the treatment.
Many clinical similarities exist between SLE and IE and there were some reports that IE shows leukopenia and autoantibodies. We must carefully differentiate both diseases especially after heart surgery.

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Large granular lymphocyte (LGL) are comprised of phenotypically and functionally heterogenous subpopulations. It is known that Leu 7 antigen is expressed on LGL in human beings. Furthermore it has been reported that the percentage of Leu 7⁺cells, especially Leu 7⁺4⁺11^- cells, are expanded in azathioprine (AZ)-treated renal transplant patients with long-term stable graft function. In this study, we explored a phenotypical and functional characteristics of Leu 7⁺cells in Ciclosporin (CS) and AZ-treated renal transplant patients with long-term stable graft function. The following results were obtained: (1) The subpopulation of LGL, the phenotype of which was Leu 7⁺11^-OKT 3⁺(8⁺), was expanded in CS and AZ-treated patients and the tendency was more prominent in AZ-treated patients. (2) Leu 7^-11⁺cells, which possess the strongest natural killer (NK) activity, was decreased in CS and AZ-treated patients and the tendency was more prominent in AZ-treated patients. (3) The percentage of B lymphocytes was decreased in CS and AZ-treated patients and the tendency was more prominent in AZ-treated patients. (4) The percentage of Leu 7⁺11^-cells have a significant correlation with the change of B lymphocytes but no correlation with the percentage of Leu 7^-11⁺cells in CS and AZ-treated patients.
These results suggest: (1) The expanded Leu 7⁺LGL have an immunomodulatory function such as suppressor function in CS and AZ-treated patients. (2) The change of Leu 7⁺LGL and B lymphocytes has a greater relation to AZ-immunosuppressive mechanism than to CS-immunosuppressive mechanism.

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