Measurement of rheumatoid factor (RF) has been broadly used for evaluation of rheumatoid arthritis and the other diseases. For the detection of RF, passive hemaglutination test and Latex fixation test (LFT) are mainly used. However, they sometimes give controversial results under the influence of C_??_ and excess amount of γ-globulin. In this study described here, RF activity was measured in Laser Nephelometer (LN) by using human heat aggregated IgG as a antigen and compared the titer in LFT. By LFT and LN, RF activity in fresh sera found to have no differences, whereas RF activity in the long standing sera or particularly in the longstanding hyper γ-globulinemic sera found to be significantly increased in the LFT, comparing its activity in the fresh serum. But LN showed almost same results in the RF activity in both fresh or longstanding sera.
Positivity of RF activity in sera and joint fluids from patients with rheumatoid arthritis was 79% and 60% in LN and 82% and 64% in LFT, respectively. The RF activity in the 2-mercapto-ethanol (2-ME) treated sera and-joint fluids found to have 21% and 24% in LN and 34% and 33% in LFT, respectively. The RF activity in the 2-ME treated LFT-positive sera from the patients with liver cirrhosis found to have 3% in LN and 11% in LFT.
Thus, the RF activity measured by LN seems to be more accurate than that measured by LFT. Furthermore, these results suggested that the RF activity measured by LN in 2-ME treated sera indicated to be non-IgM-RF, presumably mainly containing IgG-RF.

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In this study, we tried to detect DNA-anti-DNA complexes, which were isolated from SLE sera by 3.5% PEG precipitation, by fluorophotometry using DABA.
In 22 of 31 sera from patients with active SLE and in 9 of 48 sera from patients with inactive SLE, DNA-anti-DNA complexes were found. The amount of DNA in the immune complexes in sera of SLE with active disease (4.43±2.10μg/ml) was significantly greater than that of SLE with inactive disease (1.20±1.15μg/ml, P<0.01). In addition, that of SLE correlated with the titer of anti-DNA antibodies and serum complement activity, but had no relationship with proteinuria. On the clinical coarse, that decreased significantly after prednisolone therapy.
On these results, it was suggested that the fluorophotometry was useful to detect DNA-anti-DNA complexes in sera from SLE patients.

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To further clarify the clinical significance of anti-DNA antibodies in SLE, anti-DNA antibodies measured by radioassay, electrosyneresis (ES) and complement fixation technique (CF) were assessed on patients with SLE and other diseases. By radioassay, 109 of 117 sera from clinically active SLE (per cent positive; 93%, mean value; 234u/ml), 69 of 147 sera from inactive SLE (47%, 43 u/ml) and 7 of 104 sera from other diseases (7%, 9u/ml) were positive. The binding activities of the seven sera in other diseases were less than 40u/ml. Sera reacting to native DNA by ES and/or CF showed high levels of DNA binding, and some sera reacting to heat denatured DNA also showed high values by radioassay. In this series, six patients with SLE who showed persistent high levels of DNA binding and the absence of active disease for several years were recognized. In there sera, differed from results of clinically active patients, anti-DNA antibodies by ES or CF were not detected, levels of serum complement were within normal range, and values of circulating immune complex were low except for one case. A case of them possessed anti-ENA antibodies with high titers. Immunoglobulin classes of anti-DNA antibodies were investigated. In those sera, immunoglobulin class of anti-DNA antibodies belonged mainly to IgG fraction, as well as in sera from patients with clinically and serologically active SLE.

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Macrophages are frequently found adjacent to surfaces of active bone resorption in victims of rheumatoid arthritis and periodontal disease, and may play a key role in bone resorption. This study offers evidence that macrophages can directly resorb bone.
Killed rat parietal bone was prelabeled with ⁴⁵Ca and cultured for 48-96 hours in the presence of rat peritoneal cells. Bone resorption was measured by the release of ⁴⁵Ca from the bone into the culture medium. Peritoneal exudate cells (PEC), chiefly induced by paraffin oil, were found to resorb rat parietal bone. Peritoneal resident cells (RC) were also found to be capable of resorbing bone, but to a lesser degree than PEC.
This difference may be due to the difference in cell activity, specifically with respect to the activity of lysosomal enzyme and phagocytosis, which was found to be higher in PEC than in RC. It was also deduced that only the PEC which had attached to the plastic dish exhibited bone resorbing activity non-attached cells failed to resorb bone.
These results suggest that macrophages may play an important role in the process of bone destruction that occurs with chronic inflammatory diseases such as rheumatoid arthritis and periodontal disease.

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A microplate method for total hemolytic complement (CH 50) assay was described. The effect of unlysed sensitized red cells on the absorbance at 405mμ was minimal and the complement dependent hemolytic curve was similar to those obtained by Mayer's method. The mean titer of normal 19 sera showed 226±56 (mean±ISD) and the correlation coefficient to the titers obtained by Mayer's method in various disease sera was 0.92 (n=41).

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Human polymorphonuclear neutrophils (PMNs) have been shown to have a cytotoxic effect on tumor cells primarily by utilizing the mechanism of oxidative metabolism. The PMN chemiluminesence response (CL) dependent on Luminol (3-aminophthalic hydrazide) was studied in 60 patients with cancers along with 24 patients with benign diseases to determine the oxidative metabolic activities. The mean peak CLR was 45.6+11.6 relative intensity (RI) (m±SD) in the healthy control group. Although no significant abnormalities were demonstrated either in patients with cancers of the stomach, colon, lung and breast or in subjects with benign disorders such as peptic ulcer, ulcerative colitis, cholelithiasis and so forth, the peak CLR of PMNs obtained from sixteen patients with advanced gastric cancer in which the depth of the tumor invasion is extended to the propria muscle layer or more deeply was 26.7±12.7RI. This was significantly (p<0.05) less than that observed in the healthy control group. The results suggest that PMNs in advanced gastric cancer patients may have defective oxidative metabolistm or impaired tumoricidal and bactericidal activity.

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Little attention has been focused on the function of polymorphonuclear neutrophil (PMN) in cancer patients, whereas the cell has been shown to have a cytotoxic effect on neoplasms. In the present study, PMN chemotactic response and random migration were measured using an agarose method in 65 patients with cancers and in 24 patients with benign diseases. The chemoattractants used were zymosan-activated serum (ZAS), Escherichia coli culture supernatant (SEc), Staphylococcus aureus culture supernatant (SSt), and N-formyl methionyl-leucyl-phenylalanine (FMLP). Chemotactic responses in normal subjects were 89.7±8.4mm (M±SD, ×40) to ZAS, 70.5±4.1mm to SEc, 66.6±8.7mm to SSt, and 78.1±5.6mm to FMLP, and the random migration was 53±4.3mm. There was a statistically significant (p<0.01) loss of chemotaxis to SEc and SSt, and RM in 28 gastric cancer patients. Chemotaxis and RM in 17 patients with advanced gastric cancer in which the depth of cancer invasion was extended to the propria muscle layer or more deeply were all significantly lower than those in normal subjects (p<0.05). In the remaining of 11 patients with early gastric cancer, however, a significant increase in chemotaxis to SEc and FMLP, and a significant decrease in RM were observed. No significant change of chemotaxis was obtained from patients with cancers of the esophagus, colon, breast and lung; but RM was significantly decreased (p<0.05) breast and lung cancer patients. There was also a significant decrease (p<0.05) in chemotaxis to SEc in 4 patients with obstructive jaundice including 3 malignant neoplasm patients. Chemotactic responses to SEc and FMLP were significantly increased(p<0.05)in 7 patients with ulcerative colitis, though RM was normal. In two patients with severe bacterial infection, both chemotaxis and RM were decreased. The data from gastric cancer patients suggest that PMN chemotaxis in earlier stage diseases may be increased and beneficial to the host defense system against infection and neoplasma; but in the more advanced stage diseases the more defecttive PMN function may lead to its more impaired tumoricidal and bactericidal activity.

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Luminol-dependent chemiluminescence in whole blood (whole blood CL) was estimated using various kinds of whole blood from the patients with pediatric disease. Three types of information can be obtained from the kinetics of whole blood CL as previously shown¹⁾; 1) Total phagocytic function of whole blood which depends on the number of granulocytes in whole blood as the material and their function. 2) Phagocytic and microbicidal activity of granulocytes themselves. 3) Opsonic activity of whole blood for the agent which is phagocytosed. In the present study two types of CL inducer were used. One was nonopsonized zymosan, and the other was aggregated gamma globulin (Agg). The latter inducer can detect the real CL response of granulocytes, because it can induce CL without the opsonization. Results obtained in the present study were as follows; 1) Blood obtained from cord and newborn showed a prolonged time showing the peak CL, suggesting low opsonic activity. CL response of granulocytes themselves were slightly decreased in cord blood, but not in blood of newborn. 2) The patients with chronic granulomatous disease (CGD) showed no CL response, and 2/3 of their mothers showed a moderately decreased response, suggesting that they are carriers of CGD. 3) Two patients with hypocomplementemia, namely SLE and chronic nephritis, showed a remarkably prolonged time showing the peak CL for zymosan as the CL inducer, but showed rather an enhanced response for Agg, suggesting that serum opsonic activity for zymosan, namely C3b, is low, but function of granulocytes themselves is enhanced. 4) Patients with pediatric malignancy tended to show a decreased peak CL of whole blood due to decreased number of granulocytes, but phagocytic function itself seemed to be not impaired. Some patients during chemotherapy showed a prolonged time showing the peak CL. It was suggested that chemotherapy, especially L-asparaginase, suppress the production of complement. 5) Phagocytic function of whole blood in patients with severe neutropenia was estimated after the granulocyte transfusion by the method of filtration leukaphresis, and an increased function was observed in 5 of 7 cases, but the degree was not enough compared with normal value. These results suggest that the method of whole blood CL is a useful one to evaluate the phagocytic function of whole blood and opsonic activity in the clinical laboratory.

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A boy with severe combined immunodeficiency received bone marrow transplantation from an HLA-compatible sibling, and immunological reconstitution was achieved. He had hypogammaglobulinemia, decrease in T cell number, inbalance of T cell subsets, and defective lymphocyte blastoid transformation. At age of 14 months, bone marrow cells from his sister were infused intravenously. Eleven days after the transplantation, positive mitogenic responses to PHA and Con A were first demonstrated. However, acute graft-versus-host disease was observed at 2 weeks, but it was mild and lasted for a few weeks. Two months later, serum IgG and IgM increased rapidly up to the levels of 888 mg/dl and 268 mg/dl, respectively, accompanied by the elevation of specific serum antibody titers, and the number of T cells and T cell subsets were normalized. Positive delayed-type cutaneous hypersensitivities to some specific antigens were also demonstrated. Lymphocyte chimerism after marrow transplantation was shown by analysis of sex-chromosome. He has been well, for the last 21 months without any treatment.

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We experienced a case of insulin dependent diabetes mellitus (DM) with Graves' discase and examined immunological functions. The absolute numbers of the peripheral blood lymphocytes and lymphocyte subpopulation did not differ from those of the controls. She had normal number and ratio of Fc receptor-positive lymphocytes. Mitogenic response by peripheral blood lymphocytes were normal and number of pokeweed mitogen-induced immunoglobulin producing cells were also normal. Even though, cell-mediated cytotoxic activity and natural killer (NK) activity were normal, a defect in antibody-dependent cell-mediated cytotoxicity (ADCC) was elicited. Although ADCC and NK appear to be functionally distinct forms, the physical isolation of highly pure NK and K effector cells has proven extremely difficult. Thus, the relationship between NK and K effector cells is presently unclear. Some authors have speculated that the two effector cell populations are identical. However, the presence of this case strongly suggest that K cell is distinct from NK cell. In order to resolve the question whether loss of ADCC activity have an important role in development of DM and Graves' disease or not, accumulation of cases and further studies are necessary.

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Patients with common variable immunodeficiency (CVID) have low-level immunoglobulins involving all classes and include a variety of disorders. Very low levels of serum immunoglobulins (Ig) were discovered in a 67-year-old woman who had been suffered from carpal tunnel syndrome and had been taking low dose of glucocorticoid for several years. Quantitative measurement of serum Ig concentration resulted in IgG 600 mg/dl, IgA 20 mg/dl, IgM 20 mg/dl and IgE 25 u/dl. Analysis of the peripheral lymphocytes revealed that the count was normal (3, 600/cmm) and T:B cell ratio was 78:22 (control 75:25). Surface IgG, A, M bearing cells were detected in normal ratio by direct immunofluorescencec-onjugated antibody method. The amount of Ig synthesis by PWM stimulated peripheral mononuclear cells from the patient was measured in vitro using solid phase radio-immunoassay. Co-culture of normal B cells with patient's T cells resulted in reduced synthesis of all classes of Ig, however, normal B cells incubated with X-ray treated patient's T cells could synthesize normal amounts of all classes of Ig. Moreover, combination of patient's B cells and normal T cells resulted in the synthesis of normal amounts of Ig. Thus, it was demonstrated that low levels of serum Ig in this case were due to hyperfunction of the suppressor T cells.

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