Deborah A. Merrill

Salivary immunoglobulinand albumin: Development during the newborn period

Summary Salivary levels of γG, γA, γM globulins andalbumin were measured serially in saliva of newborn infants by electroimmunodiffusion. Salivary γA was not detected at birth but appeared beginning at one week of age. By 4 weeks of age 92 per cent of normal infants had “adult” levels of γA in their saliva. γM was not detected. γG and albumin were temporarily present in many salivary samples in appreciable amounts before 10 days of age but these proteins disappeared as γA appeared in saliva. Serial determinations of salivary γA may provide a simple rapid method for early detection of defects of immunoglobulin production. The temporary appearance of γG and albumin in saliva may represent “leakage” from serum and probably reflects the increased permeability to proteins of mucous membranes in the immediate postnatal period.

Prevention of chronic neonatal hepatitis B virus infection with antibody to the hepatitis B surface antigen.

Abstract The efficacy of specific-antibody treatment in preventing hepatitis B virus infection in infants born to mothers positive for the hepatitis B surface antigen was evaluated. Four babies wer...

Salivary immunoglobulins: Normal adult values and dissociation between serum and salivary levels

Abstract Salivary immunoglobulin levels were measured by electroimmunodiffusion (EID) in adults in health and disease. Forty parotid fluid samples from 18 healthy adults showed no detectable γG (one exception), γM, or γD. γA was present in all samples (2.8 to 15 mg. per cent, median 9.5 mg. per cent). Serial samples from the same individual showed considerable variation. Simultaneous samples of right and left parotid fluids showed little differences. In general, parotid fluid γA levels were higher than mixed submandibular-sublingual fluid γA levels. Eight patients with congenital sex-linked hypogammaglobulinemia and 3 patients with dysgammaglobulinemia had no detectable serum or salivary γA. A number of patients had dissociation of serum and salivary γA with low serum γA but normal levels of parotid fluid γA. These data suggest that the serum and salivary immunoglobulin pools are under separate regulation.

Serum immunoglobulin measurement during the first year of life and in immunoglobulin-deficiency states.

Serum immunoglobulin concentrations at several age intervals during the first year of life have been determined by a capillary immunoprecipitation technique. Immunoglobulin G was present in cord sera and declined during the first six months of life, following which an increase to almost three-fourths of the normal adult level was observed in the next six months. Immunoglobulin A was absent in the cord serum and progressively increased, reaching a level by one year of age approximately one-fifth that of the adult. Immunoglobulin M was present in most cord sera studied and steadily rose to one-half of adult levels by 52 weeks of age. Serum immunoglobulin determinations for selected immunologic deficiency states are reported.

Disaccharidase deficiency in children with immunologic deficits

Eighteen Caucasian patients with various immunologic deficiencies had gastrointestinal manifestations such as diarrhea, steatorrhea, partial villous atrophy, and lymphoid nodular hyperplasia. The levels of IgA in the saliva and in the duodenal juice correlated well with each other and also reflected the serum levels of IgA. Determinations of the jejunal disaccharidase activity revealed an isolated lactase deficiency with normal villi in 3 of the 18 patients. Seven of the 8 patients with deficiencies of cellular immunity and one with isolated IgA deficiency and normal cellular immunity, were found to have decreased lactase, sucrase, and maltase activity despite the presence of a normal villous pattern and of intact epithelial cells.

Immunotherapy with antibody, lymphocytes and transfer factor in chronic hepatitis B

Abstract The efficacy of adoptively transferred humoral and cell-mediated immunity in chronic hepatitis B infection was studied in three patients. The first patient with renal failure and chronic active hepatitis received high titered human antibody to the hepatitis B antigen. The second, an asymptomatic chronic antigen carrier, received “immune” lymphocytes and transfer factor (which was not tested for biologic activity in a normal recipient) prepared from the same collection of cells. In the third patient who had acquired hepatitis B from her mother at birth, transfer factor prepared from maternal leukocytes was given on two occasions. Clinically, there was no change in the first patients liver function despite transient descreases in hepatitis B antigen and increases in antibody titers. Coexistent antigen and antibody persisted for over 4 mo. In the second patient, the immune lymphocytes induced biochemical signs of transient acute hepatitis associated with increased antigen levels, whereas transfer factor did not have an effect. In the third patient, maternal transfer factor caused increased hepatitis B antigen and transaminase levels on two occasions. Subsequently, liver function became normal and the antigen titer was reduced by 95%. Adoptive transfer of humoral immunity does not appear to modify established hepatitis B infection, whereas cell-mediated immunity does. It is postulated that liver cell injury in hepatitis B may be more related to the hosts cell-mediated immune response rather than to a cytopathogenic effect of the putative hepatitis B virus.

Hypergammaglobulinemia—the role of the immunoglobulins (γG, γA, γM)

Scrum immunoglobulins (γG, γA and γM) were measured in 86 adult patients with hypergammaglobulinemia and 66 normal adults. Hypergammaglobulinemia includes a heterogeneous collection of instanees in which the immunoglobulins may be elevated singly or in various combinations. No pattern of immunoglobulin change was specific for a particular discase or diseased organ system. (Monoclonal gammopathies were excluded). γA was the immunoglobulin elevated most frequently and to the greatest extent. Serum clectrophoresis was a good screening test for elevated immunoglobulins. Normal valucs for 66 normal adults are: (fifth percentile—mean—nincty-fifth percentile). γG, 720-995-1400 mg. per cent; γA, 84-177-314 mg. per cent; γM, 93-187-320 mg. per cent.

Quantitation of the hepatitis-associated antigen by electroimmunodiffusion***

Electroimmunodiffusion (EID) was adapted for the detection of hepatitis-associated antigen (HAA) and compared with immunoelectroosmophoresis (IEOP) and double diffusion (DD) with respect to sensitivity and applicability to rapid screening of large numbers of sera. EID is as sensitive as IEOP, requires less antiserum, and is quantitative. Results may be obtained within 45 minutes if high-titer antiserum is available. Using this technique, 26 HAA-positive sera were identified among 10,303 potential blood donors during a 3 month period.