F. Kissmeyer-Nielsen

Occurrence of lymphocytotoxic lymphocytes and antibodies after corneal transplantation.

Twentyfive recipients of penetrating corneal grafts were investigated for the presence in the peripheral blood of cytotoxic lymphocytes by the Direct Cell Mediated Lympholysis (Direct CML) test as well as for lymphocytotoxic antibodies.

HISTOCOMPATIBILITY ANTIGENS ON THE HL-A LOCUS IN GENERALISED GESTATIONAL CHORIOCARCINOMA: A Family Study

Abstract Six families, including six women, five of their husbands, and seventeen of a total of eighteen children were tissue-typed, by a battery of well characterised, lymphocytotoxic sera and by other methods. All the women had or had had generalised, placental choriocarcinoma. In the husbands, one or more tissue antigens were demonstrated (major incompatibilities) which could not be found in their wives. Tissue typing of the children showed, however, that five of the matings were able to produce zygotes with tissue types compatible with those of the mothers. In these five marriages, twelve out of sixteen children investigated were compatible with the mothers. In one marriage, five major incompatibilities were found between the only child and the mother. The results of the investigations are consistent with the hypothesis that the survival of the placental choriocarcinoma in the maternal host presupposes a high degree of histocompatibility between the fœtus and the mother as regards strong transplantation antigens.

HL‐A and ABO antigens and malignant melanoma. A study of 212 cases

Two hundred twelve melanoma patients, including 38 prospective and 174 retrospective cases, were ABO and HL‐A typed, and the results were compared with those obtained in a sample of 562 healthy controls. The phenotype frequencies within the ABO system were identical in patients and controls. A lower frequency of HL‐A7 (significant at the 5% level) was observed in the melanoma patients. Furthermore, deviations from the controls were observed in the following subgroups of patients: a deficiency of HL‐A7 in the female patients (5% level); and a surplus of HL‐A1 (1% level) and W19 (5% level) in patients with chances of 5‐year corrected survival rates of 0–19% and 20–79(%, respectively. However, although statistically significant, the deviations should at present be considered to be fortuitous as roughly 200 comparisons were made. It is concluded that the investigation did not throw any light on the etiology of the disease or the prognosis of the patients.

Blocking Effect of Rheumatoid Factor on Complement Fixation by Thrombocyte Iso‐Antibodies

The extensive work of SHULMAN et al. [14] has shown that complement fixation (C’F) is a very reliable method for demonstration of some specific thrombocyte iso-antibodies. Some thrombocyte iso-antibodies do not fix C’, but will interfere with the reactivity of a human C’-fixing, specific thrombocyte antibody, in a manner similar to tha t of blocking antibodies interfering with erythrocyte iso-agglutinins. These thrombocyte antibodies are called incomplete or C‘ blocking. Three out of 10 C’-blocking thrombocyte antibodies were found to give a positive antiglobulin consumption with thrombocytes used as antigen [14]. It is well known that many sera from patients with systemic lupus erythematosus (SLE) give a positive antiglobulin consumption when thrombocytes are used as antigen [3]. Thus, there is some similarity between the reactivity of incomplete or C’-blocking thrombocyte isoantibodies and antibodies from patients with SLE. Consequently, the possibility existed that the LE-factor could be demonstrated by a blocking effect on the C’F of specific thrombocyte antibodies. To test this hypothesis sera containing various antinuclear factors (ANF) were tested for blocking effect on C’F by known thrombocyte isoantibodies using thrombocytes as antigen. No correlation was found between the presence of antinuclear factors and the blocking effect, but sera containing a rheumatoid factor (RF) exhibited a distinct blocking effect. The suspected correlation between the presence of R F and the blocking effect on C‘F by thrombocyte antibodies was consequently investigated in a larger series of sera.

HL‐A in Hodgkin's Disease. III. A Prospective Study

The results of numerous investigations of possible associations between HL-A antigens and Hodgkins disease are conflicting. We have previously reported an increased frequency of HL-Al and HL-A8 in two different series of retrospectively studied Caucasian patients from Denmark (Kissmeyer-Nielsen et al. 1971, 1972). The results reported in 1972 were very similar to those obtained in a Canadian series of patients studied by Falk «fe Osoba (1971). The same trend was foimd in a combined material of 523 patients studied during the Fifth Workshop in Histocompatibility Testing (Morris et al. 1972). No really convincing evidence for an increase of 4C related antigens (i.e. HL-A5, W5 and W18) was found. A larger combined study including the above-mentioned reports (Svejgaard et al. 1974) showed increases for a substantial number of LA and FOUR antigens in Hodgkins disease and among them were HL-Al, HL-A8, HL-A5 and W18. However, the results of previously reporied investigations are not completely convincing, and a majority of the materials studied can be criticized espedally as most of them do comprise retrospective as well as prospective cases, which might severely influence the results.

The impact of HLA-DR antigen matching on the survival of cadaveric renal allografts. A prospective one-center analysis.

The impact of HLA-DR antigen matching on the survival of cadaveric renal allografts was assessed in 158 consecutive transplants performed in our unit since early 1978. In 41 donor-recipient pairs with two shared HLA-DR antigens, the actuarial graft survival rate at 6 months was 73% as compared with 51% in 76 transplants with one HLA-DR antigen shared and 32% in 41 transplants with zero shared HLA-DR antigens. This finding is highly significant (P for heterogeneity [PH] = 0.0005 and P for trend, [PT] = 0.0001). Our data clearly indicate that HLA-DR antigen sharing is more beneficial than merely avoiding HLA-DR incompatibility. But, the frequent antigen HLA-DRw6 was not taken into account in this study due to difficulties in its identification. We found no evidence that the observed beneficial effect of HLA-DR matching could be explained by interaction of other prognostic factors, such as sex, age, previous transplantation, diabetes mellitus or pretransplant blood transfusion. Patients who did not receive blood transfusion prior to transplantation had a significantly lower graft survival rate than those who did (13% vs. 56% at 6 months). HLA-DR matching was found to have a powerful effect on graft survival even among pre-transplant blood transfused recipients (PH = 0.002, PT = 0.0006). We conclude that selection of recipients for transplantation should attempt to achieve HLA-DR identical combinations.

The HL‐A Antigen, KN‐HN(=HL‐A13)

Using a previously described micro-lymphocytotoxic technique [2] an increasing number of HL-A antigens are being defined. An HL-A specificity, KN-HN, belonging t o the Four-series, was defined a couple of years ago with one serum originating from a nontransfused patient cured of choriocarcinoma. The results of HL-A typing in the family, which have previously been published [6], showed that the patient was HL-Al,Z,KNTlB, the husband HL-A2, R *,KN-HN and two children HL-A2,KN-HN. The KN-HN antigen has previously been shown to fit into the still unknown number of multiple allelic genes belonging to the Fourseries [3, 5, 71. The HN-specificity has been found to be completely ‘included’ in two different anti-4A sera (KN-4A1 and KN-4A2) which correlated very closely to the 4A-specificity of VAN ROOD during the Torino Workshop [l, 41. These data indicate that this HL-A antigen may be fairly important. The same specificity of an HL-A antibody has not been reported from other laboratories, which is apparent from a quite extensive WHO investigation organized in 1968 by TERASAKI [8]. I n this study the HN-specificity was included among a fairly large number of sera which were analysed for correlation between all of the sera