Hitoshi Hatano

Capability of complement fixation of pemphigus antibodies in vitro.

The capability of complement fixation of pemphigus antibodies was tested using combined in vitro complement immunofluorescent (IF) staining methods. Three sera out of 25 serum samples from 22 pemphigus patients revealed positive reactions, while all other sera gave negative results. Specificity control tests confirmed the positive reactions to be specific for complement staining. Complement fixing pemphigus antibodies were titrated lower than corresponding IgG antibodies and were demonstrable only in the extensive stage of the disease. Thus, the present work supplied evidence that pemphigus antibodies fix complement in vitro. However, the discrepancy still remains between the in vivo deposition of complement in most cases of pemphigus and in vitro capability of complement fixation in only few cases. More investigations should be needed to explain the exact role of complement in pemphigus acantholysis.SummaryThe capability of complement fixation of pemphigus antibodies was tested using combined in vitro complement immunofluorescent (IF) staining methods. Three sera out of 25 serum samples from 22 pemphigus patients revealed positive reactions, while all other sera gave negative results. Specificity control tests confirmed the positive reactions to be specific for complement staining. Complement fixing pemphigus antibodies were titrated lower than corresponding IgG antibodies and were demonstrable only in the extensive stage of the disease. Thus, the present work supplied evidence that pemphigus antibodies fix complement in vitro. However, the discrepancy still remains between the in vivo deposition of complement in most cases of pemphigus and in vitro capability of complement fixation in only few cases. More investigations should be needed to explain the exact role of complement in pemphigus acantholysis.ZusammenfassungMit Hilfe von dem kombinierten in vitro-Immunofluores-cenzkomplementfixationstest wurde in vitro-Bindung von Komplement durch Pemphigusantikörper untersucht. Drei Seren aus den 25 Seren von 22 Patienten mit Pemphigus zeigten positive Bindung von Komplement (K3), während die übrigen Seren negative Befunde zeigten. Die Spezifitätskontrolltests bestätigten, daß die positive Reaktionen spezifisch für Komplementfixation waren. Diese Komplementbindungsantikörper zeigten einen niedrigeren Titer als die korrespondierenden IgG-Antikörper und konnten nur im ausgedehnten Krankheitszustand gefunden werden. Diese Ergebnisse belegten, daß Pemphigusantikörper das Komplement in vitro fixieren. Jedoch gibt es Diskrepanzen zwischen in vivo-Komplementsvorkommen und in vitro-Komplementsbindung. Die genaue Rolle des Komplements bei der Pemphigusacantholyse muß noch weiter untersucht werden.

A CASE OF PLASMACYTOSIS WITH MULTIPLE PECULIAR ERUPTIONS

A 32‐year‐old man had been in good health until he noticed painful swelling of the lymph nodes in the left occipital region in spring of 1975. Half a year later, multiple, infiltrating erythematous or nodular lesions appeared on the anterior chest and then spread over almost his entire body except for the lower extremities. These skin lesions were reddish brown to purplish brown in color, and irregular in shape and size. All of his superficial lymph nodes were palpable, and pain was felt on pressure. No other systemic symptoms were noted.

Multinucleate epidermal cells in non-neoplastic dermatoses.

Multinucleate epidermal cells (MEC) originated from keratinocytes were observed histologically in 92 of 197 cases of non‐neoplastic dermatoses, such as lupus erythematosus (26 of 70), lichenoid eruptions (26 of 47), Hailey‐Hailey disease (5 of 5), psoriasis vulgaris (20 of 49) and so on. Most of these cells had two nuclei, and a few had three nuclei. MEC usually showed perinuclear bands of eosinophilic material which also showed positive staining for epidermal fibres (tonofilaments). In all cases of Hailey‐Hailey disease, close correlation between formation of MEC and dyskeratotic tendency was observed. From these findings, it is concluded that the mechanism of formation of MEC in these dermatoses may be similar to that of Bowens disease, in which dyskeratotic tonofilaments become entangled with the spindles of the mitotic apparatus so that normal cell division cannot take place. It seems likely that MEC are a manifestation not only of malignant dyskeratosis but also of benign one.

DISTRIBUTION OF GLYCOSAMINOGLYCANS IN DERMAL CONNECTIVE TISSUE FROM SCLERODERMA PATIENTS

Lesional skin specimens from scleroderma patients were sliced horizontally into three layers. The ratio of hyaluronic acid to dermatan sulfate in each layer was analyzed. The ratios in each layer of scleroderma skin were lower than those in the corresponding layers of normal skin and the lowest value was found in the bottom layer of scleroderma skin. The possible involvement of glycosaminoglycan metabolism in the pathophysiology of scleroderma is discussed.

Serologic differences in strains of Sporothrix schenckii

To obtain evidence that Sporothrix scheneckii enters the body by contact with contaminated materials, the antigenic property of strains from different sources was investigated. The reciprocal absorption test of the antisera against a soil isolate and a human isolate (KO 4606) showed that the absorbed antisera against KO 4606 possessed unique antigen(s) in addition to the common antigen of both strains. Twenty-three clinical isolates were tested with absorbed antisera. Not all of them possessed the unique antigen(s), but there were serologic varieties among S. schenckii strains, regardless of their sources, clinical type of the disease and the morphology of the yeast phase cells.

Capability of complement fixation by in vivo bound antibodies in pemphigus skin lesions.

Skin biopsy was performed in five cases of pemphigus; direct immunofluorescence (IF) studies demonstrated intercellularly bound IgG and C3 in each case. Sections of lesional skin, containing in vivo bound IgG were, in two cases, capable of further binding C3in vitro from normal human serum, an effect most marked in relation to areas of acantholysis. This work provides additional evidence that the complement system is involved in the process of pemphigus acantholysis.

Experimental acantholysis by complement-fixing intercellular antibodies

SummaryComplement-fixing intercellular antibodies were detected in 10 of 17 sera from untreated pemphigus patients. The role of complement in the organ culture system was investigated using these sera. Ten sera possessing complement-fixing intercellular antibodies showed IgG binding to the intercellular substance in the organ-cultured skin and acantholysis-like changes were observed in eight cases. C3 deposition was not seen in any case. However, after treatment of the sections of cultured skin with fresh normal human serum, complement fixation of the intercellular substance by bound IgG was revealed in all the ten cases. No significant differences in the grade of acantholysis-like changes between the complement-depleted system and the complement-supplied system were observed. Complement does not appear to be necessary in the acantholytic process in the in vitro organ culture system, even though we considered the presence of complement-fixing intercellular antibodies.

Comparison of in vivo and in vitro Capability of Complement Fixation by Pemphigus Antibodies

Using complement immunofluorescence, the capability of complement fixation by bound antibodies in pemphigus lesional skin was compared with circulating intercellular antibodies of complement-fixing type in the same patient. Five lesional skin samples from 6 patients, containing bound IgG, gave positive binding of complement (C3) supplied from fresh guinea pig serum, while only one serum sample showed complement-fixing pemphigus antibodies in the circulation. These results support the view that complement-fixing pemphigus antibodies are rapidly localized to the skin and play a role on the production of acantholysis.

Antigenic similarity between Ceratocystis species and Sporothrix schenckii as observed by immunofluorescence

Antigenic properties of Sporothrix schenckiii and 2 species of Ceratocystis (C. stenoceras and C. ulmi) were compared by indirect immunofluorescent staining technique. Both species of Ceratocystis and 2 strains of S. schenckii reacted equally well with the unabsorbed antisera against 2 strains of S. schenckii, indicating that these three species share common antigen. The absorption experiments showed that only S. schencki human strain demonstrated a unique antigen. These results support the hypothesis of Ceratocystis-Sporothrix complex in the point that both species have one major common antigen.

CORRELATION BETWEEN COMPLEMENT-FIXING PEMPHIGOID ANTIBODY TITRES AND DISEASE ACTIVITY

A positive correlation between complement‐fixing pemphigoid antibody titre and disease activity was observed in 4 of 8 patients with bullous pemphigoid using complement immunofluorescence. The fact that this correlation cannot always be demonstrated seems to contradict the active role of complement‐fixing pemphigoid antibodies in the pathogenesis of bulla formation. The similarity of bullous pemphigoid and herpes gestationis is discussed.