J. Kaldor

FÆCAL ANTIGEN IN VIRAL HEPATITIS

Abstract An antigen has been detected in faecal extracts from 90 out of 220 patients with viral hepatitis and from 5 of 158 patients with other diseases. In viral hepatitis this antigen is present early in the disease and usually disappears within three weeks of the first appearance of dark urine. It seems to be particulate and is serologically distinct from Australia antigen.

Serum Immunoglobulin Levels in Acute A, B, and Non-A, Non-B Hepatitis

Immunoglobulin M, G, and A concentrations were determined by radial immunodiffusion in sera collected from 117 patients with acute hepatitis A, hepatitis B, or non-A, non-B hepatitis. Statistically significant differences in IgG and IgM levels were detected between the three groups. In particular, elevated IgG and almost-normal IgM levels were regularly detected in patients with non-A, non-B hepatitis while the opposite pattern was seen in patients with hepatitis A. Calculation of a serum IgG/IgM ratio enabled discrimination between most patients with non-B hepatitis. In 92% of patients with hepatitis A, the ratio was less than 6, whereas 82% of patients with non-A, non-B hepatitis had ratios of greater than 6. The IgG/IgM ratio may be of value in distinguishing between subjects with the two forms of the disease when specific serologic tests are unavailable.

Australia Antigen and Viral Hepatitis: A Brief Review and a Preliminary Australian Report

&NA; Immunodiffusion methods were used to test for the presence of Australia antigen in sera from Australian patients. Antibody‐containing sera for these tests were obtained from Melbourne haemophiliacs. When antigen was detected its specificity was verified using a reference human anti‐Au(1) serum supplied by Blumberg. All antigen‐containing sera thus detected gave reactions of identity with one another and with an Australia‐antigen‐positive serum tested by Blumberg. Australia antigen was detected in 5 of 10 patients with post‐transfusion hepatitis, in 3 of 93 patients with acute viral hepatitis unrelated to transfusion, in 2 of 17 patients with chronic hepatitis, in 8 of 32 institutionalized patients with Downs syndrome, in 1 member on the staff of a dialysis unit, in 1 Blood Bank donor on a panel when the recipient developed viral hepatitis but in none of 121 control sera.

Guillain-Barré syndrome and Campylobacter jejuni/coli.

A close temporal relationship between Guillain-Barre syndrome (GBS) and preceding Campylobacter jejuni or C. coli (CJC) infection has been reported by us’ and in a prospective study in south-east England.’ The acute paralytic symptoms coincide with a serum antibody pattern characteristic of recent infection with CJC. This association suggests a possible immunological cross reaction between the organism and certain hostspecific tissue component(s), hence we undertook to investigate the possible cross-reactivity between CJC and human sciatic nerve (SN) antigens using immunoblotting. For this experiment we used a homogenate of fresh human nerve obtained at lower limb amputation or SN obtained from a sacrificed primate (Rhesus monkey) and a dense suspension of 12 fecal isolates of CJC, none of which had been implicated in a GBS episode. Anti CJC antibodies were produced by immunizing rabbits with twice weekly intravenous injections for a period of 4 wks with a dose increasing weekly from 0.2 mL to 1.0 mL in the fourth week. Many rabbits in our colony are sub-clinically infected with Campylobacter jejuni or Campylobacter coli. and therefore rabbits were selected for immunization if their preimmunization sera showed no or minimal levels of anti CJC antibodies on immunoblotting. Approval for the above experiments was obtained from the hospital’s animal ethics committee. The antisera obtained were then used in a immunoblot setting following our previously published method.’ The neural or CJC peptides were separated by electrophoresis in 12% polyacrylamide gel and then blotted onto a nitrocellulose. The individual nitrocellulose strips containing peptide were then reacted with: (a) pre-bleeds of the immunized rabbits, (b) post-immunization bleeds and (c) postimmunization bleeds which were first absorbed with a dense suspension of CJC. The results of these reactions for the 4 rabbits’ sera are shown in the Figure. As expected and shown on the left side of the

Serotyping of Streptococcus Pneumoniae by Latex Agglutination

&NA; A simple method is presented for serotyping Streptococcus pneumoniae which uses easily prepared sensitized polystyrene latex particles. The technique is simple, fast and reliable and can detect pneumococcal antigens in body fluids.

An Evaluation of the Techniques Used for the Detection of Australia Antigen and Antibody

Summary It is probable that testing for Australia antigen and antibody will soon become a routine procedure in hospital and blood transfusion laboratories. An outline of the methods currently available is presented and an evaluation given. The technique of cross‐over immuno‐electrophoresis is sensitive, simple and provides an answer in one to two hours. It might well become the method of choice.

The incidence of liver specific antigens in liver disease

&NA; Three soluble, liver‐specific antigens were demonstrated in the sera of between 20 and 40% of patients suffering from liver related diseases; the pattern of distribution of these antigens in patients suffering from hepatitis A, hepatitis B, non‐A non‐B hepatitis and from glandular fever is described. Liver‐specific antigens were also detected in approximately 10% of patients in whom no primary liver abnormality was suspected but not in a control group of healthy individuals. Our results suggest that the appearance of liver antigens in the sera of patients suffering from specific diseases associated with abnormalities of liver function is inconstant and hence of no clinical value.