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Only a few markers have been instrumental in the diagnosis of cancer. In contrast, tumor markers play a critical role in the monitoring of patients. The patient’s clinical status and response to treatment can be evaluated rapidly using the tumor marker half-life (t1/2) and the tumor marker doubling time (DT). This report reviews the interest of determining these kinetic parameters for prostate-specific antigen, human chorionic gonadotropin, α-fetoprotein, carcinoembryonic antigen, cancer antigen (CA) 125, and CA 15-3. A rise in tumor markers (DT) is a yardstick with which benign diseases can be distinguished from metastatic disease, and the DT can be used to assess the efficacy of treatments. A decline in the tumor marker concentration (t1/2) is a predictor of possible residual disease if the timing of blood sampling is soon after therapy. The discrepancies in results obtained by different groups may be attributable to the multiplicity of immunoassays, the intrinsic characteristics of each marker (e.g., antigen specificity, molecular heterogeneity, and associated forms), individual factors (e.g., nonspecific increases and renal and hepatic diseases) and methods used to calculate kinetics (e.g., exponential models and timing of blood sampling). This kinetic approach could be of interest to optimize patient management.

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We measured the serum concentrations of IgG subclasses in healthy subjects (n = 26) and in patients with community-acquired pneumonia (CAP) on admission (n = 38), at recovery (n = 21), and 9 months after admission (n = 19). Then, in 8 of the control subjects and 15 of the patients, we measured IgG subclasses and mean serum antibody concentrations of pneumococcal capsular polysaccharides before and 3 wk after immunization with a pneumococcal vaccine. Compared to the control subjects, the serum concentration of the IgG2 subclass was lower at admission in patients with CAP of bacterial or unknown cause (p less than 0.005). Concentrations of IgG subclasses in patients did not differ between admission and recovery, or between admission and 9 months later. After vaccination, in both control subjects and patients, there was an increase in the concentrations of IgG2 subclasses (p = 0.01) and antipneumococcal antibodies (p less than 10(-4)). We show that serum IgG2 concentration in patients with CAP of bacterial or unknown cause is lower than in healthy subjects and remains lower for several months. After immunization with a pneumococcal vaccine, the increase in serum concentrations of IgG subclasses and antipneumococcal antibodies in patients does not differ from those in control subjects.

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The protein concentration of 35 pleural effusions was compared with that in the serum. The ratio of the pleural and serum concentration of albumin, IgG, IgA, and IgM is always below unity and appears to have no diagnostic value. However, the ratio of the concentration of these proteins was inversely related to their molecular weight. The underlying mechanism in malignant and inflammatory effusions appear similar and is in keeping with a diffusion process. Immunofluorescent staining of the pleura suggests the intercellular passage of the proteins through the mesothelial barrier.There are very few reports of the distribution of plasma proteins in pleural effusions. The 52 cases studied by Zinneman et al (1957) These fragments were immediately embedded in a cube of Cryoform TM (Damon Inc Division) and frozen instantaneously with liquid nitrogen. These cubes were stored at -200C until required. The embedded fragments were then cut in a Cryostat (Damon CTD Harris) at -200C into 4 ,um sections, laid on microscopic glass slides, and fixed for 10 minutes in absolute ethanol at +200C. These sections were treated by a direct immunofluorescent method using monospecific serum labelled specifically for human IgG, IgA, IgM, IgE (Hyland), and IgD (Behring). The sera were tested before use by immunoelectrophoresis with standard normal human serum (Behring). The sections were incubated with the conjugates diluted to 1/5, 1/10, and 1/20 for 30 minutes at 200C, rinsed with two baths of Coons buffer, pH 7*4, for 15 minutes each, and were mounted in glycerol at 50%.A Leitz fluorscence microscope was used for observation. Results PLEURAL EFFUSION PROTEINSThe 35 effusions were exudates, having a pleural fluid protein concentration greater than 3 g/ 100 ml. They were divided into three groups according to the causal lesion: 14 were of carcinomatous origin, 10 tuberculous, and 11 miscel-389 on 3 April 2019 by guest. Protected by copyright.

Summary:Enhanced serum IgA concentrations are common in alcoholic liver cirrhosis, but functional differences between IgA subclasses and their relation with interleukin-6 (IL-6) have not been described. Distinct immunoregulatory mechanisms may exist that selectively affect one subclass. This possibility prompted us to investigate the distribution of IgAl and IgA2 subclasses in the serum of 25 heavy alcohol drinkers (alcohol: 80 to 200 g per day) without clinical disorders, in comparison with 35 patients affected by alcoholic liver cirrhosis, 29 viral hepatitis patients and 33 social drinkers as a control group. Mean (± SD) IgA2 concentration (0.56 ± 0.31 g/1) was significantly increased (p < 0.01) in heavy alcohol drinkers, with an IgA2/IgAl ratio of 0.33 ± 0.12, while the mean total IgA concentration was similar to the control group. Mean IgAl and IgA2 concentrations were significantly increased (p < 0.001) in alcoholic liver cirrhosis patients (6.13 ± 4.52 g/1 and 1.83 ± 1.93 g/1 respectively, with an IgA2/IgAl ratio of 0.32 ± 0.19) and viral hepatitis patients (3.66 ± 2.59 g/1 and 0.69 ± 0.67 g/1 respectively, with an IgA2/IgAl ratio of 0.21 ±0.14) High serum IL-6 concentrations (34 ± 33 ng/1) were correlated with elevated IgAl and IgA2 concentrations only in patients with alcoholic liver cirrhosis. IgA2 subclass and IgA2/IgAl ratio could therefore be used as markers of chronic alcohol abuse directly related to the extent and duration of the alcohol abuse and the effectiveness of alcohol withdrawal.