This report analyzes the life span of Ig-containing cells (IgCC) in different sites of antibody production. The experimental approach was based upon the observations that most IgCC are derived from proliferating precursors while IgCC themselves are mainly nondividing end cells. Rats were given a continuous infusion of [3H] thymidine via an osmotic pump inserted in the peritoneal cavity. At intervals of 1, 3, 5 or 10 days after starting infusions, tissues were taken and analyzed by a combination of immunohistology and autoradiography to identify the proportions of IgCC which had gone through S phase of the cell cycle during the period of infusion. After 3 days infusion the median and (range) percent-labeled IgCC in the medullary cords of mesenteric and cervical lymph nodes and the red pulp of the spleen were, respectively, 88 (81-90), 75 (66-77) and 88 (82-93). Conversely that for IgCC in bone marrow was only 13 (11-17) and that in the lamina propria of the jejunum 47 (33-68). The rate of increase in labeling of bone marrow IgCC with length of infusion was approximately linear. Extrapolation of this slope suggests that bone marrow IgCC have a life span in excess of 3 weeks. The slopes of increase in IgCC labeled with time for lymph nodes and spleen were clearly biphasic suggesting that while most IgCC in these tissues have a life span of less than 3 days, there is also a minor population of long-lived IgCC. The lamina propria appears to have approximately equal proportions of long and short-lived IgCC. The life span of IgCC, with the exception of IgMCC, appears to be a feature of the site of antibody production rather than the Ig class produced. Almost all IgM-containing cells were found to be short lived.

Patients with dermatitis herpetiformis can include moderate amounts of oats in their gluten-free diets without deleterious effects to the skin or intestine.

SummaryHereditary angioedema (HAE) and acquired angioedema (AAE) are rare lifethreatening conditions caused by deficiency of C1 inhibitor (C1INH). Both are characterized by recurrent unpredictable episodes of mucosal swelling involving three main areas: the skin, gastrointestinal tract and larynx. Swelling in the gastrointestinal tract results in abdominal pain and vomiting, while swelling in the larynx may be fatal. There are limited UK data on these patients to help improve practice and understand more clearly the burden of disease. An audit tool was designed, informed by the published UK consensus document and clinical practice, and sent to clinicians involved in the care of HAE patients through a number of national organizations. Data sets on 376 patients were received from 14 centres in England, Scotland and Wales. There were 55 deaths from HAE in 33 families, emphasizing the potentially lethal nature of this disease. These data also show that there is a significant diagnostic delay of on average 10 years for type I HAE, 18 years for type II HAE and 5 years for AAE. For HAE the average annual frequency of swellings per patient affecting the periphery was eight, abdomen 5 and airway 0·5, with wide individual variation. The impact on quality of life was rated as moderate or severe by 37% of adult patients. The audit has helped to define the burden of disease in the UK and has aided planning new treatments for UK patients.

The migration of recirculating B cells was compared with that of newly produced virgin B cells following passive cell transfer between congenic strains of rats differing in their kappa immunoglobulin light chain (kappa) allotype. The number and location of donor B cells in the secondary lymphoid organs was determined at intervals following transfer by immunohistology using monoclonal antibodies specific for rat kappa allotypes. Recirculating B cells were obtained from thoracic duct lymph while bone marrow from rats depleted of recirculating cells was used as a source of newly produced virgin B cells. B cells from both sources gained immediate access to extrafollicular areas of secondary lymphoid organs rich in interdigitating cells and T cells. However, in lymph nodes extrafollicular B cells were found adjacent to lymphatics and not in the central paracortex. By 8 h after transfer most B cells from thoracic duct lymph were found in follicles. However, the capacity of the bone marrow B cells to enter follicles was very limited. These results are interpreted in relation to previous observations concerning (a) the timing of virgin B cell recruitment into T cell-dependent antibody responses, and (b) the role of B cells in antigen presentation.

Suppressor cells were assayed by numerical and functional tests in adults on chronic hemodialysis. Peripheral blood mononuclears (PBM) were classified as total T-cells by E-rosettes and by the monoclonal antibody OKT3, as T-cell subsets by OKT4 (inducer/helper T-cells) and OKT8 (cytotoxic/suppressor T-cells) and as B-cells by the presence of surface immunoglobulin. The suppressive effect of PBM pretreated with either Concanavalin A (Con A), sodium periodate, or serum rich in immune complexes, on normal homologous phytohemagglutinin (PHA) lymphocyte transformation, was determined. Usual tests of T-cell function were not done. T lymphopenia was due to significant diminution (P less than 0.002) in numbers of OKT4+ cells in patients (516 +/- 44 cells/mm3, mean +/- sem) as compared to controls (906 +/- 96 cells/mm3). The number of OKT8+ cells in patients was not different from normal although their percentage (45 +/- 4%) was slightly higher than controls (36 +/- 5%) (P less than 0.10). Suppressor activity using only a suboptimal dose of Con A (5 micrograms/ml), was significantly lower (P less than 0.002) in uremic patients (36 +/- 12%) than in controls (67 +/- 7%). An important finding was that no significant correlations were detected between the numerical and functional assays of suppression used or between any of these immunological tests and biochemical parameters studied. The implications of these results for immunoparesis in uremia are discussed with particular reference to the discordance between marker and functional assays of suppressor cells.