Pharmacologic management of elderly patients is difficult because of two age-related factors: (1) physiologic changes, especially in hepatic and renal function, and (2) presence of more diseases, requiring combination drug therapy and resulting in increased drug interactions and drug-induced side effects. Nevertheless, drugs have essentially the same benefits in the elderly as in younger patients and should be used for the same indications. Fewer problems will result if the clinician remembers that most drugs produce exaggerated responses, both beneficial and detrimental, in the elderly.
The use of peripheral blood leukocytes in the capillary-migration test is presently a very active area of investigation. A technique was developed in our laboratory which made possible the use of rabbit leukocytes in this in vitro test for cellular reactivity. Using a combination of gelatin sedimentation and sucrose-density gradient centrifugation, it was possible to harvest white cell populations from 59 rabbits which had median percentages of 74% mononuclear cells and 26% granulocytes with a median percent recovery of 34% of cells for the entire group. When testing cell populations from rabbits sensitized with killed mycobacteria, significant inhibition of migration was found when particulate antigen was included in the tissue-culture medium. Purified Protein Derivative (PPD) failed to elicit a similar response under the same conditions of experiment. Migration inhibition was also found when cells from animals immunized with ovalbumin were tested in the presence of specific antigen.
In a recent communication (1) we described a method, heterologous adoptive cutaneous anaphylaxis (HACA),2 for the detection of reaginic antibody-forming cells (RAFC). Spleen, bone marrow, or lymph node cells taken from immunized CBA mice 28 and 56 days after immunization were transferred to the skin of rats. Twenty-four hours later the rats were challenged with antigen and Evans blue dye and a blue area appeared within minutes at the site of deposition of mouse cells. Since mouse IgG1 antibody will fix to mouse but not to rat mast cells (2), one can feel confident that HACA detects only reaginic antibody formation (1).
We now report the optimal conditions for HACA as well as the development of RAFC in the spleen and bone marrow of a moderate (SWR) and a poor (SJL) reagin-producing strain of mice from 3 to 61 days post-immunization. Levine (3) has proposed two kinds of genetic control of reagin production in mice.
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