434 and to allogenic lymphocytes in mixed-lymphocyte culture. They also found that plasma from patients in remission lacked this inhibitory power. Our studies of the blastogenic response of lymphocytes to P.H.A. in patients with glomerulonephritis point to an immunological distinction of minimal-change glomerulonephritis from other types of glomerulonephritis.3 We used the isotopic method measuring, the incorporation of 14C-thymidine, with a gas-flow scintillation counter. Lymphocytes from patients with active submicroscopic glomerulonephritis showed a striking and homogeneous blastogenic response In nine
cases out of ten blastic transformation varied range from 1582 to 1856 counts/min; the excepwas a patient with a very low blastic transformation (685 counts/min). The mean ±s.D. blastic transformation (1594t320 counts/min), was much lower than that of the controls (2188±1046). In patients with chronic proliferative glomerulonephritis (63) and chronic membranous glomerulonephritis (14) the results were widely scattered and values (2558t208I and 1990±1794 counts/min, respectively) were not significantly different from the controls. We re-tested 4 patients with minimal-change glomerulonephritis after they had responded to treatment with steroids.4 Our results were only partially consistent with those of Moorthy et al. Blastic transformation rose in 2 cases; in the other 2 there was no change, perhaps because the second blood-samples were taken early on in remission. It remains open to question whether the decrease of lymphocyte reactivity to P.H.A. in minimal-change glomerulonephritis results exclusively from the presence of humoral inhibitory factors or if it depends directly on a disorder in T-lymphocyte activity, which may predispose to this disease. Our preliminary findings with P.H.A. and other non-specific mitogens and radioactivity measurements in a liquid scintillation counter, confirm the
to P.H.A.
in a tion
narrow
and antigenic composition of the sequestered viral proteins and the resulting biochemical changes which are probably related to the central-nervous-system lesions ofM.s. Our preliminary findings in the’jejunum in A.L.S., a disease in which immune complex is often present in renal glomeruli6 suggest that similar mechanisms may operate in this disease. Thus, it seems that chronic viral infection of the small bowel is not unique to M.S. and, indeed, may occur in various diseases. Ultimately, these disease processes may be found to differ only in the nature of the antigen harboured in the gut and the target tissue attacked by the accompanying immunological-biochemical responses of the host. a
We shall publish an account of our further detailed report of our findings in A.L.S.
experience with-tvt.s.
and
Downstate Medical Center, Brooklyn, New York
ALBERT W. COOK LOUIS P. PERTSCHUK
Long Island College Hospital, Brooklyn, New York
JAGDISH K. GUPTA
’
above observations. Nephrological Clinic, Institute of Internal Diseases, Medical Academy, 50 417 Wroclaw, Poland
Z. SZEWCZYK M. KLINGER K. MAIGA
JEJUNAL VIRAL ANTIGEN IN MULTIPLE SCLEROSIS AND AMYOTROPHIC LATERAL SCLEROSIS
SIR,-We reported5 the detection of measles viral antigen by the fluorescent antibody technique in jejunal suction biopsies from 24 consecutive patients with multiple sclerosis (M.S.). Viral antigen was found in epithelial cells, epithelial basement membranes, and cells and capillaries of the lamina propria. In most cases, deposits of viral antigen were accompanied by deposits of complement and/or iminunoglobulins. We have studied 6 more cases with identical results. Control jejunal specimens from 26 patients without neurological disease have been negative, as have colon biopsies from 5 patients with M.S. We also examined tissue from 5 patients with amyotrophic lateral sclerosis (A.L.s.) by the same method and we found abnormal deposits of complement and immunoglobins in the jejunal lamina propria. Polioviral antigen has been identified in 3 patients, and herpes-simplex antigen in great abundance in 1. Insufficient tissue was available for study of viral antigen in the other patient. The presence of measles antigen in the jejunum provides substantial support for the suspected relationship between M.S. and persistent measles infection. Hitherto the source of continued antigenic stimulation was unknown. The accompanying immunological reaction supports the view that immunological events are concerned in M.S. Our attempts to culture measles virus from the jejunum of these patients and to find viral particles by electron microscopy will, we hope, clarify the nature 3
Szewczyk, Z., Melcer, H., Klinger,
M. Arch. Immun. Ther. exp.
617. 4.
5.
Szewczyk, Z., Klinger, M., Melcer, H., Falkiewicz, K. ibid. p. 367. Pertschuk, L. P., Cook, A. W., Gupta, J. Life Sci. 1976, 19, 1603.
DR MIKHAIL SHTERN
SIR,-This month in the U.S.S.R., Dr Mikhail Shtern
begins
the third year of an eight-year sentence in a labour camp. This endocrinologist was arrested when he refused to withhold permission for his two sons to emigrate to Israel. Shortly afterwards he was charged with attempting to poison some of his patients, but this was dropped in response to an international outcry. The charge was then changed to one of accepting bribes and financial extortion during a thirty-year period in practice. Transcripts of his trial show that the verdict against Dr Shtern could hardly have been reached by any reasonable tribunal: that was the opinion of a group of lawyers headed by Sir John Foster, Q.c., who examined the evidence in April, 1976. Despite repeated pleas from scientists, doctors, and men of letters that the charges be dropped or that Dr Shtern be released on the grounds of his serious ill-health, the Russian authorities show no signs of being willing to reconsider his case.
Andrei Sakharov has written: "In the conviction in Vinnitsa of honoured Dr Mikhail Shtern, I see an attitude of contempt for the medical profession that would be unthinkable, it seems 7 to me, in any other country". Free members of the medical profession have a duty to support the cause of colleagues wherever they are persecuted and to protest against unjust and unfeeling treatment. I can only hope that such protest may induce the authorities to reconsider the case of Dr Shtern. Hope Hospital, Salford M6 8HD
L. A. TURNBERG
TISSUE FROM HYDATIDIFORM MOLE Dr SYLVIA D. LAWLER and Dr CLARA MARGOLES (Royal Marsden Hospital, London SW3 6JJ) write: "We seek supplies of fresh, sterile tissue from abortuses or curettings from patients with suspected molar pregnancies who are to be registered with the Royal College of Obstetricians and Gynaecologists Tumour Registry under the hydatidiform mole follow-up scheme. We plan to correlate our cytogenetic, biochemical, and immunogenetic findings with the outcome of the molar pregnancy. We will collect tissue from hospitals in the London area or from railway termini if we are warned on the Fetal Tissue Bank Ansafone 01-3510979."
1975, 23, 6.
Oldstone, M. B. A., Wilson, C. B., Perrin, L. H., Norris, F. H. Jr. Lancet, 1976, ii, 169. 7. Sakharov, A. D. My Country and the World. London, 1975.
cases out of ten blastic transformation varied range from 1582 to 1856 counts/min; the excepwas a patient with a very low blastic transformation (685 counts/min). The mean ±s.D. blastic transformation (1594t320 counts/min), was much lower than that of the controls (2188±1046). In patients with chronic proliferative glomerulonephritis (63) and chronic membranous glomerulonephritis (14) the results were widely scattered and values (2558t208I and 1990±1794 counts/min, respectively) were not significantly different from the controls. We re-tested 4 patients with minimal-change glomerulonephritis after they had responded to treatment with steroids.4 Our results were only partially consistent with those of Moorthy et al. Blastic transformation rose in 2 cases; in the other 2 there was no change, perhaps because the second blood-samples were taken early on in remission. It remains open to question whether the decrease of lymphocyte reactivity to P.H.A. in minimal-change glomerulonephritis results exclusively from the presence of humoral inhibitory factors or if it depends directly on a disorder in T-lymphocyte activity, which may predispose to this disease. Our preliminary findings with P.H.A. and other non-specific mitogens and radioactivity measurements in a liquid scintillation counter, confirm the
to P.H.A.
in a tion
narrow
and antigenic composition of the sequestered viral proteins and the resulting biochemical changes which are probably related to the central-nervous-system lesions ofM.s. Our preliminary findings in the’jejunum in A.L.S., a disease in which immune complex is often present in renal glomeruli6 suggest that similar mechanisms may operate in this disease. Thus, it seems that chronic viral infection of the small bowel is not unique to M.S. and, indeed, may occur in various diseases. Ultimately, these disease processes may be found to differ only in the nature of the antigen harboured in the gut and the target tissue attacked by the accompanying immunological-biochemical responses of the host. a
We shall publish an account of our further detailed report of our findings in A.L.S.
experience with-tvt.s.
and
Downstate Medical Center, Brooklyn, New York
ALBERT W. COOK LOUIS P. PERTSCHUK
Long Island College Hospital, Brooklyn, New York
JAGDISH K. GUPTA
’
above observations. Nephrological Clinic, Institute of Internal Diseases, Medical Academy, 50 417 Wroclaw, Poland
Z. SZEWCZYK M. KLINGER K. MAIGA
JEJUNAL VIRAL ANTIGEN IN MULTIPLE SCLEROSIS AND AMYOTROPHIC LATERAL SCLEROSIS
SIR,-We reported5 the detection of measles viral antigen by the fluorescent antibody technique in jejunal suction biopsies from 24 consecutive patients with multiple sclerosis (M.S.). Viral antigen was found in epithelial cells, epithelial basement membranes, and cells and capillaries of the lamina propria. In most cases, deposits of viral antigen were accompanied by deposits of complement and/or iminunoglobulins. We have studied 6 more cases with identical results. Control jejunal specimens from 26 patients without neurological disease have been negative, as have colon biopsies from 5 patients with M.S. We also examined tissue from 5 patients with amyotrophic lateral sclerosis (A.L.s.) by the same method and we found abnormal deposits of complement and immunoglobins in the jejunal lamina propria. Polioviral antigen has been identified in 3 patients, and herpes-simplex antigen in great abundance in 1. Insufficient tissue was available for study of viral antigen in the other patient. The presence of measles antigen in the jejunum provides substantial support for the suspected relationship between M.S. and persistent measles infection. Hitherto the source of continued antigenic stimulation was unknown. The accompanying immunological reaction supports the view that immunological events are concerned in M.S. Our attempts to culture measles virus from the jejunum of these patients and to find viral particles by electron microscopy will, we hope, clarify the nature 3
Szewczyk, Z., Melcer, H., Klinger,
M. Arch. Immun. Ther. exp.
617. 4.
5.
Szewczyk, Z., Klinger, M., Melcer, H., Falkiewicz, K. ibid. p. 367. Pertschuk, L. P., Cook, A. W., Gupta, J. Life Sci. 1976, 19, 1603.
DR MIKHAIL SHTERN
SIR,-This month in the U.S.S.R., Dr Mikhail Shtern
begins
the third year of an eight-year sentence in a labour camp. This endocrinologist was arrested when he refused to withhold permission for his two sons to emigrate to Israel. Shortly afterwards he was charged with attempting to poison some of his patients, but this was dropped in response to an international outcry. The charge was then changed to one of accepting bribes and financial extortion during a thirty-year period in practice. Transcripts of his trial show that the verdict against Dr Shtern could hardly have been reached by any reasonable tribunal: that was the opinion of a group of lawyers headed by Sir John Foster, Q.c., who examined the evidence in April, 1976. Despite repeated pleas from scientists, doctors, and men of letters that the charges be dropped or that Dr Shtern be released on the grounds of his serious ill-health, the Russian authorities show no signs of being willing to reconsider his case.
Andrei Sakharov has written: "In the conviction in Vinnitsa of honoured Dr Mikhail Shtern, I see an attitude of contempt for the medical profession that would be unthinkable, it seems 7 to me, in any other country". Free members of the medical profession have a duty to support the cause of colleagues wherever they are persecuted and to protest against unjust and unfeeling treatment. I can only hope that such protest may induce the authorities to reconsider the case of Dr Shtern. Hope Hospital, Salford M6 8HD
L. A. TURNBERG
TISSUE FROM HYDATIDIFORM MOLE Dr SYLVIA D. LAWLER and Dr CLARA MARGOLES (Royal Marsden Hospital, London SW3 6JJ) write: "We seek supplies of fresh, sterile tissue from abortuses or curettings from patients with suspected molar pregnancies who are to be registered with the Royal College of Obstetricians and Gynaecologists Tumour Registry under the hydatidiform mole follow-up scheme. We plan to correlate our cytogenetic, biochemical, and immunogenetic findings with the outcome of the molar pregnancy. We will collect tissue from hospitals in the London area or from railway termini if we are warned on the Fetal Tissue Bank Ansafone 01-3510979."
1975, 23, 6.
Oldstone, M. B. A., Wilson, C. B., Perrin, L. H., Norris, F. H. Jr. Lancet, 1976, ii, 169. 7. Sakharov, A. D. My Country and the World. London, 1975.
