This paper reports the results of a qualitative analysis of semi-structured interviews with 79 members of the Birmingham Untreated Heavy Drinkers Cohort. The cohort was recruited in 1997 when all participants were drinking 50 or more standard units of alcohol (men) or 35 or more units (women) most weeks. Present interviews were carried out as part of the fourth wave of interviews, held in 2003. The topic was the participants' places of drinking in the community and the functions those places served. The present analysis focused on the relationship between pubs and community. The strongest theme to emerge was that the pub provided for many participants a real sense of community in itself. It did so by enabling participants to meet with like-minded others, in a setting distinct from home or work, where conversing and confiding Could take place in a relaxed atmosphere, with a range of other activities and forms of social support available to many. At the same time, participants were discriminating about which pubs they used, and when, and with whom they chose to interact. There was less consensus about whether the pub served a wider function by contributing to a positive sense of community in the local neighbourhood. It is suggested that English pubs, at least in a large conurbation such as the West Midlands, are very varied, sometimes continuing to serve as 'the local' for a community, sometimes being part of a variety of drinking places which between them provide people with it diversity of social niches to meet their increasingly diverse choices and preferences, and sometimes reflecting and even contributing to local community disorganisation. Copyright (C) 2008 John Wiley & Sons, Ltd.

This article uses qualitative methods to compare two groups of heavy drinkers - those who had recently sought specialist help, and those who were currently 'self-directing' change in drinking. Thirty-six heavy drinkers, selected from a larger cohort in the English West Midlands, took part in semi-structured interviews on drinking change. Key themes for the 'self-directed change' group were: confidence in self-sufficiency to change, internalised social pressure for change, and social collaboration with other drinkers for changing drinking. In contrast, themes for the 'specialist help' group were: feeling 'out of control', lacking confidence in the decision to change drinking, external social pressure for change, and alienation from social collaboration in changing drinking. Results suggest that specialist help might exploit or develop opportunities for collaboration with others. To maintain change, specialist help may need to take more into account those social roles that appear to encourage the stabilisation of drinking in the long term.

The study of the Ig variable region heavy chain (VH) genes used to encode antibodies specific for self-epitopes from murine hybridomas showed that three VH families are primarily utilized: VH J558, the largest family, and VH QPC52 and VH 7183, the families most proximal to the Ig joining region heavy chain genes. These monoclonal autoantibodies express cross-reactive idiotopes shared by rheumatoid factors and antibodies specific for Sm. The expression of these idiotypes is independent of major histocompatibility complex and Ig constant region heavy chain haplotypes, self-antigen specificity, and even the VH gene family utilized. Though the experiments described here are limited to murine autoantibodies, similarities exist between murine and human autoimmune diseases. Studies that aim to investigate the relationship between VH gene expression and the presence of cross-reactive idiotypes among human autoantibodies should enable us to better understand the mechanisms of autoimmunity and self-tolerance.

Immunological ReviewsVolume 94, Issue 1 p. 75-98 Functional and Molecular Studies of V Genes Expressed in Autoantibodies Catherine Painter, Catherine Painter Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this authorMarc Monestier, Marc Monestier Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this authorBeatrice Bonin, Beatrice Bonin Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this authorConstantin A. Bona, Constantin A. Bona Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this author Catherine Painter, Catherine Painter Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this authorMarc Monestier, Marc Monestier Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this authorBeatrice Bonin, Beatrice Bonin Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this authorConstantin A. Bona, Constantin A. Bona Mount Sinai School of Medicine, Department of Microbiology, New York, New York 10029, USA.Search for more papers by this author First published: December 1986 https://doi.org/10.1111/j.1600-065X.1986.tb01165.xCitations: 50AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL REFERENCES Bellon, B., Manheimer-Lory, A., Monestier, M., Moran, T., Dimitriu-Bona, A., Alt, F. & Bona, C. High frequency of autoantibodies bearing crossreactive idiotopes among hybridomas using VH 7183 genes prepared from normal and autoimmune strains. J. Clin Invest. (Submitted). Bona, C. A. (1987) Regulatory Idiotopes. John Wiley & Sons, New York . Bona, C. & Cazenavne, P. A. (1977) Release from maternally-indueed allotypic suppression in rabbit by Noeardia water soluble mitogen. J. Exp. Med. 146, 881. Bona, C. A., Goldberg, B., Metzger, D., Urbain, J. & Kunkel, H. G. (1984) Anti-immunoglobulin antibodies IV. Crossreaction of antiidiotypic antibodies specific for rabbit and murine anti-al allotype antibodies with Fc fragment of human immunoglobulins. Eur. J. Immunol. 14, 548. Bona, C. A., Heber-Katz, E. & Paul, W. E. (1981) Idiotype-antiidiotype regulation I. Immunization with a levanbinding myeloma protein leads to the appearance of autoanti (antiidiotype) antibodies and to the activation of silent clones. J. Exp. Med. 153, 951. Bona, C. A., Mond, J., Stein, K., House, S., Lieberman, R. & Paul, W. E. (1979b) Immuneresponse to levan IIL Late appearance of anti-inulin response. J. Immunol. 123, 1484. Bona, C. A. & Pernis, B. (1984) Idiotype networks. In: Fundamental immunology, ed. W. E. Paul, p. 577. Raven Press, New York . Bona, C. A., Stein, K. E., Lieberman, R. & Paul, W. E. (1979a) Direct and indirect suppression induced by antiidiotype antibody in the inulin-bacterial levan antigenic system. Mol. Immunol. 16, 1093. Bona, C. A., Yang, C.-Y, Kohler, H. & Monestier, M. (1986) Epibody: the image of the network created by a single antibody. Immunol. Rev. 90, 115. Brodeur, P. H. & Riblet, R. (1984) The immunoglobulin heavy chain variable region (Igh-V) locus in mouse. I. One hundred Igh-V genes comprise seven families of homologousgenes. Eur. J. Immunol, 14, 922. Burnet, F. M. (1959) The Clonal Selection Theory of Acquired Immunity. Cambridge University Press, London . Capra, J. D. & Kehoe, J. D. (1974) Structure of antibodies with shared idiotypy: The complete sequence of the heavy chain V-regions of two IgM anti-A globulins. Proc. Natl. Acad. Sci. USA 71, 4032. Chen P.P., Fong, S., Normansell, D., Houghten, R. A., Karras, J. G., Vaughan, J. H. & Carson, D. A. (1984) Delineation of a cross-reactive idiotype on human auto antibodies with antibody against a synthetic peptide. J. Exp. Med. 159, 1502. Clarke, S. H., Huppi, K., Ruezinsky, L., Staudt, L., Gerhard, W. & Weigert, M. (1985). Inter and intractonal diversity in the response to influenza hemaglutinin. J. Exp Med. 161, 687. Cleveland, W. L., Wasserman, N. H., Sarangarajan, P., Penn, A. S. & Erlanger, B. F. (1983) Monoclonal antibodies to the acetylcholine receptor by a normally functioning autoantiidiotypic mechanism. Nature 305, 56. Dawson, J. F., Brochier, J., Schmidt, D., Saeland, S. & Thivolet, J. (1986) Elastic fibres: histologic correlation with orcein and a new monoclonal antibody HB8 Br J Dermatol. 110, 539. Dighiero, G., Lymberi, P., Holmberg, D., Lundquist, I., Coutinho, A. & Avrameas, S. (1985) High frequency of natural autoantibodies in normal newhorti mice. J Immunol 134, 765. Dildrope, R. (1984) A new classification of mouse VH sequence. Immunology Today 5, 85. Dwyer, D. S., Bradley, R. J., Urquhart, C. K. & Kearney, J. F. (1983) Naturally occurring antiidiotypic antibodies in myasthenia gravis patients. Nature 301, 611. Ehrlich, P. (1900) On immunity with special reference to cell life. Croonian Lecture. Proc. Roy. Soc. London. 66, 424. Fernandez, C., Hammarstrom, L., Moller, G., Primi, D. & Smith, C. J. E. (1979) Immunological tolerance affects only a subpopulation of the antigen specific B cells: evidence against clonal deletion as the mechanism of tolerance induction. Immunol. Rev. 43, 3. Grabar, R (1983) Autoantibodies and physiological role of immunoglobulins. Immunol. Today 14, 337. Green, M. C. & Schultz, L. D. (1975) Motheaten, an immunodeficient mutant of the mousel. Genetics and Pathology. J. Heredity. 66 250. Hahn, B. H. & Ebling, F. M. (1984) A public idiotypic determinant is present on spontaneous cationic IgG antibodies to DNA from mice of unrelated lupus-prone strains. J. Immunol, 133, 3015. Hayakawa, K., Hardy, R. R. & Herzenberg, L. A. (1986) Peritoneal Ly.1 B cells: genetic control, autoantibody production, increased lambda chain expression. Eur. J. Immunol. 16, 450. Hayakawa, K., Hardy, R. R., Herzenberg, L. A. & Herzenberg, L. A. (1985) Progenitors for Ly. I B cells are distinct from the progenitors of other B cells. J. Exp. Med 16, 1554. Hayakawa, K., Hardy, R. R., Honda, M., Herzenberg, L. A., Steinberg, A. D. & Herzenberg, L. A. (1984) Ly.l B cells; functionally distinct lymphocytes that secrete IgM autoantibodies. Proc. Natl. Acad. Sci. 81, 2494. Hayakawa, K., Hardy, R. R., Parks, D. R. & Herzenberg, L. A. (1983) The "Ly.lB" cell subpopulation in normal, immunodefective and autoimmune mice. J. Exp. Med 157, 202. Holmdahl, R., Jansson, L., Larsson, E., Rubin, K. & Klareskog, L. (1986) Homologous type II. collagen induces chronic and progressive arthritis in mice. Arthr. Rheum. 29, 106. Howe, M. L., Goldstein, A. L. & Battisto, J. R. (1970) Isogeneic lymphocyte interaction: recognition of self antigens by cells of the neonatal thymus. Proc. Nad. Acad Sci. 67, 613. Isenberg, D., Dudeney, C., Wojnaruska, F., Ghogel, B. S., Rauch, J., Schattner, A., Naparstek, Y. & Duggau, D. (1985) Detection of crossreactive anti-DNA antibody idiotypes on tissue-bound immunoglobulins from skin biopsies of lupus patients. J Immunol 135, 261. Izui, S., Eisenberg, R. A. & Dixon, F. J. (1979) IgM rheumatoid factors in mice injected with bacterial lipopolysaccharides. J. Immunol. 122, 2096. Janke, U., Fischer, E. H. & Alvord, E. C. (1985) Sequence homology between certain viral proteins and proteins related to encephalomyelitis and neuritis. Science 229, 282. Kofler, R., Noonan, D. J., Levy, D. E., Wilson, M. C., Moller, N. R. H., Dixon, F. J. & Theophilopoulos, A. N. (1985) Genetic elements used for a murine lupus anti-DNA autoantibody are closely related to those for antibodies to exogenous antigens. J. Exp. Med, 151, 850. Kunkel, H. G., Winchester, R. J., Joslin, F. G. & Capra, J. D. (1974) Similarities in the light chains of anti-y-globulins showing crossreactive specificities. J. Exp. Med, 149, 128. Malynn, B. A., Berman, J. E., Yancopoulos, G. D., Bona, C. A. & Alt, F. W. (1986) Expression of the immunoglobulin heavy chain variable gene repertoire. In: Current Topics in Microbiology and Immunology eds. Ch. Paige & R. Gisler (in press). Manheimer, A. J., Victor-Kobrin, C., Stein, K. E. & Bona, C. A. (1984) Anti-immunoglobulin antibodies V. Age-dependent variation of clones stimulated by polysaccharide TI- 2 antigens in 129 and MRL mice spontaneously producing anti-y-globulin antibodies. J. Immunol, 133, 562. Manheimer-Lory, A. J., Monestier, M., Bellon, B., Alt, F. W. & Bona, C. A. (1986) Fine speeifieity, idiotypy and nature of cloned VH genes of murine monoclonal rheumatoid factor antibodies. Proc. Natl. Acad. Sci. USA. (in press). Mercolino, T. J., Arnold, L. W. & Houghton, G. (1986) Phosphatidyl choline is recognized by a series of Ly-1+ murine B cell lymphomas specific for erythrocyte membranes. J. Exp. Med 163, 155. Mond, J. J., Lieberman, R., Inman, J. K., Mosier, D. E. & Paul, W. E. (1977) Inability of mice with a defect in B-lymphocytes maturation to respond to phosphorylcholine on immunogenic carriers. J. Exp. Med, 146, 1138. Monestier, M., Bonin, B., Datta, S., Maurer, P. & Bona, C. Multispecific antibodies I. Binding to foreign antigens and extensive cross-reactive idiotype of autoantibodies eneoded by genes from J558 family (manuscript in preparation). Monestier, M., Manheimer-Lory, A., Bellon, B., Painter, C., Dang, H., Talal, N., Zanetti, M., Schwartz, R., Pisetsky, D., Kuppbers, R., Rose, N., Brochier, J., Klareskog, L., Holmdahl, R., Erlanger, B., Alt, F. & Bona, C. (1986) Shared idiotopes and restricted VH genes characterize murine autoantibodies of various specificities. J. Clin. Invest, 78, 753. Monier, J. C., Brochier, J., Moreira, A., Sault, C. & Roux, B. (1984) Generation of hybridoma antibodies to double-stranded DNA from non-autoimmune BALB/c strain: studies on anti-idiotype. Immunol. Letters 8, 61. Moran, T. M., Monestier, M., Lai, A. C. K., Norton, G., Reale, M. A., Thompson, M. A., Schulman, J. L., Riblet, R. & Bona, C. A. (1987) Characterization of variable region genes and shared crossreactive idiotypes of antibodies is specific for antigens of various influenza viruses. Virol. Immunol, (in press). Oudin, J. & Cazenave, P. A. (1971) Similar idiotypic specificities in immunoglobulin fractions with different antibody functions or even without detectable antibody function. Proc. Natl. Acad. Sci. USA 68, 2616. Painter, C., Monestier, M., Quartin, R., Bona, A., Mayer, R., Sidman, C. & Bona, C. High frequency of autoantibodies among hybridomas prepared from motheaten mice. (In preparation). Paul, W. E., Subbarao, B., Mond, J. J., Sieckmann, D. G., Zitron, I., Ahmed, A., Mosier, D. E. & Scher, I. (1979) Analysis with a mutant mouse strain in cells immunoglobulin synthesis. In: B lymphocytes development and activation, eds. B. Pernis & H. Vogel, pp. 383– 396. Academic Press, New York . Perlmutter, R. M., Kearney, J. F., Chang, S. P. & Hood, L. E. (1985) Developmentally controlled expression of immunoglobulin VH genes. Science 227, 1597. Pisetsky, D. S. & Lerner, E. A. (1982) Idiotypic analysis of a monoclonal anti-Sm antibody. J. Immunol, 129, 1489. Poncet, R., Kocher, H. R., Pages, J., Jatou, J. C. & Bussard, A. E. (1985) Monoclonal antibodies against mouse red blood cells: a family of structurally restricted molecules. Mol. Immunol, 22, 541. Rauch, J., Murphy, E., Roths, J. B., Stollar, D. & Schwartz, R. S. (1982) A high frequency idiotypic marker of anti-DN A autoantibodies in MLR/lpr mice. J. Immunol, 129, 236. Rose, N. R., Accavitti, M. A. & Leon, M. A. (1985) Thyroglobulin-specific monoclonal antibodies. In: Antibodies: protective, destructive and regulatory role, eds. F. Milgrom, C. J. Abeyounis & B. Albini, pp. 171– 178. Karger, Basel . Schlomchik, M. J., Nemazee, D. A., Sato, V. L., van Snick, J., Carson, D. A. & Weigert, M. G. (1986) Variable region sequence of murine IgM anti-IgGi monoclonal autoantibodies (rheumatoid factors): a structural explanation for the high frequency of IgM anti-IgG B cells. J. Exp. Med, 164, 407. Shlomchik, M., Nemazee, D., Snick, J. & Weigert, M. (1986) Comparison of V-region sequences from murine IgM anti-IgG, (rheumatoid factor) hybridomas derived by LPS stimulation or secondary protein immunization, (submitted). Sidman, C. L., Shultz, L. D., Hardy, R. R. Hayakawa, K. & Herzenberg, L. A. (1986) Production of immunoglobulin isotypes by Ly. 1+ B cells in viable motheaten and normal mice. Science 232, 1423. Sieckmann, D. G., Asofsky, R., Mosier, D. D., Zitron, I. M. & Paul, W. E. (1978) Activation of mouse lymphocytes by anti-immunoglobulin I. Parameters of the proliferative response. J. Exp. Med, 147, 814. Smith, H. R., Yaffe, L. J., Chused, T. M., Ravenche, E. S., Klinman, D. M. & Steinberg, A. D. (1982) Analysis of B cell subpopulation. I. Relationship among splenic xid, Ly.l+ and Lyb.5+ B cells. Cell. Immunol, 92, 190. Victor-Kobrin, C., Bonilla, F. A., Bellon, B. & Bona, C. A. (1985) Immunochemical and molecular characterization of regulatory idiotopes expressed by monoclonal antibodies exhibiting or lacking β2-6 fructosan binding activity. J. Exp. Med, 162, 647. Victor-Kobrin, C., Manser, T., Moran, T. M., Imanishi-Kari, T., Gefter, M. & Bona, C. (1985) Shared idiotopes among antibodies encoded by VH genes members of the J558 VH family as basis for cross-reactive regulation of clones with different antigen specificity. Proc. Nad. Acad. Sci, 82, 7696. Welch, M. J., Fong, S., Vaugham, J. H. & Carson, D. A. (1983) Increased frequency of rheumatoid factor precursor B lymphocytes after immunization of normal adults with tetanus toxoid. Clin. Exp. Immunol, 51, 299. Yancopoulos, G. D., Desiderio, D. V., Paskind, M., Kearney, J. F., Baltimore, D. & Alt, F. W. (1984) Preferential utilization of the most JH proximal VH gene segments in pre B cells lines. Nature 311, 757. Zanetti, M. (1986) Idiotypic regulation of autoantibody production. Crit. Rev. Immunol, 6, 151. Zanetti, M. de Baets, M. & Rogers, J. (1983) High degree of idiotypic cross-reactivity among murine monoclonal antibodies to thyroglobulin. J. Immunol, 131, 2452. Citing Literature Volume94, Issue1December 1986Pages 75-98 ReferencesRelatedInformation