Filarial infections commonly involve chronic tissue responses to these complex and resiliant organisms. These responses, which occur with a number of the parasitic stages of filariae, involve macrophages, and these cells appear to be important in immunologically induced destruction and removal of these important parasites of man and animals. Details of their presence and experimental induction as well as their distinction into a number of morphological types, including multinuclear (giant cell) forms, is described in this communication. The ability of these various forms to function in phagocytic and immunologically mediated adherance assays is also described.

This present study describes the ontogeny and morphology of mononuclear and multinuclear macrophages in murine Brugia pahangi infections. Intraperitoneal infection with L 3 resulted in the development of adult worms and the production of microfilariae in many mice; however, all worms were usually removed by 100 days post infection (p.i.). The infection induced predominantly mononuclear and multinuclear macrophage responses in the peritoneal cavity, with maximum numbers of peritoneal cells being achieved by 8-12 weeks p.i. and at this time some 20% of the macrophages were multinucleated. Lymphocyte numbers were also increased during infection. The reactions around the filariae involved macrophages (both single and multinucleated), eosinophils, fibroblasts and the laying down of collagen. Most worms were involved in these cellular reactions by 5-6 weeks p.i., with the multinuclear macrophages generally seen lying close to the parasites. All stages of parasites developed vacuolar internal changes early in their degeneration with calcification being a later change. The destruction and removal of the sheath was not apparently a prerequisite for degeneration of the body of microfilariae. Rosetting techniques showed that 75% of peritoneal cells (macrophages) in infected animals possessed Fc receptors compared with 32% of those in uninfected mice, and for C3 receptors the respective results were 35% and 5%. The multinuclear cells possessed both types of receptors at levels similar to those of mononuclear macrophages. Likewise both cell types were found to readily phagocytose yeast and latex particles, as well as staining positively for non-specific esterases.(ABSTRACT TRUNCATED AT 250 WORDS)

Suspension cultures of human bone marrow mononuclear cells form colonies of fibroblastoid cells which expand to form confluent monolayers. These fibroblastoid cells are thought to represent elements of the bone marrow stroma. Fibroblastoid cells failed to proliferate when the cultures were initiated and maintained in the presence of 50% (v/v) of medium conditioned by phytohaemagglutinin (PHA)-stimulated blood mononuclear cells or supernatant media from one-way mixed lymphocyte reactions (MLR). Under these conditions, the cultures contained a pleomorphic population of macrophage-like cells. Some of the characteristics of the fibroblastoid and macrophage-like cells have been compared and a separate origin of the two cell types has been demonstrated. Further experiments indicated that T lymphocytes were the source of the factor(s) in the conditioned media which was responsible for the growth of the macrophage-like cells at the expense of the fibroblastoid cells and suggested that activation of the T cells was neccessary for them to exert their effect. The results support the idea that T lymphocytes can influence the haemopoietic microenvironment of the bone marrow.

The pharmacology and toxicology of the phenylalkanoic derivatives are discussed with particular reference to Ibuprofen. Clinical trials of Ibuprofen are reviewed and their methodology assessed. A more rational approach to anti-inflammatory drug evaluation is suggested and the need for closer international co-operation in establishing a standardized approach to clinical trial methodology is emphasised.

A total of 125 patients with rheumatoid arthritis were investigated about their drug therapy before referral to a specialist centre. Most referrals were from general practitioners. Only 47 of the patients had received salicylates as the first drug and 18 had never had them at all. Soluble aspirin was the preparation of salicylates most frequently prescribed (for 63 patients). Only 60 patients had been given an adequate dose and only 62 an adequate course of treatment with salicylates. In 28 patients salicylates had been stopped on account of side effects. About one-third of the patients had been prescribed oral corticosteroids. The referral letters were poor in giving details of past and present drug therapy, and there were serious omissions in reporting of previous side effects. Seventy-five general practitioners were asked to rate several currently marketed antirheumatic drugs in terms of effectiveness. Though prednisolone 15 mg daily ranked higher than aspirin 4 g daily the difference was not significant. The study shows the inadequacies of drug prescribing for rheumatoid arthritis in the Glasgow area.

SummaryThe effect of 750 mg. of niflumic acid per day administered orally was studied in 15 patients with active rheumatoid arthritis in a double-blind cross-over trial. The patients were followed over a 2-week period with 3 assessments of joint pain and tenderness, duration and severity of morning stiffness, digital joint circumference, grip strength and radioactive pertechnetate (99m Tc) knee and wrist joint uptakes.The results show that niflumic acid was more effective in relieving pain than placebo. Anti-inflammatory effects could not be demonstrated.