Antisera to certain isolates of Klebsiella pneumoniae have a specific lymphocytotoxic effect on the HLA–B27 bearing lymphocytes in 83% of B27 positive patients with ankylosing spondylitis and about 60% of patients with HLA–B27 positive Reiter's syndrome and asymmetrical peripheral arthritis. These findings indicate cross-reactivity between a Klebsiella antigen and a “modified” HLA–B27 or a closely associated structure in patients with ankylosing spondylitis and related arthropathies. Family studies indicate that the alteration in HLA–B27 is not a direct genetic effect.

Abstract. This study reports two modifications of the Platelet Suspension Immunofluorescence Test which make it more convenient to use for the rapid identification of platelet‐specific antibodies and for screening individuals if platelet donors of a particular type are urgently required. Platelets frozen both before and after paraformaldehyde (PFA) fixation were compared with fresh PFA‐fixed platelets using anti‐PLA1 and anti‐HLA antisera. Further, a comparison was made between the results of the test when performed in tissue culture trays or in tubes as originally described. Platelets, prefixed with PFA and then frozen appeared similar in all respects to fresh PFA‐fixed platelets with no loss of antigenicity and no non‐specific fluorescence. Although platelets fixed after frozen storage were also satisfactory, they were less convenient to use and lost some brilliance in staining. When the test was performed in tissue culture trays, there was no loss in sensitivity, and the volume of antiserum used was halved. However, the main advantage was the efficiency and ease with which the test could be performed, especially when handling large numbers of samples.

It has been suggested that some Klebsiella sp may cross-react with a cell surface determinant on the lymphocytes of B27+AS+ individuals. Studies were undertaken to identify culture filtrates capable of rendering the lymphocytes of B27-positive healthy controls susceptible to lysis by the anti-Klebsiella antiserum. Polyacrylamide gel electrophoresis of cell wall material of Klebsiella K43 prepared by sonication, high-speed centrifugation, and nonidet solubilization, demonstrated the presence of four major protein bands. When antisera raised in rabbits to each of these were tested for their cytotoxic effect on the lymphocytes of B27+AS+ individuals, an antiserum to one component only, of 40-52 K daltons molecular weight, reproduced the activity of the whole serum. Studies on the K43 filtrate indicated that the 'modifying' factor appeared to reside in a 25-50 K dalton component. Immunoelectrophoresis against anti-K43 serum demonstrated overlapping bands in the culture filtrate and the 40-52 K dalton cell wall fraction and these appeared to be identical on immunodiffusion. Antibody to the cell wall component removed both the 'modifying' activity and the appropriate protein band from the filtrate. The results suggest that a 40-52 K dalton component of the Klebsiella K43 cell wall is cross-reactive with a determinant on the lymphocytes of B27+AS+ individuals and is similar to or identical with a modifying factor in K43 culture filtrate which renders the lymphocytes of B27-positive healthy controls susceptible to lysis by anti-Klebsiella antiserum.

Australian and New Zealand Journal of MedicineVolume 7, Issue 6 p. 676-676 RECENT ADVANCES IN ORGAN TRANSPLANTATION Helen V. Bashir, Helen V. Bashir Tissue Typing Laboratory, NS W Red Cross Blood Transfusion ServiceSearch for more papers by this author Helen V. Bashir, Helen V. Bashir Tissue Typing Laboratory, NS W Red Cross Blood Transfusion ServiceSearch for more papers by this author First published: December 1977 https://doi.org/10.1111/j.1445-5994.1977.tb02359.xAboutPDF 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 Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume7, Issue6December 1977Pages 676-676 RelatedInformation

methylmalonic acid was first isolated from pooled human urine in 1957 by Thomas and Stalder and convincing evidence has since been obtained to show that in man the isomerization of l‐methylmalonyl‐Co A to succinyl‐Co A is dependent on the B 12 coenzyme dimethylbenzimidazolyl cobamide (White, 1962). Indeed, Cannata, Focesi, Mazumder, Warner and Ochoa (1965) showed recently that l‐methylmalonyl‐Co A mutase bears two molecules of cobamide coenzyme firmly attached to its molecule. In a series of 30 patients Cox and White (1962) detected excessive methylmalonic acid in the urine of all patients with serum vitamin B 12 levels below 140 pg./ml., their lower limit of normal. Patients with normal serum B 12 levels excreted up to 4 mg. of methylmalonic acid in 24 hours. Their series included six patients who were treated with intramuscular hydroxocobalamin (1000 μg.). In five of these, excretion fell to normal within 3 days, and on the fifth day after injection in the sixth patient. Barness, Young, Mellman, Khan and Williams (1963) reported one vitamin B 12 deficient patient in whom the urinary excretion of methylmalonic acid reached 500 mg. in 24 hours. Recently Khan, Williams, Barness, Young, Shafer, Vivacqua and Beaupre (1965) have described seven out of nine patients with pernicious anaemia in whom methylmalonic acid excretion persisted for some months after the institution of B 12 therapy. This occurred despite full clinical and haematological remissions and in four patients, normal serum vitamin B 12 levels. The present study was undertaken to determine the value of urinary methylmalonic acid excretion as a screening test for vitamin B 12 deficiency. The estimation of methylmalonic acid was carried out by a rapid thin layer chromatographic technique, suitable for routine laboratory use. Normal controls and patients suffering from general haematological and medical disorders were screened as well as patients suffering from megaloblastic anaemia. In several patients the excretion of methylmalonic acid was followed for a short period after B 12 therapy.