Levine P
Haematologia (Budap). 1980;13(1-4):249-61.
The remarkable history of the 1951 pp 66 year old woman with gastric adenocarcinoma is reviewed. After subtotal gastrectomy she survived for 22 years without any metastases. Presumably the artificially induced high titer IgG, anti-P1 proved to be cytotoxic in two stages: (1) binding of anti-P1 to the terminal fifth sugar, galactose, and (2) the action of cellular immunity in the form of killer T derived lymphocytes containing receptors for IgG molecules. An identical mechanism may be operative in inducing abortions in the pp pregnant woman with a P1 fetus. P1 illegitimate glycolipid (GL) red cell antigen and Forssman (Fs) tissue in adenocarcinoma suggest the self-nonself concept because these are genetically foreign to the host. This concept applies also to numerous "autoimmune" diseases such as RA, lupus, glomerulonephritis, Coombs positive hemolytic anemia and other diseases with immune complexes (ICs) of 20--22 Svedberg units deposited as lesions with tissue damage. In the presence of the GL antigens (ABO, P, Fs), the normal serum contains antibodies for the missing antigen(s). The predicted anti-Fs was present in about 80% of normal employees of ages 18--70. In cancer sera the incidence was 35--40%. On testing normal sera by age in terms of decades anti-Fs was present in 93% in the youngest, and only 55% in the oldest group. This may be associated with the gradual loss of protein synthesis with aging and/or the accumulation of soluble ICs which bind the C1q portion of the C added to the test mixture of heat-inactivated serum (1 : 8) g.p. C (1 : 30) and srbc. In "autoimmune" diseases there is an active immune response to viral or bacterial infections or infestations or drugs which attach to rbc and/or tissue cell membranes. This results in the deposition in selected organs of ICs of 20--22 S units with lesions and tissue damage. For therapy plasma (from young donors) exchange has been recommended to compensate for the loss of IgG antibodies and C.
回顾了一位1951年出生、66岁患胃腺癌女性的非凡病史。胃次全切除术后，她存活了22年且无任何转移。据推测，人工诱导产生的高滴度抗P1 IgG在两个阶段具有细胞毒性：（1）抗P1与末端第五个糖，即半乳糖结合；（2）以含有IgG分子受体的杀伤性T衍生淋巴细胞形式的细胞免疫作用。相同的机制可能在怀有P1胎儿的孕妇流产过程中起作用。腺癌中的P1非法糖脂（GL）红细胞抗原和福斯曼（Fs）组织提示了自我-非自我概念，因为这些对宿主来说在基因上是外来的。这个概念也适用于许多“自身免疫性”疾病，如类风湿性关节炎、狼疮、肾小球肾炎、库姆斯阳性溶血性贫血以及其他有20 - 22斯维德伯格单位免疫复合物（ICs）沉积并伴有组织损伤的疾病。在存在GL抗原（ABO、P、Fs）的情况下，正常血清中含有针对缺失抗原的抗体。预计抗Fs在18 - 70岁的正常人群中约80%存在。在癌症患者血清中，这一发生率为35 - 40%。按年龄段检测正常血清时，抗Fs在最年轻组中占93%，而在最年长组中仅占55%。这可能与衰老过程中蛋白质合成的逐渐丧失和/或可溶性ICs的积累有关，这些可溶性ICs会结合添加到热灭活血清（1:8）、豚鼠补体（1:30）和绵羊红细胞测试混合物中的补体C的C1q部分。在“自身免疫性”疾病中，对病毒或细菌感染、侵扰或附着于红细胞和/或组织细胞膜的药物会产生活跃的免疫反应。这导致20 - 22 S单位的ICs沉积在特定器官中并伴有病变和组织损伤。对于治疗，已建议进行血浆（来自年轻供体）置换以补偿IgG抗体和补体的损失。
