1382 withSinemet ’ they occurred in 16 and were marked in 4. Like Professor Barbeau, we have found it difficult to correct these levodopa-related symptoms. Lowering the daily dosage or individual doses, although it attenuates the dystonic movements, is accompanied by re-emergence of more Parkinson’s-disease symptoms. However, in some found that administration of levodopa in we have patients doses at short intervals, to lessen fluctuations of plasmareduces the dyskinesias which occur dopa concentrations, " " off " effect. at the time of the on " or
treatment
Brookhaven National Laboratory, Associated Universities, Inc.,
Upton, Long Island, New York 11973, U.S.A.
EDUARDO S. TOLOSA WILLIAM E. MARTIN HAROLD P. COHEN.
C3 IN CYSTIC FIBROSIS SiR,-Conover and his colleagues reported elevated C3 levels in patients with cystic fibrosis (c.F.).1 In another study Hann and his colleagues reported raised C3 levels in 28 of 51 patients with c.F. and in 7 of 24 controls.2 However, we believe that serum-levels of individual complement components in children cannot be meaningfully interpreted unless they are compared with normal values obtained from age-matched controls. In a study of 163 healthy infants and children we found a statistically significant correlation of C3 levels with age, but not with
in the appropriate age-group (see figure). The projected high and low values using 95% confidence limits are included. Only 4 of the 23 c.F. patients have raised C3 levels; however, these 4 patients could not be distinguished from the other c.F. patients by clinical evaluation. 2. In groups 5, 6, and 7 the mean C3 level for the c.F. patients in each group was compared with the mean C3 level for all the normal subjects included in the same group. There was no significant difference between the means in any of these groups (p > 0-3 by Student’s t test for each group).
Also there was no apparent correlation of the C3 level with the sex or the Shwachman score of the c.F. patients. In contrast to previous reports, we did not find raised C3 levels in the majority of our c.F. patients when the values were compared with projected group mean values for the appropriate age, and we did not find a significant elevation of the mean C3 level for the c.F. patients in any of the age-groups tested. We should like to emphasise the importance of establishing normal values in any laboratory that measures complement profiles in childhood diseases. Department of Pediatrics, Children’s Hospital of
Philadelphia, University of Pennsylvania,
Philadelphia, Pennsylvania 19104, U.S.A.
THOMAS F. SCANLIN, JR. MICHAEL E. NORMAN MARY LORETTA ROSENLUND.
UNSATURATED FATTY ACIDS AND TRANSPLANTATION
C3 levels in children with C.F. and
age-matched controls.
race, and we also found a wide range of values within any given age-group.33 Therefore C3 levels were measured in 23 children with C.F., and the results were compared with the findings in normal age-matched controls. Samples of venous blood were allowed to clot for 2 hours at 4°C. Sera were then separated and aliquots were snap-frozen and stored at —70°C. C3 levels were determined in duplicate within two weeks of storage, using the technique of Mancini et awl.4 Immunoplates were bought from Hyland, Inc. (Division of Travenol Laboratories, Inc.,
sex or
Costa Mesa, California). The data
were
analysed in the following ways
:
SiR,—There is evidence that free polyunsaturated fatty acids suppress cellular immunity in vitro.1-3 However, experiments designed to study their effect in vivo must recognise their toxicity. Ring et al. reported that the mean survival-time of grafts from black inbred BD-6 rats onto white male Sprague-Dawley rats increased when the latter were treated with linoleic acid (L.A.). L.A. was toxic when given intraperitoneally (44% of the animals died within 5-10 days), and some orally treated animals had diarrhoea. Since the control group " remained entirely untreated" (i.e., free from treatment stress), it was difficult to determine how much of the observed immunological suppression was caused by a non-specific toxic effect and how much depended upon the specific suppression of the immune response. Ring et al. concluded that " only oral administration of unsaturated fatty acids can be recommended ". Subcutaneous injection of L.A. (a less stressful method of administration) prolonged the survival of tails grafted from female A mice onto female CBA mice, the controls being injected with saline.b Experiments have been carried out to assess the nonspecific stress effect operating in the above studies. 4 out of 5 female CBA mice died after receiving tail grafts from female A mice and daily subcutaneous injections of 100 1. L.A. (Sigma Chemicals). All 13 grafted animals died after daily subcutaneous injection of 100 jjd. oleic acid. Graft survival was prolonged in the single mouse which survived L.A. treatment (16 days as compared with 11-2±0-75 for a control group). In further experiments the effect ofNaudicelle’ oil (Bio-Oils Research, Nantwich), containing triglyceride esters of linoleic acid (70%) and y-linoleic acid (7%), has been tested. Although this material was not toxic
1. The C3 values for the c.F. patients were plotted against the projected group mean C3 values for 95 % of the general population
there was no difference in the mean survival-time of these tail grafts when 100 z.1. of oil was given subcutaneously
1. Conover, J. H., Conod, E. J., Hirschorn, K. Lancet, 1973, ii, 1501. 2. Hann, S., Holsclaw, D. S., Shin, H. S. ibid. 1974, ii, 520. 3. Norman, M. E., Gall, E. P., Taylor, A., Laster, L., Nilsson, U. R. J. Pediat. (in the press). 4. Mancini, G., Carbonara, H. O., Heremans, J. F. Immunochemistry,
1. Mertin, J., Shenton, B. K., Field, E. J. Br. med. J. 1973, ii, 777. 2. Field, E. J., Shenton, B. K., Joyce, G. ibid. 1974, i, 412. 3. Mertin, J., Hughes, D., Shenton, B. K., Dickinson, J. P. Klin. Wschr. 1974, 52, 248. 4. Ring, J., Seifert, J., Mertin, J., Brendel, W. Lancet, 1974, ii, 1331. 5. Mertin, J. ibid. p. 717.
1965, 2, 235.
treatment
Brookhaven National Laboratory, Associated Universities, Inc.,
Upton, Long Island, New York 11973, U.S.A.
EDUARDO S. TOLOSA WILLIAM E. MARTIN HAROLD P. COHEN.
C3 IN CYSTIC FIBROSIS SiR,-Conover and his colleagues reported elevated C3 levels in patients with cystic fibrosis (c.F.).1 In another study Hann and his colleagues reported raised C3 levels in 28 of 51 patients with c.F. and in 7 of 24 controls.2 However, we believe that serum-levels of individual complement components in children cannot be meaningfully interpreted unless they are compared with normal values obtained from age-matched controls. In a study of 163 healthy infants and children we found a statistically significant correlation of C3 levels with age, but not with
in the appropriate age-group (see figure). The projected high and low values using 95% confidence limits are included. Only 4 of the 23 c.F. patients have raised C3 levels; however, these 4 patients could not be distinguished from the other c.F. patients by clinical evaluation. 2. In groups 5, 6, and 7 the mean C3 level for the c.F. patients in each group was compared with the mean C3 level for all the normal subjects included in the same group. There was no significant difference between the means in any of these groups (p > 0-3 by Student’s t test for each group).
Also there was no apparent correlation of the C3 level with the sex or the Shwachman score of the c.F. patients. In contrast to previous reports, we did not find raised C3 levels in the majority of our c.F. patients when the values were compared with projected group mean values for the appropriate age, and we did not find a significant elevation of the mean C3 level for the c.F. patients in any of the age-groups tested. We should like to emphasise the importance of establishing normal values in any laboratory that measures complement profiles in childhood diseases. Department of Pediatrics, Children’s Hospital of
Philadelphia, University of Pennsylvania,
Philadelphia, Pennsylvania 19104, U.S.A.
THOMAS F. SCANLIN, JR. MICHAEL E. NORMAN MARY LORETTA ROSENLUND.
UNSATURATED FATTY ACIDS AND TRANSPLANTATION
C3 levels in children with C.F. and
age-matched controls.
race, and we also found a wide range of values within any given age-group.33 Therefore C3 levels were measured in 23 children with C.F., and the results were compared with the findings in normal age-matched controls. Samples of venous blood were allowed to clot for 2 hours at 4°C. Sera were then separated and aliquots were snap-frozen and stored at —70°C. C3 levels were determined in duplicate within two weeks of storage, using the technique of Mancini et awl.4 Immunoplates were bought from Hyland, Inc. (Division of Travenol Laboratories, Inc.,
sex or
Costa Mesa, California). The data
were
analysed in the following ways
:
SiR,—There is evidence that free polyunsaturated fatty acids suppress cellular immunity in vitro.1-3 However, experiments designed to study their effect in vivo must recognise their toxicity. Ring et al. reported that the mean survival-time of grafts from black inbred BD-6 rats onto white male Sprague-Dawley rats increased when the latter were treated with linoleic acid (L.A.). L.A. was toxic when given intraperitoneally (44% of the animals died within 5-10 days), and some orally treated animals had diarrhoea. Since the control group " remained entirely untreated" (i.e., free from treatment stress), it was difficult to determine how much of the observed immunological suppression was caused by a non-specific toxic effect and how much depended upon the specific suppression of the immune response. Ring et al. concluded that " only oral administration of unsaturated fatty acids can be recommended ". Subcutaneous injection of L.A. (a less stressful method of administration) prolonged the survival of tails grafted from female A mice onto female CBA mice, the controls being injected with saline.b Experiments have been carried out to assess the nonspecific stress effect operating in the above studies. 4 out of 5 female CBA mice died after receiving tail grafts from female A mice and daily subcutaneous injections of 100 1. L.A. (Sigma Chemicals). All 13 grafted animals died after daily subcutaneous injection of 100 jjd. oleic acid. Graft survival was prolonged in the single mouse which survived L.A. treatment (16 days as compared with 11-2±0-75 for a control group). In further experiments the effect ofNaudicelle’ oil (Bio-Oils Research, Nantwich), containing triglyceride esters of linoleic acid (70%) and y-linoleic acid (7%), has been tested. Although this material was not toxic
1. The C3 values for the c.F. patients were plotted against the projected group mean C3 values for 95 % of the general population
there was no difference in the mean survival-time of these tail grafts when 100 z.1. of oil was given subcutaneously
1. Conover, J. H., Conod, E. J., Hirschorn, K. Lancet, 1973, ii, 1501. 2. Hann, S., Holsclaw, D. S., Shin, H. S. ibid. 1974, ii, 520. 3. Norman, M. E., Gall, E. P., Taylor, A., Laster, L., Nilsson, U. R. J. Pediat. (in the press). 4. Mancini, G., Carbonara, H. O., Heremans, J. F. Immunochemistry,
1. Mertin, J., Shenton, B. K., Field, E. J. Br. med. J. 1973, ii, 777. 2. Field, E. J., Shenton, B. K., Joyce, G. ibid. 1974, i, 412. 3. Mertin, J., Hughes, D., Shenton, B. K., Dickinson, J. P. Klin. Wschr. 1974, 52, 248. 4. Ring, J., Seifert, J., Mertin, J., Brendel, W. Lancet, 1974, ii, 1331. 5. Mertin, J. ibid. p. 717.
1965, 2, 235.
