- Email: [email protected]
LACK OF ASSOCIATION BETWEEN HL-A ANTIGENS AND MEASLES ANTIBODY IN MULTIPLE SCLEROSIS
441
higher titres to measles virus than the sera of healthy controls (to be published), but no association between single HL-A antigens, especially HL-A3,7, and measles antibody titres in the sera of M.S. patients as well as of the controls could be observed (see accompanying table). So the results of Jersild et al.I could not be confirmed by our more extended study. These findings, however, add to the difficulties of finding a possible relationship between the genetically controlled immune response and histocompatibility antigens in outbred populations like man-a relationship which has been shown to exist in inbred strains of mice and guineapigs "-and furthermore they stress the complexity of a possible aaiological role of
to a request for treatment. Precisely the problems arise when we are asked to prescribe tranquillisers for situations of minor anxiety-driving Patients will tests, examinations, domestic crises, &c. never learn from experience how to handle anxiety, and develop the self-reliance which results from so doing. General practitioners in particular will see their responsibility as providing patient care over many years. The realistic aim of this must be to encourage adaptation to stress rather than attempting to shield individuals throughout their lives from the problems of living. It is for precisely these reasons that I think we must
event
will lead
same
with interest their biochemical and electrocardiois
note
graphic findings, but firmly reject that this suggestion likely to have a place in practical professional advice.
measles virus in
J. BERTRAMS
Dr
Gray’s Hospital, Elgin, Morayshire.
Department of Medical Virology and Immunology, University of Essen (Gesamthochschule), 43 Essen, West Germany.
R. D. M. MACLEOD.
LACK OF ASSOCIATION BETWEEN HL-A ANTIGENS AND MEASLES ANTIBODY IN MULTIPLE SCLEROSIS
E. VON FISENNE P. G. HÖHER E. KUWERT.
MANAGERIAL HIERARCHIES
SIR,-In the new structure of the N.H.S. an immense bureaucratic machine of full-time officers will be established. These officers will be, at the lowest level, those of the district management team (D.M.T.). It must be made absolutely clear to doctors that, whatever double-talk is put forward about " consensus management " and so on, the full-time officers (the district nursing officer, finance officer, administrator, and community physician, &c.) are in fact in a managerial subordinate position to their opposite numbers at area and regional level. This is, of course, denied by the " Grey Book ", but one must remember that the district officers will be " monitored " by the area team of officers and their promotion will ultimately depend on references made by these, their superior officers. If you realise that, for example, the district community physician’s salary range runs from E5085 to E7599, the area c.p. from S7695 to E9354, and the region officer’s top rate is 5::10,248, it must be clearly seen that the district officers cannot afford to be identified as a source of difficulty " by their
SIR,-Dr Jersild and his colleaguesreported a significant association between antigens HL-A3,7,W18 and antibody titres to measles virus among 102 patients with multiple sclerosis (M.S.). Our HL-A typings of 1000 German M.S. patients and 1000 healthy controls, performed with the same serum set during the same time, showed an increased incidence of HL-A3 (P < 0-001) and HL-A7 (r < 0-0005) and a decreased incidence of the antigens HL-A2 (p < 0-005), HL-A12 (p < 0-001), and W15 (p < 0-0005) (results to be published in detail elsewhere). These data correspond to our previous findings 2,3 as well as to the data of others 4,5 and confirm the association, especially of the antigen HL-A3 with M.S. Hxmagglutination-inhibition tests for measles-antibody titres in the sera of 941 M.S. patients as well as in a sexmatched and age-matched control group (126 persons) were carried out to check for possible association between those HL-A antigens, which had an increased or decreased incidence in M.S., and the titres of measles antibody. As could be expected 6,7 M.s. patients’ sera showed significant
"
superiors. Clearly the hierarchical officers are in a totally different position on the D.M.T. from that of the part-timers-the consultant and the general practitioner.
1. Jersild, C., Ammitzbøll, T., Clausen, J., Fog, T. Lancet, 1973, i, 151. 2. Bertrams, J., Kuwert, E. Europ. Neurol. 1972, 7, 74. 3. Bertrams, J., Kuwert, E., Liedtke, U. Tissue Antigens, 1972, 2, 405. 4. Naito, S., Namerow, N., Mickey, M. R., Terasaki, P. I. ibid. p. 1. 5. Jersild, C., Svejgaard, A., Fog, T. Lancet, 1972, i, 1240. 6. Pette, E., Kuwert, E. Arch. ges. Virusforsch. 1965, 16, 141. 7. Norrby, E. Acta neurol. scand. 1972, suppl. 49-51, p. 337.
MEASLES ANTIBODY AND
M.S.
I suggest that the hierarchical officers will not be able to afford to take a stand against the " guidelines " coming from on high via their superior officers (whatever the 8.
HL-A
Benacerraf, B., McDevitt, H. O. Science, 1972, 175, 273.
ANTIGENS IN MULTIPLE SCLEROSIS
Controls
higher titres to measles virus than the sera of healthy controls (to be published), but no association between single HL-A antigens, especially HL-A3,7, and measles antibody titres in the sera of M.S. patients as well as of the controls could be observed (see accompanying table). So the results of Jersild et al.I could not be confirmed by our more extended study. These findings, however, add to the difficulties of finding a possible relationship between the genetically controlled immune response and histocompatibility antigens in outbred populations like man-a relationship which has been shown to exist in inbred strains of mice and guineapigs "-and furthermore they stress the complexity of a possible aaiological role of
to a request for treatment. Precisely the problems arise when we are asked to prescribe tranquillisers for situations of minor anxiety-driving Patients will tests, examinations, domestic crises, &c. never learn from experience how to handle anxiety, and develop the self-reliance which results from so doing. General practitioners in particular will see their responsibility as providing patient care over many years. The realistic aim of this must be to encourage adaptation to stress rather than attempting to shield individuals throughout their lives from the problems of living. It is for precisely these reasons that I think we must
event
will lead
same
with interest their biochemical and electrocardiois
note
graphic findings, but firmly reject that this suggestion likely to have a place in practical professional advice.
measles virus in
J. BERTRAMS
Dr
Gray’s Hospital, Elgin, Morayshire.
Department of Medical Virology and Immunology, University of Essen (Gesamthochschule), 43 Essen, West Germany.
R. D. M. MACLEOD.
LACK OF ASSOCIATION BETWEEN HL-A ANTIGENS AND MEASLES ANTIBODY IN MULTIPLE SCLEROSIS
E. VON FISENNE P. G. HÖHER E. KUWERT.
MANAGERIAL HIERARCHIES
SIR,-In the new structure of the N.H.S. an immense bureaucratic machine of full-time officers will be established. These officers will be, at the lowest level, those of the district management team (D.M.T.). It must be made absolutely clear to doctors that, whatever double-talk is put forward about " consensus management " and so on, the full-time officers (the district nursing officer, finance officer, administrator, and community physician, &c.) are in fact in a managerial subordinate position to their opposite numbers at area and regional level. This is, of course, denied by the " Grey Book ", but one must remember that the district officers will be " monitored " by the area team of officers and their promotion will ultimately depend on references made by these, their superior officers. If you realise that, for example, the district community physician’s salary range runs from E5085 to E7599, the area c.p. from S7695 to E9354, and the region officer’s top rate is 5::10,248, it must be clearly seen that the district officers cannot afford to be identified as a source of difficulty " by their
SIR,-Dr Jersild and his colleaguesreported a significant association between antigens HL-A3,7,W18 and antibody titres to measles virus among 102 patients with multiple sclerosis (M.S.). Our HL-A typings of 1000 German M.S. patients and 1000 healthy controls, performed with the same serum set during the same time, showed an increased incidence of HL-A3 (P < 0-001) and HL-A7 (r < 0-0005) and a decreased incidence of the antigens HL-A2 (p < 0-005), HL-A12 (p < 0-001), and W15 (p < 0-0005) (results to be published in detail elsewhere). These data correspond to our previous findings 2,3 as well as to the data of others 4,5 and confirm the association, especially of the antigen HL-A3 with M.S. Hxmagglutination-inhibition tests for measles-antibody titres in the sera of 941 M.S. patients as well as in a sexmatched and age-matched control group (126 persons) were carried out to check for possible association between those HL-A antigens, which had an increased or decreased incidence in M.S., and the titres of measles antibody. As could be expected 6,7 M.s. patients’ sera showed significant
"
superiors. Clearly the hierarchical officers are in a totally different position on the D.M.T. from that of the part-timers-the consultant and the general practitioner.
1. Jersild, C., Ammitzbøll, T., Clausen, J., Fog, T. Lancet, 1973, i, 151. 2. Bertrams, J., Kuwert, E. Europ. Neurol. 1972, 7, 74. 3. Bertrams, J., Kuwert, E., Liedtke, U. Tissue Antigens, 1972, 2, 405. 4. Naito, S., Namerow, N., Mickey, M. R., Terasaki, P. I. ibid. p. 1. 5. Jersild, C., Svejgaard, A., Fog, T. Lancet, 1972, i, 1240. 6. Pette, E., Kuwert, E. Arch. ges. Virusforsch. 1965, 16, 141. 7. Norrby, E. Acta neurol. scand. 1972, suppl. 49-51, p. 337.
MEASLES ANTIBODY AND
M.S.
I suggest that the hierarchical officers will not be able to afford to take a stand against the " guidelines " coming from on high via their superior officers (whatever the 8.
HL-A
Benacerraf, B., McDevitt, H. O. Science, 1972, 175, 273.
ANTIGENS IN MULTIPLE SCLEROSIS
Controls