- Email: [email protected]
Principles of immunology and immunodiagnostics
HUMAN PATHOLOGY
Volume 20, No. 1 (January 1989)
provides a very well-written and well-illustrated way to do just that. One last problem remains, as pointed out by one of the authors; how is Dr Kaposi’s name pronounced? Perhaps a second edition can address that qXCt.--STEBBINS B. CHANDOR, MD, Chairman, Department of Pathology, Marshall University, Huntington, WV.
The next two chapters deal with lupus-like autoimmunity in murine graft-v-host disease and graft-v-host disease following bone marrow transplantation. The first chapter is written by Portanova and Kotzin. They are from the Department of Medicine and Microbiology/Immunology, VA Medical Center and the University of Colorado. It is concise and well-written, and as a VA physician, I was pleased that the VA received proper acknowledgment. The second chapter is written by Shulman and Sullivan and is a timely summary of what is currently known about CvsH disease, which the authors point out is a “complex set of reactions.” I would have liked to see some summary about how one can prevent GvsH disease. However, Shulman and Sullivan are pathologists, so we may have to excuse this oversight. The final chapter concerns ageing, and was written by M. M. B. Kay. I am often intimidated by names with more than three initials, but Dr Kay is affiliated with a VA institution, so I will let this pass. In her concluding remarks, she states that “ageing is characterized by a declining ability of the individual to adapt to environmental stress.” I really like that quote and hope that I can remember it as I get older. The bottom line is that the text can serve as a good reference on the specific diseases it discusses. It is quite readable and points out the complexities of autoimmune diseases such as lupus, GvsH disease, and ageing(?). (I don’t mind ageing, but I hate to think of it as an autoimmune disease.) I sometimes think that autoimmune diseases are like listening to a one-man band. One is never sure where the music is coming from, how it all gets started, and how it continues.-H. TERRY WEPSIC, MD, Professor of Pathology and Staff Pathologist, Loyola University Medical School and Hines VA Hospital, Pathology Research, Hines, IL.
Principles of Immunology Ralph M. Aloisi. Philadelphia, pages.
and Immunodiagnostics. Lea & Febiger, 1988, 238
This volume is designed to provide the student of laboratory medicine a focused view of immunology and immunodiagnostics. To this end, the overall concepts of immunology are presented clearly and concisely in the first several chapters. This material is followed by three chapters dealing with infectious and tumor immunity, transplantation, and immunopathology. The second section of the book, consisting of six chapters, deals entirely with immunodiagnosis. For the most part, the introductory material is accurate, though over-simplified. The portion dealing with lymphokines is weak, as it focuses entirely on afferent mediators involved in induction of the immune response, with no attention to t,he inflammatory lymphokines that participate in most of the important effector reactions of cellular immunity. Even when the interferons are discussed, their role in host defense through activation of inflammatory cells is poorly defined. In earlier sections, defining the T cell response as cell-mediated immunity does not clarify this important concept. It is only later, in the chapter on immunopathology, that the phenomenon is clearly defined, but only in relation to hypersensitivity manifestations. A similar weakness is seen in the material on tumor immunity, where there is little information on modern approaches to immunotherapy utilizing recombinant-derived lymphokines. Finally, as a small point, in spite of what is stated on page 52, the International Nomenclature Committee that was first convened to deal with lymphokine terminology did not accept the interleukin nomenclature; it became standardized because of the zeal of its adherents rather than by official decree. In contrast, the material on complement is quite clear and thorough, and presents an excellent description of the cascades involved in both the classical and alternative pathways, the functional consequences of complement activation, and the regulatory networks involved in the complement system in physiologic and pathologic states. Similarly, the material on the HLA system makes a very complex topic easy to understand. The sections on immunodiagnosis are extremely wellwritten, but do not cover functional assays such as blast transformation and chemotaxis, which should probably be part of the armamentarium of any clinical immunology laboratory. Indeed, any modern investigation of an immunodeficient state should take into account not only defects in immune cells and their products, but also defective responses by cells that are targets for those products. Thus, other important assays, such as those dealing with phagocytosis and superoxide production, should also be included. Since many of these various topics are covered in the section on principles of immunology, they could have easily been presented as diagnostic procedures as well. The main strength of the book is its clarity and the logical flow of the exposition. The major weakness is in its emphasis on humoral or serologic aspects, with inadequate
Kaposi’s Sarcoma. Pathophysiology and Clinical Management. John L. Ziegler, Ronald F. Dorfman (eds): New York, Marcel Dekker, 1988, 266 pages. This is a multi-authored text by 14 authors dealing with a rather uncommon medical entity in a thorough manner. After an overview, there are chapters dealing with the pathology, histogenesis, etiology, clinical aspects, radiologic features, and therapy of Kaposi’s sarcoma. The authors are from institutions that have a significant amount of experience with the disease, and this experience is made evident, in part, by the numerous histologic, radiologic, and clinical illustrations of the lesions. Particularly good for pathologists are the number and quality of the histologic illustrations, especially those demonstrating the evolution of the lesion. The descriptions of this progression and how the lesions appear in various organs are well-done. A few minor problems relate to having multiple authors. There is more than one review of the background of the entity, and some of the histologic pictures are redundant. It would be easier to understand the current thinking of its etiology with only one chapter on the subject, combining the discussion on CMV, angiogenesis, and immunosuppression. It would have been helpful for pathologists to have provided more of a discussion of the differential diagnosis at various stages, perhaps in tabular form, combining some of the material presented in the chapters on pathology and histogenesis. Kaposi’s sarcoma is a lesion that few clinicians or pathologists have had much contact with in the past. However, as people travel and the population of immunosuppressed patients expands, we will all have exposure to this disease entity in the future. Therefore, people in the health field should become familiar with Kaposi’s sarcoma and this text
94
NOTICES
attention to cell-mediated phenomena and the detection, quantitation, and analysis of cellular immunity. On balance, it represents a worthwhile contribution to the literature that is likely to be useful for medical technologists and individ-
uals in master’s degree programs. It is less likely to be sufficient as a self-standing text for house officers and PhD candidates-STANLEY COHEN, MD, Professor and Chairman, Hahnemann University School of Medicine, Philadelphia.
NOTICES
Courses: 30th Annual Postgraduate Institute for Pathologists in Clinical Cytopathology Course A: February-April 1989 (Home Study Course A) Course B: April 24-May 5, 1989 (In-Residence Course B) Baltimore, MD: Johns Hopkins University School of Medicine (Course A is a mandatory prerequisite of Course 8) For further information, contact John K. Frost, MD, or B. Clendaniel, 604 Pathology Bldg, The Johns Hopkins Hospital, Baltimore, MD 21205; (3011955-3522.
Symposium: Spring Symposium on “Oncogenes and Onto-Suppressor Genes” March 30-April 1, 1989 Athens, Greece: European Association for Cancer Research For further information, contact Professor D. A. Spandidos, National Hellenic Research Foundation, 48 Vass. Constantinu Ave, GR- 11635, Athens, Greece; 30-I-72298 11.
95
Volume 20, No. 1 (January 1989)
provides a very well-written and well-illustrated way to do just that. One last problem remains, as pointed out by one of the authors; how is Dr Kaposi’s name pronounced? Perhaps a second edition can address that qXCt.--STEBBINS B. CHANDOR, MD, Chairman, Department of Pathology, Marshall University, Huntington, WV.
The next two chapters deal with lupus-like autoimmunity in murine graft-v-host disease and graft-v-host disease following bone marrow transplantation. The first chapter is written by Portanova and Kotzin. They are from the Department of Medicine and Microbiology/Immunology, VA Medical Center and the University of Colorado. It is concise and well-written, and as a VA physician, I was pleased that the VA received proper acknowledgment. The second chapter is written by Shulman and Sullivan and is a timely summary of what is currently known about CvsH disease, which the authors point out is a “complex set of reactions.” I would have liked to see some summary about how one can prevent GvsH disease. However, Shulman and Sullivan are pathologists, so we may have to excuse this oversight. The final chapter concerns ageing, and was written by M. M. B. Kay. I am often intimidated by names with more than three initials, but Dr Kay is affiliated with a VA institution, so I will let this pass. In her concluding remarks, she states that “ageing is characterized by a declining ability of the individual to adapt to environmental stress.” I really like that quote and hope that I can remember it as I get older. The bottom line is that the text can serve as a good reference on the specific diseases it discusses. It is quite readable and points out the complexities of autoimmune diseases such as lupus, GvsH disease, and ageing(?). (I don’t mind ageing, but I hate to think of it as an autoimmune disease.) I sometimes think that autoimmune diseases are like listening to a one-man band. One is never sure where the music is coming from, how it all gets started, and how it continues.-H. TERRY WEPSIC, MD, Professor of Pathology and Staff Pathologist, Loyola University Medical School and Hines VA Hospital, Pathology Research, Hines, IL.
Principles of Immunology Ralph M. Aloisi. Philadelphia, pages.
and Immunodiagnostics. Lea & Febiger, 1988, 238
This volume is designed to provide the student of laboratory medicine a focused view of immunology and immunodiagnostics. To this end, the overall concepts of immunology are presented clearly and concisely in the first several chapters. This material is followed by three chapters dealing with infectious and tumor immunity, transplantation, and immunopathology. The second section of the book, consisting of six chapters, deals entirely with immunodiagnosis. For the most part, the introductory material is accurate, though over-simplified. The portion dealing with lymphokines is weak, as it focuses entirely on afferent mediators involved in induction of the immune response, with no attention to t,he inflammatory lymphokines that participate in most of the important effector reactions of cellular immunity. Even when the interferons are discussed, their role in host defense through activation of inflammatory cells is poorly defined. In earlier sections, defining the T cell response as cell-mediated immunity does not clarify this important concept. It is only later, in the chapter on immunopathology, that the phenomenon is clearly defined, but only in relation to hypersensitivity manifestations. A similar weakness is seen in the material on tumor immunity, where there is little information on modern approaches to immunotherapy utilizing recombinant-derived lymphokines. Finally, as a small point, in spite of what is stated on page 52, the International Nomenclature Committee that was first convened to deal with lymphokine terminology did not accept the interleukin nomenclature; it became standardized because of the zeal of its adherents rather than by official decree. In contrast, the material on complement is quite clear and thorough, and presents an excellent description of the cascades involved in both the classical and alternative pathways, the functional consequences of complement activation, and the regulatory networks involved in the complement system in physiologic and pathologic states. Similarly, the material on the HLA system makes a very complex topic easy to understand. The sections on immunodiagnosis are extremely wellwritten, but do not cover functional assays such as blast transformation and chemotaxis, which should probably be part of the armamentarium of any clinical immunology laboratory. Indeed, any modern investigation of an immunodeficient state should take into account not only defects in immune cells and their products, but also defective responses by cells that are targets for those products. Thus, other important assays, such as those dealing with phagocytosis and superoxide production, should also be included. Since many of these various topics are covered in the section on principles of immunology, they could have easily been presented as diagnostic procedures as well. The main strength of the book is its clarity and the logical flow of the exposition. The major weakness is in its emphasis on humoral or serologic aspects, with inadequate
Kaposi’s Sarcoma. Pathophysiology and Clinical Management. John L. Ziegler, Ronald F. Dorfman (eds): New York, Marcel Dekker, 1988, 266 pages. This is a multi-authored text by 14 authors dealing with a rather uncommon medical entity in a thorough manner. After an overview, there are chapters dealing with the pathology, histogenesis, etiology, clinical aspects, radiologic features, and therapy of Kaposi’s sarcoma. The authors are from institutions that have a significant amount of experience with the disease, and this experience is made evident, in part, by the numerous histologic, radiologic, and clinical illustrations of the lesions. Particularly good for pathologists are the number and quality of the histologic illustrations, especially those demonstrating the evolution of the lesion. The descriptions of this progression and how the lesions appear in various organs are well-done. A few minor problems relate to having multiple authors. There is more than one review of the background of the entity, and some of the histologic pictures are redundant. It would be easier to understand the current thinking of its etiology with only one chapter on the subject, combining the discussion on CMV, angiogenesis, and immunosuppression. It would have been helpful for pathologists to have provided more of a discussion of the differential diagnosis at various stages, perhaps in tabular form, combining some of the material presented in the chapters on pathology and histogenesis. Kaposi’s sarcoma is a lesion that few clinicians or pathologists have had much contact with in the past. However, as people travel and the population of immunosuppressed patients expands, we will all have exposure to this disease entity in the future. Therefore, people in the health field should become familiar with Kaposi’s sarcoma and this text
94
NOTICES
attention to cell-mediated phenomena and the detection, quantitation, and analysis of cellular immunity. On balance, it represents a worthwhile contribution to the literature that is likely to be useful for medical technologists and individ-
uals in master’s degree programs. It is less likely to be sufficient as a self-standing text for house officers and PhD candidates-STANLEY COHEN, MD, Professor and Chairman, Hahnemann University School of Medicine, Philadelphia.
NOTICES
Courses: 30th Annual Postgraduate Institute for Pathologists in Clinical Cytopathology Course A: February-April 1989 (Home Study Course A) Course B: April 24-May 5, 1989 (In-Residence Course B) Baltimore, MD: Johns Hopkins University School of Medicine (Course A is a mandatory prerequisite of Course 8) For further information, contact John K. Frost, MD, or B. Clendaniel, 604 Pathology Bldg, The Johns Hopkins Hospital, Baltimore, MD 21205; (3011955-3522.
Symposium: Spring Symposium on “Oncogenes and Onto-Suppressor Genes” March 30-April 1, 1989 Athens, Greece: European Association for Cancer Research For further information, contact Professor D. A. Spandidos, National Hellenic Research Foundation, 48 Vass. Constantinu Ave, GR- 11635, Athens, Greece; 30-I-72298 11.
95