Irritant dermatitis is a common condition, accounting for a significant proportion of occupational skin disease. The recent advent of non-invasive skin bioengineering technology has accelerated dermatology research in this field. This book comprises an exhaustive reference text on irritant contact dermatitis, covering all aspects of the condition: clinical features, epidemiology, prevention and therapy, prognosis, mechanisms, pathology and regulatory issues. The book also presents novel in vitro and in vivo research techniques and findings. As irritant dermatitis affects multiple specialties, the audience for this book is wide, including clinical and investigative dermatologists, allergists, toxicologists, pharmaceutical scientists, occupational and environmental physicians, public health physicians, cosmetologists and skin bioengineers.

This issue of Immunology and Allergy Clinics of North America, guest edited by Dr. David Stukus, is devoted to Pediatric Allergy. Articles in this important issue include: It's Not Mom's Fault: Prenatal and Early Life Exposures that Do and Do Not Contribute to Food Allergy Development; Implementation of Early Peanut Introduction Guidelines: It Takes a Village; Managing Younger Siblings of Food Allergic Children; Oral Food Challenges in Infants and Toddlers; Moving Past 'Avoid all Nuts': Individualizing Management of Children with Peanut/Tree Nut Allergies; Eczema is a Barrier Issue, Not an Allergy Issue; Tips and Tricks for Controlling Eczema; What to Do with an Abnormal Newborn Screen for Severe Combined Immune Deficiency; Vocal Cord Dysfunction: The Spectrum Across the Ages; It's Time to Start Phenotyping Our Patients with Asthma; Asthma Self-Management: It's Not One Size Fits All; and How Dr. Google is Impacting Parental Medical Decision Making.

The Dictionary of Contact Allergens is a helpful guide for the reader to familiarize with the structures of chemicals implicated in contact dermatitis. Each molecule is described with its principal name for classification. The most important synonyms, the Chemical Abstract Service (CAS) Registry Number that characterizes the substance and its chemical structure and relevant literature references are also listed. Further, the reader will find a unique chapter on Patch Testing with the patient's own products. This guide is a 'must-have' for each physician involved with the diagnosis and treatment of patients with contact dermatitis and allergic skin disease.

Continuing the exciting series of "BNF Task Force Reports", "Adverse Reactions to Foods" covers in depth food allergy, food intolerance, nutrition and the immune system and autoimmune disease. Chaired by Professor Dame Barbara Clayton, task force members have provided cutting edge information, which is a must-have reference for a whole range of professionals, including dietitians, nutritionists, health visitors, family practitioners, nursing practitioners and many other health professionals.

L'esigenza di chiarire i concetti attuali dell'atopia, che per troppo tempo hanno oscillato tra una primitiva visione squisitamente clinica ed una successiva unicamente immunologica, era matura da tempo. L'avere compreso che il ruolo delle immunoglobuline E non e esaustivo ed avere accettato la salomonica divisione tra atopia intrinseca ed estrinseca, sono stati i primi due passi fondamentali. Le recenti scoperte del ruolo dell'immunita innata, e quindi dei peptidi antimicrobici, hanno aperto dei fondamentali spazi di comprensione nell'atopia e non solo. Quello che ora appare chiaro e che l'atopia non e la malattia di un organo ma piuttosto un difetto delle membrane che delimitano il nostro "self." Il fatto che queste membrane si chiamino pelle, intestino, congiuntiva, bronchi o quant'altro ha artificialmente frammentato la comprensione ed il trattamento di un fenomeno unitario. Questo libro vuole cercare di fare una sintesi delle diverse esperienze ma soprattutto essere uno stimolo a far si che la medicina si focalizzi costruttivamente sullo stesso bersaglio. Se cosi sara, non assisteremo piu a"guerre di religione" tra scienziati e medici pratici o, peggio ancora, tra i differenti specialisti che si contendono il paziente. Se l'atopia, come noi crediamo, e un problema globale, esso puo essere adeguatamente affrontato solo in un contesto pluridisciplinare e in clima collaborativo, non solo tra medico e medico ma anche tra medico e paziente.

The first book to explore food allergies in the United States from the perspective of disability and race Are food allergies disabilities? What structures and systems ensure the survival of some with food allergies and not others? Allergic Intimacies is a groundbreaking critical engagement with food allergies in their cultural representations, advocacy, law, and stories about personal experiences from a disability studies perspective. Author Michael Gill questions the predominantly individualized medical approaches to food allergies, pointing out that these approaches are particularly problematic where allergy testing and treatments are expensive, inconsistent, and inaccessible for many people of color. This thought-provoking book explores the multiple meanings of food allergies and eating in the United States, demonstrating how much more is at stake than we realize, at a critical time when food allergies are on the rise: An estimated 32 million Americans, including one in thirteen children, have food allergies. Diagnoses of food allergies in children have increased by 50 percent since 1997. Yet as the author makes clear, the whiteness of the food allergy community and single-identity disability theory is inherently limiting and insufficient to address the complex choices that those with food allergies make. Gill argues that racism and ableism create unique precarity for disabled people of color that food allergic communities are only beginning to address. There is a huge disparity in access to testing and treatment, with African American and Latinx children having higher risk of adverse outcomes than white children, including more rates of anaphylaxis. Food allergy professionals have a responsibility to move beyond individualized approaches to more robust coalitional efforts grounded in disability and racial justice to undo these patterns of exclusion. Allergic Intimacies celebrates the various creative ways food allergic communities are challenging historical and current practice of exclusion, while identifying the depth of work that still needs to be done to shift focus from a white allergic experience toward a more representative understanding of the racial, ethnic, religious, and economic diversity of those in the United States. Gill's book is a discerning and vital exploration of the key debates about risks, dangers, safety, representations, and political concerns affecting the lives of individuals with food allergies.

In November 1998 many of the key leaders of new drug discovery for inflammatory diseases gathered at Hershey, Pennsylvania for the 9th International Conference of the Inflammation Research Association. The Conference was held over a five day period and provided a stimulating environment for the open exchange of important advances in basic inflammation research as well as new drug discovery and development. This book encompasses some of the highlights of several presentations made at the Conference. It contains some of the latest and important developments in the field of inflammation research. Topics include the status of eotaxin and chemokines in asthma and allergy, signal transduction and regulation of diverse mediators such as the JNK group of MAP kinases, TNF and IL-1 signaling of NF-kB as well as regulators of AP-1, macrophage metalloproteinases, lymphotoxin and further insights into the role of MCP-1 in disease. Also discussed are drug targets in rheumatoid and osteoarthritis, fibrotic diseases,...

Allergic skin diseases belong to the most common dermatoses. This book deals with fundamental (in particular immunological aspects) as well as clinical symptoms and therapeutic strategies of the allergic skin diseases. Cells involved in the pathomechanisms of allergic skin disease are described in individual chapters. The allergic skin diseases which will be discussed are atopic dermatitis, being the chronic inflammatory skin disease with the highest prevalence, allergic contact dermatitis with special focus on contact dermatitis from cosmetics, being the most frequent cause of contact dermatitis and occupational contact dermatitis. The broad ethiology of urticaria and the value of several therapeutic strategies will be explained. The chapter on drug allergy will deal with the variety of symptoms and the difficulties concerning in vitro and in vivo diagnosis. The book is of great interest to clinicians working in the field of dermatology, allergology, pediatrics and even general practitioners...

Two decades have passed since the mechanisms of protein synthesis became well enough understood to permit the genetic modification oforganisms. An impressive amount of new knowledge has emerged from the new technology, but much ofthe promise of20years ago has notyet been fulfilled. In biotechnology, efforts to increase the yields of commercially valuable metabolites have been less successful than ex pected, and when they have succeeded it has often been as much from selective breeding as from new methods. The cell is more complicated than what is presented in the classical teaching of biochemistry, it contains more structure than was dreamed of 20 years ago, and the behaviour ofany systemofenzymes is more elaborate than can be explained in terms ofa single supposedly rate-limiting enzyme. Even if classical enzymology and meta bolism may have seemed rather unfashionable during the rise ofmolecular biology, they remain central to any modification ofthe metabolic behaviour oforganisms. As such modification is essential in much ofbiotechnology and drug development, bio technologists can only ignore these topics at their peril."

The traditional Vienna Asthma Forum was held in early June 1996 and th was the 6 in a biennial mode within 10 years. This time it was dedicated to the long-acting beta-2-agonists, which were registered (or just about to be) in most European countries. The introduction of this therapeutic principle into routine praxis of asthma therapy was so successful that a closer view on the subject from a scientific point was warranted. Salmeterol, shortly afterwards formo- terol are the drugs available for the inhalative route, while bambuterol serves as an oral agent. The scientists particularly involved in the design and pharma- cokinetics of these drugs were invited, and we were lucky that Malcolm Johnson (Glaxo), Leif Svensson (Astra) and Gary Anderson (Ciba- Geigy) delivered fascinating contributions. However, drug therapy of this kind can only be effective if based on a thorough understanding of the molecular biology of cells and receptors, which was superbly covered by Sheila Collins (Durham) and Ian M. Adcock (London). The pediatric indications for beta-2-agonists were commented by Manfred G6tz (Vienna), and a large spectrum of clinical studies, reported by G. Boyd (Glasgow), A.P. Greening (Edinburgh), M.

To some, food allergies seem like fabricated cries for attention. To others, they pose a dangerous health threat. Food allergies are bound up with so many personal and ideological concerns that it is difficult to determine what is medical and what is myth. Another Person's Poison parses the political, economic, cultural, and genuine health factors of a phenomenon that dominates our interactions with others and our understanding of ourselves. For most of the twentieth century, food allergies were considered a fad or junk science. While many physicians and clinicians argued that certain foods could cause a range of chronic problems, from asthma and eczema to migraines and hyperactivity, others believed that allergies were psychosomatic. 'This book traces the trajectory of this debate and its effect on public-health policy and the production, manufacture, and consumption of food. Are rising allergy rates purely the result of effective lobbying and a booming industry built on self-diagnosis and expensive remedies? Or should physicians become more flexible in their approach to food allergies and more careful in their diagnoses? Exploring the issue from scientific, political, economic, social, and patient-centered perspectives, this book is the first to engage fully with the history of a major modern affliction, illuminating society's troubled relationship with food, disease, nature, and the creation of medical knowledge.

This is the fourth of a series of Symposia in Immunology which were organized to bring important new information on the expanding field of immunology to practicing physicians interested in the field. Highly renowned basic scientists share their results with physicians conducting clinical research and those experienced in the treatment of the respective diseases. This series of symposia is planned to cover different areas of immunology and will help to close the gap between special achievements of scientists and practicing physicians.

Investigative Immunotoxicology provides a critical evaluation of proposed experimental animal models and approaches, and discusses the contribution that immunotoxicity can make to the overall assessment of chemical-induced adverse health effects on humans and the ecosystem. Following a review of general concepts in immunotoxicology, the book discusses emerging methodologies at the cellular and molecular levels, and describes advances in and requirements for animal model development in testing the allergenicity of foods and genetically modified products. It presents animal models of autoimmunity associated with chemical exposure, includes recommendations for the selection of sentinel species in ecotoxicology, and presents an in-depth review of immunotoxicology as it relates to a variety of wildlife species. Finally, the book explains the role of immunotoxicology in human health risk assessment and the regulatory process. Outlining the potential chemical hazards facing human and ecosystem health, this is a valuable reference for professionals and researchers in immunotoxicology and risk assessment. It also deserves the attention of the pharmaceutical industry and environmental toxicologists who are concerned about the effects of xenobiotics on ecosystems.

The Austrian Pneumological Society held its 33th Workshop on "Clinical Respiratory Physiology" at Graz, November 1 st -3rd, 1990. Bronchial hyperresponsiveness has been known nearly as long as asthma bronchia Ie itself. During the last two decades while exploring the inflammatory nature of asthma bronchiale we have learned a lot about measuring and modifying this phenomenon. Because of the practical relevance and owing to the high competence of the authors we hope that the lectures and discussions we had at Graz will inform and enjoy the interested reader. I want to express my deep gratitude to all the authors for providing us with the manuscripts and graphs. Finally I am especially grateful to Mrs. H. Weber for her secreterial work and to Mrs. Mag. A. Lahrmann-Ramharter for correcting the written version of the speeches and preparing a manuscript that was ready for the press. Prim. Dr. Hartmut Zwick Contents Barnes P. : Cellular and Biochemical Aspects of Airway Hyperresponsiveness. . . . . . . . . . 1 Hargreave F. E. : Airway Hyperresponsiveness and Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Ingram R. H. : Physiologic Correlates of Increased Airway Responsiveness . . . . . . . . . . . . . . . . 36 K errebijn K F. : Bronchial Provocation Testing in Children -Methods and Clinical Relevance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Tattersfield A. E. : Bronchial Provocation Testing in Adults -Is There Clinical Relevance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Kummer F. : Principles and Approaches in Asthma Therapy. . . . . . . . . . . . . . . . . . . . . . . . . .

Many people experience, or believe they experience, a physical reaction to some sorts of food. These may range from allergies to psychologically based aversions. Frequently difficult to diagnose, they present particular problems for medical practitioners and health care workers, and they impinge on the food supply system as a whole. This book sets out to cover the whole question of food reactions and intolerance in a sympathetic, impartial and understanding way. It starts by placing the question in context, with a look at overall questions of nutrition, attitudes to food, and the position of food within society and within "alternative" medical practice. The physiology of digestion is then covered, together with food intolerance, clinical manifestations and testing methods. Reactions to food additives, milk and gluten are considered in detail. The book concludes with a chapter dealing with the dilemma faced by patients with reactions to food. Anybody with an interest in this subject should find this book useful. It may be of particular interest to allergy specialists, family doctors, dietitians and those likely to encounter food intolerance professionally. It should also prove valuable to agriculturalists, food manufacturers and retailers, legislators and consumer groups.

Die j{hrlichen H{mophilie-Symposien befassen sich mit neuen Erkenntnissen aus der Grundlagenforschung und Klinik der H{- mophilie, verwandter angeborener und erworbener Blutungs- krankheiten und thrombophiler Diathesen. Diese Veranstaltun- gen verfolgen das Ziel, unter Mitwirkung kompetenter Modera- toren und Referenten aller involvierten Fachdisziplinen, [rzten und Wissenschaftler aus dem zentraleurop{ischen Raum aktuelle Erkenntnisse und Erfahrungen zu vermitteln und eine stetige Verbesserung der Krankenversorgung zu bewirken. Die Hauptthemen des vorliegenden Bandes sind auf therapiebe- dingte Gef{hrdungendurch Virusinfektionen und nicht-infek- ti|se Nebenwirkungen gerinnungsaktiver Plasmapr{parate ge- richtet. Im Vordergrund stehen dabei H{ufigkeit, Verlauf, Verh}tung und Therapie der HIV-Infektion, H{ufigkeit und Verh}tung der Hepatitis B- und C-Infektion sowie Behand- lungswege der Hemmk|rperh{mophilie. In weiteren Hauptthemen werden angeborene bzw. heredit{re thrombophile Diathesen, insbesondere Protein C- und Antithrombin III-Mangelzust{nde sowie neue, vor allem molekularbiologische Fortschritte in der h{mostaseologischen Diagnostik verhandelt. Den Abschlu~ bildet eine Serie freier Vortr{ge }ber spezielle klinische Probleme bei angeborenenund erworbenen H{mostasest|rungen.

Neuere Entwicklungen in der Molekulargenetik sowie die Notwendigkeit, unanfechtbare Beweise zu liefern, haben zu immer schnelleren Fortschritten auf dem Gebiet der H{mogenetik in der Gerichtsmedizin gef}hrt. Dieser Band enth{lt die Beitr{ge mit neuesten Erkenntnissen, die hierzu auf dem Kongre im September 1991 in Mainz vorgetragen wurden. Im Zentrum steht die Frage der forensischen Anwendung bzw. Andwendbarkeit der DNS-technologischen Forschung. Einige Artikel befassen sich mit Standardisierungs-, Artefakt- und Identifikationsproblemen bez}glich menschlicher ]berreste. Auch ethische und juristische Gesichtspunkte werden diskutiert.

You see things, and sa)' why? But I dream 1hings that never were, and I say, 11'hy 110t? George Bernhard Shaw Far ahead of his time, June 1st, 1909, Alexander Maximov communicated in a lecture, given in the Charite in Berlin, the fundamental knowledge, that there exists a lymphoid hemopoetic stem cell. Alexander Friedenstein explained that during the following years, Maximov also showed that the idea of interaction between hemopoetic cells and their stroma to be one of the most significant experiences. Monoclonal antibodies, recombinant DNA technics and the improvement of tissue culture models are the major developments to improve our possibilities to clarify growth and differentiation functions of hemopoetic cells. During the last two decades it was shown that soluble products, released from T cells, were not only involved in inducing B cells to produce specific immunoglobulin secretion after antigen stimulation. Furthermore, lymphokines together with other cytokines regulate the growth and differentiation of hemopoetic cells. As I have learned from Dick Gershon, our knowledge of the cellular basis for immunoregulation has come a long way since 450 B.C. Thucydides comments on the possible role of immune response in controlling the Black Death. Dick Gershon speculated that no scientific interest for these interesting observations was put forth at that time. Perhaps the problems, the Athenians were having with the Spartans, converted money from basis research into the military budget.

The 1st International Workshop in the Molecular and Cell Biology of Autoan tibodies and Autoimmunity is convened at a time when recombinant DNA tech niques have yielded the first set of data providing initial glimpses of epitopes recognized by autoantibodies. It's aim is to bring together cell and molecular biologists with clinical scien tists to discuss the broad spectrum of questions concerning the relationship be tween clinical symptoms and the specificity of autoantibodies. The response to the call for abstracts was overwhelming: Nearly one hundred abstracts were received from many laboratories throughout the world. The topics covered by them are representative of the current research efforts going on to study cause and effect of autoimmune diseases. One of the aims of this workshop is to bring the rapid advances in the elucidation of the molecular structure of auto antigens to the attention of immunologists, cell biologists and clinical scien tists and also to make molecular biologists bei6ple aware of the difficulties lying ahead in trying to understand the cellular and molecular basis of rheumatic dis eases. The organisers wish to thank NIH, BMFT and the Japanese Educational Foundation for financial support, the Heidelberg Academy for the Humanities and Sciences for hosting the workshop, Springer Verlag for their generous cooperation in including late abstracts in this volume, and, last not least, Ms. Simone KRAMBS for untiring secretarial help."

The third volume of "Advances in Forensic Haemogenetics" contains the th scientific contributions presented at the 13 Congress of the International Society for Forensic Haemogenetics, held on October 19-21, 1989 in New Orleans, USA. The conference was organized and chaired by Dr. Herbert Polesky from Minneapolis. He and the local organizing committee which consisted of our friends and colleagues (J. Soubrada, L.R.Bryant, Dale D.Dykes, Ch.Harrison, P.Newall and R. Walker) deserve the thanks of our Society for a very successful meeting. Herb Polesky has also contributed a great deal to the preparation of this book. The contributions to the conference covered all fields of forensic haemo genetics, but an outstanding highlight of this conference was the application ofDNA-polymorphisms to paternity and to the identification of stains. This included basic lectures on biostatistical approaches as well as on molecular biology and many new technical approaches to our general and special aims. Forensic haemogenetics has now merged into a new discipline without having lost its original identity. On behalf of the Executive Committee of our Society I would like to extend my thanks to the authors of the articles contained in this book and to Springer-Verlag for having made such a quick publication possible. The volume should give the reader a picture of the state of the art and a survey of the most recent developments in the field of forensic and general haemo genetics.

Publication of papers presented at the 12th International Meeting for Forensic Haemogentics Wien 1987. Topics covered included: Formal genetics, population genetics, biochemistry and serology of nearly all hereditary blood group poly- morphisms. Also several reviews of e.g. enzyme polymor- phisms; problems and aspects of the application for paternity testing; extensive articles on forensic stain information with numerous new methods and description of artifacts; polymorphisms in body fluids; quality control methods; use of biostatistics in forensic haemogentics.

This series ofreviews focuses on recent developments in understandingbacterialpathogenesisthathavebeengained by studying the genetic control of the susceptibility to particular diseases. The topics of the reviews include a description ofbacterial genes that effect virulence and a studyofthe genetic susceptibilityofhumans to group A streptococci and to leprosy. The most versatile model system for studies of disease susceptibility is the inbred mouse. Although seven of the chapters deal with the geneticsoftheresistanceofmice to infection, allofthem point out general principles and, wherever possible, parallelswithappropriatehumandiseases. Genetic studies of the mechanisms of resistance and pathogenesishaveanadvantageoverotherapproaches. By utilizing animals ofappropriate genotypes, it is possible tostudytheinvivoconsequencesofvariationsinparticular hostdefensesinintactanimals.Someofthemoderngenetic approachesusedinmousegeneticsarealsodescribed. Allofthechaptersdealingwithmousegeneticsdescribe studieswithrecombinantinbredmice.Achapterhasbeen included thatdescribesapproaches for the useofmice in genetic studies of disease resistance. This chapter also describesrecombinantinbred miceandameans bywhich theycanbeusedtoexaminethelinkageofgenesaffecting diseaseresistance. Thebulkofthevolumefocusesonthegeneticregulation by three different murine loci: Ips, xid, and fty. fty was the first name given to a locusthatgoverns resistance to infections with leishmania, bacille Calmette-Guerin and salmonella. Different reviews describe the relationshipof thefty locusto thediseasescaused bytwoofthese three pathogens. Thesetwo reviewsalsoincludeadiscussionof other geneticfactors that affect the susceptibilityofmice toeachpathogen.TworeviewsaredevotedtotheX-linked immunodeficiency (xid) locus. One describes the pre sent state of immunological knowledge about the immunological deficits that have been shown to be VI Preface associatedwiththedefectivexidallele.Theotherdescribes theeffectoftheseimmunodeficienciesonthesusceptibility of mice to infection with Streptococcus pneumoniae. Anotherchapter describes the effectsofthe Ips locus on the immune system and the concomitant effects these changeshaveontheresistancetobacterialinfection.There is also a chapter describing genetic studies that examine the relationship between the genetic control of certain macrophage properties and the susceptibility to Listeria infection."

1m Rahmen der 28. Jahrestagung der deutschen Gesellschaft fur Haematologie und Onkologie im Herbst 1983 in MUnster fand ein Symposion Uber Tumor-Immunolo- gie statl. Eine Reihe von Arbeitsgruppen trug dabei aktuelle Ergebnisse von Unter- suchungen vor, die sich schwerpunktmaBig mit Fragen der Wechselwirkung Tumor/ Immunsystem, der Immun-Typisierung von Malignomzellen, sowie der Immunthe- rapie von Tumorerkrankungen befaBten. Nicht zuletzt durch die zunehmende Verfugbarkeit monoklonaler Antikorper ist der klinische und/oder wissenschaftlich tatige Haematologe/Onkologe in vermehrtem MaBe auch mit immunologischen Fragestellungen konfrontiert - wenn auch bisher meist nur im diagnostischen Bereich. Dieser Tatbestand ist AnlaB zur Publikation der Symposions-Beitrage in der vorliegenden Form. Die Herausgeber v Liste der Beitragsautoren U. Abel Medizinische UniversiUitsklinik, Bergheimer Str. 58, D-6900 Heidelberg, FRG H. Arnholt Pathologisches Institut der Universitat Munchen, Thalkirchner Str. 36, D-8000 Munchen 2, FRG R. Becher Medizinische Universitatsklinik, Bergheimer Str. 58, D-6900 Heidelberg, FRG K. J. Bross Medizinische Klinik der Albert-Ludwigs-Universitat, Hugstetter Str. 55, D-7800 Freiburg, FRG Th. Buchner Medizinische Klinik der Universitat Munster, Abteilung Innere Medizin A, Albert-Schweitzer-Str. 33, D-4400 Munster, FRG F. W Busch Immunology Laboratory, Medizinische Universitatsklinik, Otfried-Muller-Str. 10, D-7400 Tubingen, FRG P. Drings Krankenhaus Rohrbach, Klinik fur Thoraxerkrankungen der LVA Baden, Amalienstr. 5, D-6900 Heidelberg-Rohrbach, FRG L. Edler Medizinische Universitatsklinik, Bergheimer Str. 58, D-6900 Heidelberg, FRG 1. Fiedorowicz-Fabrycy Hamatologische Klinik der Pommerschen Medizinischen Akademie in Szczecin, UL Czorsztywska 3412, 71-162 Szczecin, Poland M. Fink Medizinische Klinik III, Klinikum GroBhadern, Marchioninistr. 15, D-8000 Munchen 70, FRG D. Fritze Medizinische Universitatsklinik, Bergheimer Str. 58, D-6900 Heidelberg, FRG G.

Activation of the complement system gives rise to a number of molecular species which can interact with host-derived cells and regulate their function. This interaction is mediated through distinct cell surface complement receptors, and receptor engagement produces biologic responses which can either modulate host defense reactions or enhance inflammation. Although the first complement receptor was recognized more than 30 years ago [80J, detailed biochemical information concerning the receptors has only recently become available. Currently, eight distinct complement receptors are recognized. Five receptors (CRl, CR2, CR3, C3a receptor, and C3e receptor) react with various regions on C3 while the other receptors display specificity for Clq, C5a, or Factor H. This chapter focusses on the chemistry of the various ligands and receptors and discusses the biologic activities which arise as a result of receptor-ligand interaction. II. CIQ Receptor A. The Ligand Clq is the recognition molecule of the classical complement pathway [reviewed in 20, 130]. In serum, it is part of a calcium-dependent penta molecular complex containing one molecule ofClq and two molecules each of the pro enzymes Clr and CIs. During classical pathway activation, the macromolecular complex becomes associated with the activator through the Clq subcomponent. Bound Clq undergoes a conformational change and induces the proteolytic autoactivation of Clr which in turn effects the proteolytic activation of CIs. This process is controlled by the Cl inhibitor (ClINH) which binds irreversibly to activated Clr and CIs, and inhibits their enzymatic activities.