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cardiolipin 135 cartilaginous fish immunity
cells. Autoantibodies against microorganisms crossreact with
cardiac tissue. A monoclonal antibody termed D8/17 identifies
all rheumatics. This antibody is not related to the major
histocompatibility complex (MHC) system and serves as a B
cell marker associated with rheumatic fever, although no specific
role for the antigen in the disease has been demonstrated.
Numerous microbes and viruses can induce acute myocarditis.
These cases are characterized by the presence of lymphocytic
infiltrates and increased titers of heart-reactive antibodies.
Important causative agents include group B coxsackieviruses
that cause acute cardiac inflammation in humans. Rose et al.,
using an experimental mouse model, showed that only those
mice with heart-reactive antibodies in their sera went on to
develop chronic cardiomyopathy with antibodies primarily
against the cardiac isoform of myosin in their model of acute
myocarditis. Postpericardiotomy syndrome occurs in both
adults and children 10 to 14 days after surgery and is characterized
by fever, chest pain, and pericardial and pleural effusions.
This condition is associated with the presence of high-titer,
heart-reactive antibodies in the blood sera. The heart-specific
antibodies are believed to play a role in the disease pathogenesis.
Because many microbes share epitopes with human tissues,
crossreactions between antibodies against the microbe and
human tissues may be harmless or may lead to serious autoimmune
consequences in genetically susceptible hosts. Despite
the attention given to antibodies, cell-mediated immunity may
play a larger role than previously thought in both rheumatic
fever and Chagas’ disease in which T cells are specifically
cytotoxic for the target organ. Cytotoxic T cells specific for
cardiac myofibers appear in both rheumatic fever and Chagas’
disease. Only selected individuals with cardiomyopathy
develop progressive autoimmune disease after active infection.
cardiolipin
Diphosphatidyl glycerol, a phospholipid extracted from beef
heart as the principal antigen in the Wassermann complement
fixation test for syphilis used earlier in the century.
cardiolipin antibodies
Anticardiolipin antibodies (ACAs) may be linked to
thrombocytopenia, thrombotic events, and repeated fetal
loss in patients with systemic lupus erythematosus (SLE).
Caucasian but not Chinese patients with SLE may have a
relatively high incidence of valve defects associated with
the presence of these antibodies. Other conditions associated
with ACA include adrenal hemorrhage and Addison’s
disease, livedo reticularis (LR), and livedo reticularis with
cardiovascular disease (Sneddon syndrome), as well as possibly
polymyalgia rheumatica/giant cell arteritis and focal
central nervous system lupus.
cardiolipin autoantibodies
Immunoglobulin G (IgG), IgM, and IgA cardiolipin autoantibodies
are assayed by enzyme immunoassay (EIA) for the
detection of antiphospholipid antibodies (aPLs) in patients
believed to have antiphospholipid syndrome (APS). Combined
testing for phosphatidylserine autoantibodies and lupus anticoagulant
in addition to anticardiolipin autoantibodies improves
the sensitivity for the detection of antiphospholipid antibodies.
High anticardiolipin autoantibody concentrations are associated
with an increased risk of venous and arterial thrombosis, recurrent
pregnancy loss, and thrombocytopenia.
Carrel, Alexis (1873–1944)
French surgeon working at the Rockefeller Institute for
Medical Research in New York City, who first successfully
Alexis Carrel.
sewed blood vessels together after approximating their ends
by triangulation suture. The technique earned him a Nobel
Prize in Medicine and made organ and tissue grafts surgically
possible.
carriage (HIV)
The expeditious transmission of HIV through a bicellular
conjugate (an infectious synapse) from an infected antigenpresenting
cell to T cells in lymph nodes. The transport of
infected T cells to additional secondary lymphoid tissues
creates numerous reservoirs for virus dissemination
throughout the body.
carrier (person)
An individual with a latent infection who can serve
unknowingly as a source of infection to other persons.
carrier (protein)
An immunogenic macromolecular protein such as ovalbumin
to which an incomplete antigen termed a hapten
may be conjugated either in vitro or in vivo. Whereas the
hapten alone is not immunogenic, conjugation to the carrier
molecule renders it immunogenic. When self proteins are
appropriately modified by the hapten, they may serve as
carriers in vivo, a mechanism operative in allergy to drugs.
The carrier protein supplies T cell epitopes that are requisite
for B cell–T cell cooperation.
carrier effect
To achieve a secondary immune response to a hapten, both
the hapten and the carrier used in the initial immunization
must be employed.
carrier specificity
That part of an immune response, either humoral antibody
or cell-mediated immunity, that is specific for the carrier
portion of a hapten–carrier complex used as an immunogen.
The carrier-specific part of the immune response does not
react with the hapten either alone or when conjugated to a
different carrier.
cartilaginous fish immunity
Major milestones in the evolution of immunity included
the development by cartilaginous fishes, including sharks,
of the thymus, the anamnestic (secondary or memory)
antibody response, plasma cells for antibody synthesis, and
the spleen. Cartilaginous vertebrates have both 7S and 18S
disulfide-linked IgM immunoglobulins. The low and high
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