Antibody Binding Patterns Research Articles

Immunohistochemical localization of vitellogenin in rainbow trout ( Oncorhynchus mykiss) hepatocytes using immunofluorescence

In fish, vitellogenin, the egg yolk protein precursor of any oviparous species, is specifically synthesized in the liver of females in response to circulating estrogens. It is released into the blood, taken up by the ovary and used to form the yolk in the eggs. In order to localize vitellogenin in hepatocytes of rainbow trout ( Oncorhynchus mykiss) after external stimulation, both male and female fish were given a single intraperitoneal injection of 17β-estradiol at 1 mg/kg. Whereas in control male liver vitellogenin could not be demonstrated, both sexes produced vitellogenin after 17β-estradiol stimulation. Induced male fish displayed the same pattern of antibody binding as female individuals. However, in males the staining intensity was lower than in females. Under the light microscope, antibodies primarily bound to perinuclear regions, which contain, among other organelles, rough endoplasmic reticulum and Golgi fields, where vitellogenin is synthesized. Under the electron microscope, these organelles could be confirmed as the sites of vitellogenin synthesis by means of specific antibody labeling.

Immunohistochemical localization of beta-1,4-galactosyltransferase in human pancreatic tissues.

beta-1,4-Galactosyltransferase (GalTase) is the glycosyltransferase in the Golgi apparatus that transfers galactose from UDP-galactose to terminal N-acetylglucosamine residues in glycoconjugates with formation of a beta-1,4 linkage. Neoplasms undergo various changes in the carbohydrate moieties of their glycoconjugates. This process also indicates the possibility of changes in glycosyltransferases themselves. Therefore, we compared the binding pattern of a monoclonal antibody (MAb8628) against GalTase in both normal and neoplastic exocrine pancreatic tissues. Ten normal and 11 neoplastic human exocrine pancreatic tissues obtained from surgery were used. Frozen sections were incubated with this antibody. Supranuclear regions and terminal bars of normal duct cells and acinar cells revealed positive staining for GalTase at the light microscopic level. Centroacinar cells revealed positive staining in their perinuclear region. Neoplastic cells were also stained in their supranuclear regions and terminal bars. Supranuclear regions were well developed in neoplastic cells and intensely stained compared with those in normal cells. The supranuclear regions and the terminal bars corresponded to the trans cisternae of the Golgi apparatus and the junctional complex (i.e., tight junction and adherens junction), respectively, seen at the electron microscopic level. Pancreatic neoplastic changes thus led to an increase in the expression of GalTase in the Golgi apparatus, the increase of which may have an important effect on the intercellular adhesion and communication among pancreatic epithelial cells. Measurement of this enzyme is useful for diagnosis of exocrine pancreatic neoplastic changes from normal tissues.

Peripheral nerve binding patterns of anti-sulphatide antibodies in HIV-infected individuals.

HIV-positive plasma samples from patients with and without neuropathy and with high titre anti-GalS antibodies showed strong binding to the myelin membrane of both fixed and unfixed human sciatic nerve specimens. This staining pattern was also seen with a plasma sample from a patient with IgM paraproteinaemic inflammatory demyelinating neuropathy with anti-GalS IgM antibody. Teased nerve fibres incubated with these anti-GalS antibodies from both HIV and non-HIV plasma samples showed immunofluorescence at the paranodal regions and Schmidt-Lanterman incisures. These data support a potential role for these antibodies in the aetiology of HIV-associated immune mediated neuropathies.

Immunochemical characterization of morphospecies and strains of Prorocentrum (dinophyceae)

Antibodies were developed against cell surface antigens of Prorocentrum lima (Ehrenberg) Dodge, P. triestinum , P. micans Ehrenberg, P. minimum (Pavillard) Schiller and P. rostratum Stein. Positive antigenic reactions were visualized with epifluorescence microscopy, using a fluorescein isothiocyanate (FITC) indirect immunofluorescence assay. An immunoassay with a secondary magnetic bead-conjugated antibody was also used. Polyclonal antisera against P. lima and against P. rostratum were species-specific. In contrast, the other antisera showed weak cross-reactions. The antisera with insufficient specificity were improved by exposure to cross-reacting antigens. Thus, species-specific preadsorbed antisera were obtained against each species. A set of strain-specific antibodies against P. lima clones were also prepared by preadsorption. The immunomagnetic bead assay also allowed us to separate P. lima cells from sediment surface samples or macroalgae . Antibody binding patterns were used to establish phenetic relationships among species/clones examined. P. micans , P. triestinum and P. minimum appeared as closely related. In contrast, P. lima , and P. rostratum emerged distant from the other Prorocentrum species. Additionally, serological differences between natural populations of P. lima (a DSP toxin-producing benthic dinoflagellate) were detected.

KHRI-3 monoclonal antibody-induced damage to the inner ear: antibody staining of nascent scars

Intracochlear infusion of the KHRI-3 monoclonal antibody results in in vivo binding to guinea pig inner ear supporting cells, loss of hair cells and hearing loss. To further characterize the basis for KHRI-3-induced hearing loss, antibody was produced in a bioreactor in serum-free medium, affinity purified, and compared to conventionally prepared antibody by infusion into the scala tympani using mini-osmotic pumps. In vivo antibody binding was observed in 10 of 11 guinea pigs. A previously unreported pattern of KHRI-3 antibody binding to cells involved in scar formation was noted in five guinea pigs. All but one of the KHRI-3-infused animals demonstrated a hearing loss of >10 dB in the treated ear. In five of 11 animals the threshold shift was 30 dB or more, and all had hair cell losses. In one guinea pig infused with 2 mg/ml of antibody, the organ of Corti was absent in the basal turn of the infused ear. This ear had a 45–50 dB threshold shift but, curiously, no detectable antibody binding in the residual organ of Corti. Organ of Corti tissue was fragile in antibody-infused ears. Breaks within the outer hair cell region occurred in 5/11 infused ears. The contralateral ears were normal except for one noise-exposed animal that demonstrated hair cell loss in the uninfused ear. Three animals were exposed to 6 kHz noise (108 dB) for 30 min on day 7. Antibody access to the organ of Corti may be increased in animals exposed to noise, since the strongest in vivo binding was observed in noise-exposed animals. Loss of integrity of the organ of Corti seems to be the primary mechanism of inner ear damage by KHRI-3 antibody. The binding of KHRI-3 antibody in new scars suggests a role of the antigen in scar formation. Antibodies with binding properties similar to KHRI-3 have been detected in 51% of patients diagnosed with autoimmune sensorineural hearing loss; thus, it seems likely that such autoantibodies also may have pathologic effects resulting in hearing loss in humans.

Characterization of sera from subjects infected with HIV-1 subtypes B and E in Thailand by antibody binding and neutralization.

The range and specificity of the humoral immune response to HIV-1 subtypes B and E was investigated in Thai samples. Sera from HIV-1-positive subjects, consisting of subtypes B (n = 24) and E (n = 138), were characterized in relation to the neutralization of primary isolates and T-cell line-adapted (TCLA) strains and binding to monomeric gp120, the CD4/gp120 binding site (BS), and V3 peptides. A subtype-specific pattern of antibody binding was observed with the exception of the CD4/gp 120MN BS. Neutralization of TCLA strains (n = 4) was strongly type-specific (p = .002); however, neutralization of primary isolates (n = 8) was weak and group specific. Thus, the subtype specificity of B and E sera in the neutralization of TCLA strains, but not primary isolates, supports the dominance of the V3 region in TCLA virus neutralization but does not support the distinction of subtypes B and E as discrete neutralization serotypes in Thailand.

Anti-endothelial cell antibodies in primary antiphospholipid syndrome and SLE: patterns of reactivity with membrane antigens on microvascular and umbilical venous cell membranes.

Although there has been recent emphasis on autoantibodies to epitopes on beta-2-glycoprotein I and prothrombin in the pathogenesis of antiphospholipid syndrome (APS), antibodies other than those directed toward epitopes on phospholipid binding proteins are present. These include those reactive with antigens on platelet membrane glycoproteins, and with vascular endothelial cell membrane. As the pathogenesis of the thrombotic manifestations of APS remains unexplained, further characterization of these antibodies may be informative. We have confirmed anti-endothelial cell binding to a range of cell membrane antigens in systemic lupus erythematosus (SLE) and primary APS. Furthermore, differences in both the pattern of antibody binding and band intensity between human umbilical vein (HUVEC) and human microvascular endothelial cells (HMEC-1) were demonstrated. Of 17 primary APS sera, antibody binding to HUVEC cell membranes was found in nine and to HMEC-1 membranes in seven. Binding at 72-79 kD was confined to HUVEC. In 32 SLE sera, binding to HUVEC and HMEC-1 membranes was detected in 17 and 22 respectively, binding at 135-155 kD being confined to HMEC-1. These results are consistent with the phenotypic variation in endothelial cells of different origins and confirm the frequent presence of autoantibodies reactive with vascular endothelium in both SLE and PAPS. Whether these antibodies could be involved in the pathogenesis of thrombosis, through induction of endothelial cell apoptosis or damage, remains to be determined.

Expression of Functional CD32 Molecules on Human NK Cells Is Determined by an Allelic Polymorphism of the FcγRIIC Gene

AbstractHuman natural killer (NK) cells were thought to express only FcγRIIIA (CD16), but recent reports have indicated that NK cells also express a second type of FcγR, ie, FcγRII (CD32). We have isolated, cloned, and sequenced full-length cDNAs of FcγRII from NK cells derived from several normal individuals that may represent four different products of the FcγRIIC gene. One transcript (IIc1) is identical with the already described FcγRIIc form. The other three (IIc2-IIc4) appear to represent unique, alternatively spliced products of the same gene, and include a possible soluble form. Analyses of the full-length clones have revealed an allelic polymorphism in the first extracellular exon, resulting in either a functional open reading frame isoform or a null allele. Stable transfection experiments enabled us to determine a unique binding pattern of anti-CD32 monoclonal antibodies to FcγRIIc. Further analyses of NK-cell preparations revealed heterogeneity in CD32 expression, ranging from donors lacking CD32 expression to donors expressing high levels of CD32 that were capable of triggering cytotoxicity. Differences in expression were correlated with the presence or absence of null alleles. These data show that certain individuals express high levels of functional FcγRIIc isoforms on their NK cells.

Expression of Functional CD32 Molecules on Human NK Cells Is Determined by an Allelic Polymorphism of the FcγRIIC Gene

Human natural killer (NK) cells were thought to express only FcγRIIIA (CD16), but recent reports have indicated that NK cells also express a second type of FcγR, ie, FcγRII (CD32). We have isolated, cloned, and sequenced full-length cDNAs of FcγRII from NK cells derived from several normal individuals that may represent four different products of the FcγRIIC gene. One transcript (IIc1) is identical with the already described FcγRIIc form. The other three (IIc2-IIc4) appear to represent unique, alternatively spliced products of the same gene, and include a possible soluble form. Analyses of the full-length clones have revealed an allelic polymorphism in the first extracellular exon, resulting in either a functional open reading frame isoform or a null allele. Stable transfection experiments enabled us to determine a unique binding pattern of anti-CD32 monoclonal antibodies to FcγRIIc. Further analyses of NK-cell preparations revealed heterogeneity in CD32 expression, ranging from donors lacking CD32 expression to donors expressing high levels of CD32 that were capable of triggering cytotoxicity. Differences in expression were correlated with the presence or absence of null alleles. These data show that certain individuals express high levels of functional FcγRIIc isoforms on their NK cells.

Antibodies against striated muscle, connective tissue and nuclear antigens in patients with thyroid-associated ophthalmopathy: should Graves' disease be considered a collagen disorder?

The identity and subcellular localization of the principal extraocular muscle (EOM) antigens and prevalences of the corresponding serum autoantibodies in thyroid-associated ophthalmopathy (TAO) need to be clarified. We have used porcine eye muscle tissue, which expresses all autoantigens identified in human tissue, as substrate in an indirect immunofluorescence assay. Several different patterns of antibody binding to EOM tissue antigens were observed with sera from patients with TAO namely, membrane, cytoplasmic, interstitial (endomysial) and nuclear. Overall, sera from 75% of patients with TAO contained one or more antibodies reactive with EOM, compared to 32% of patients with Graves' hyperthyroidism, 38% with Hashimoto's thyroiditis, and 16% of normals. All sera which reacted with EOM membrane or cytoplasmic antigens also reacted with the same antigen(s) in other skeletal muscle, but not in the other tissues tested. Sera from 31% of patients with TAO, but only 7% of those with Hashimoto's thyroiditis, and no patient with Graves' hyperthyroidism without evident ophthalmopathy, contained antinuclear antibodies (ANA). The most common nuclear fluorescence pattern was the finely speckled type typically associated with anti-Sm or anti-RNP antibodies. Significant positive correlations in patients with TAO were found between (i) EOM dysfunction and ANA (ii) eye disease of < 1 yr duration and EOM membrane-reactive antibodies and (iii) eye disease of < 1 yr duration and interstitial (endomysial) tissue-reactive antibodies. Although patients with Graves' disease do not usually exhibit other signs or immunologic features of a generalized collagen disorder, the finding of high prevalences of ANA and anti-striated muscle antibodies and, less often, anti-connective tissue antibodies in patients with ophthalmopathy, is consistent with it being a collagen-like disorder of the striated muscle, connective tissue and the thyroid. The reason why the inflammatory process is mainly limited to these tissues is unclear although cross reaction of ANA with tissue specific proteins or increased expression of muscle and connective tissue antigens in the orbit and skin, are possibilities.

The genetic basis for lectin binding patterns in Prorocentrum lima (Dinophyceae)

No abstract available.

Sperm-associated and circulating IgA and IgG classes of antibodies recognise different antigens on the human sperm plasma membrane

IgA and IgG antibodies eluted from the surface of spermatozoa obtained from 11 infertile men were used to analyse the antigens defined by each class of sperm-associated antibodies. An enhanced chemiluminescent Western blot technique was developed to detect the low concentrations of immunoglobulins present in the eluted samples. The same analysis was performed with the sperm membrane-specific antibodies isolated from the sera of 8 of the patients included in the study. Sperm-eluted antibodies reacted with a total of 18 protein bands migrating with molecular masses of between 110 and 18 kDa. Individual antibody-binding patterns differed. Furthermore, IgA and IgG antibodies from any one patient recognised different sets of antigens. In spite of the apparent heterogeneity of the antigens defined by sperm-associated antibodies, the majority of these antibodies reacted with three protein zones of 68/64, 37/36 and 20/18 kDa. The antigens defined by the sperm surface-specific antibodies obtained from the sera of eight infertile patients differed from one patient to another and, in the majority of the patients, differed from those defined by the corresponding sperm-associated antibodies. Nevertheless, two protein zones of 68/64 and 20/18 kDa were recognised by both local and systemic antibodies in 6 and 4 patients, respectively.

Heat-treated myosin does not bind ATPase--inhibiting antibodies.

Polyclonal antibodies to native chicken pectoral fast-twitch myosin are directed to all subfragments of the molecule (S1, S2 and LMM), as seen in the ELISA and Western blotting techniques. The antibodies inhibit the Ca(2+)-activated myosin ATPase. Absorption of the antibodies with native myosin abolishes these reactions. Heat treatment of myosin for 2h at 40 degrees C will inactivate myosin ATPase and alter its antibody binding pattern: the binding of antibodies to the rod fractions is reduced, that to the globular head (S1) completely abolished. Thus, these antibodies are useful as sensitive probes for the structural integrity of the myosin head.

In vivo binding and hearing loss after intracochlear infusion of KHRI-3 antibody

The IgG1 mouse monoclonal antibody (MAb) KHRI-3, binds to an antigen of 65–68 kDa expressed on inner ear supporting cells in guinea pigs. We previously showed [Nair et al. (1995) Monoclonal antibody induced hearing loss. Hear. Res. 83, 101–113] that mice carrying the KHRI-3 hybridoma develop high frequency hearing loss and loss of hair cells in the basal turn suggesting that this MAb causes immune-mediated sensorineural hearing loss. To evaluate the specificity of this effect, sterile KHRI-3 and control IgG1 preparations were infused directly into the guinea pig cochlea using Alzet® mini-osmotic pumps. Assessments included: (1) hearing, measured by click auditory brain stem responses (ABRs); (2) in vivo antibody binding; and (3) the structural integrity of the organ of Corti. Nine animals were infused with KHRI-3 preparations and 5 controls were infused with control IgG1. Four guinea pigs given KHRI-3 developed 25–55 dB hearing loss. Control animals showed no difference from baseline. In vivo binding of KHRI-3 was detected in the organ of Corti in 6 of the 9 animals, including all 4 that had hearing loss. No staining was observed with control antibody. Confocal microscopy revealed that the in vivo KHRI-3 antibody binding pattern was identical to that obtained by incubating fixed tissue in vitro with KHRI-3. Histologic examination revealed an increased frequency of hair cell loss in KHRI-3 treated ears when compared to either the contralateral ears of the same guinea pigs or the IgG1 treated ears of control animals. The lesions in the infused ears of guinea pigs were scattered throughout the cochlea from base to apex. These experiments demonstrate the following points: (1) Antibodies can be chronically infused directly into the cochlea of living animals. (2) The KHRI-3 antibody binds to live supporting cells within the organ of Corti. (3) Infusion of an inner ear specific antibody affects auditory function. (4) The infusion of irrelevant antibody had no effect on the structure or function of the ear. This system provides an animal model for further studies of antibody-induced sensorineural hearing loss.

Recombinant staphylokinase variants with altered immunoreactivity. III: Species variability of antibody binding patterns.

The "charged cluster-to-alanine" substitution variants SakSTAR(K35A,E38A,K74A,E75A,R77A) and SakSTAR(K74A,E75A,R77A,E80A,D82A), previously identified as SakSTAR.M38 and SakSTAR.M89, respectively, induce less antibody formation in patients than wild-type recombinant staphylokinase (SakSTAR), but their specific activities are reduced by 50%. Therefore, the effect of the reversal of one or more of these substituted amino acids on the ratio of activity to antigenicity was studied. Fourteen mutants with one to four "alanine-to-wild-type" reversals were expressed in Escherichia coli and highly purified (> 95%). In rabbits immunized with wild-type SakSTAR, the combined K35,E38,K74,E75,R77 or K74,E75,R77,E80,E82 epitope accounted for only 30% of antibody absorption from plasma, and no clear immunodominant residue could be identified. In baboons immunized with SakSTAR, the K35,E38 and K74,E75,R77 epitopes or the K74,E75,R77 and E80,D82 epitopes contributed equally to account for 50% of total antibody binding, but no immunodominant residues were apparent. In pooled plasma from patients with peripheral arterial occlusion treated with wild-type SakSTAR, about 40% of the antibodies depended on K74 of epitope K74,E75,R77 for binding, whereas epitopes K35,E38 and E80,D82 had a negligible contribution toward antibody recognition. The recognition pattern by SakSTAR variants of antibodies induced with wild-type SakSTAR differs markedly among species. This implies that a systematic evaluation of reduced antigen recognition and antibody induction in humans will require the development of human or humanized systems. Surprisingly, SakSTAR(K74), with a single substitution of Lys74 with Ala, had an intact specific activity but did not absorb 40% of the antibodies induced in patients by treatment with wild-type SakSTAR.

Immunogenicity of synthetic peptides representing antigenic determinants on the infectious hematopoietic necrosis virus glycoprotein

DAO Diseases of Aquatic Organisms Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsSpecials DAO 28:175-184 (1997) - doi:10.3354/dao028175 Immunogenicity of synthetic peptides representing antigenic determinants on the infectious hematopoietic necrosis virus glycoprotein Emmenegger E, Landolt M, LaPatra S, Winton J Three peptides, P76, P226, and P268 representing 3 putative antigenic determinants on the glycoprotein of infectious hematopoietic necrosis virus (IHNV), were synthesized and injected into rainbow trout Oncorhynchus mykiss to assess their immunogenicity. Antisera extracted from the immunized trout were analyzed using an enzyme linked immunosorbent assay (ELISA) for the presence of antibodies that could bind to the peptides or to intact virions of IHNV. The antisera were also tested for neutralizing activity against IHNV by a complement-mediated neutralization assay. In general, recognition of the peptides and IHNV was low and only a few antibody binding patterns were demonstrated. Antisera from fish injected with P76 constructs recognized the homologous peptide more than the heterologous peptides, whereas antisera from fish inoculated with either P226 or P268 constructs recognized P76 equally, or better, than the homologous peptide; however, there was a high degree of individual variation within each treatment group. Neutralization activity was demonstrated by serum from a single fish injected with one of the peptides (P268) and from 7 of 10 positive control fish infected with an attenuated strain of IHNV. Possible explanations for the dichotomous immune responses are discussed. These results indicate we need to improve our overall understanding of the fish immune system in order to facilitate the development of an efficacious vaccine against IHNV. IHNV · Immunity · Rainbow trout · Synthetic peptides · Vaccine Full text in pdf format PreviousNextExport citation RSS - Facebook - Tweet - linkedIn Cited by Published in DAO Vol. 28, No. 3. Publication date: March 27, 1997 Print ISSN:0177-5103; Online ISSN:1616-1580 Copyright © 1997 Inter-Research.

Identification and classification of autoantibody repertoires (Western blots) with a pattern recognition algorithm by an artificial neural network.

The screening of sera for autoantibodies with Western blots reveals complex repertoires. the compostion of such repertoires depends on genetic control of autoantibody-producing cells, the individual's history of exposure to its own and to foreign antigens, and also on the presence of autoimmune diseases. Our method shows how staining patterns of Western blots can be recoded as binary or grey-value vectors. Vectors are transferred to artificial neural networks for learning. Artificial neural networks are able to recognize group-specific antibody binding patterns. Staining patterns can be attributed to diagnostic groups. This may support diagnostic procedures.

Honeybee venom allergy: immunoblot studies in allergic patients after immunotherapy and before sting challenge

By immunoblot techniques, detailed antibody studies were performed with sera of 20 honeybee-venom-allergic patients during or at the end of specific immunotherapy (median duration: 3 years) and before honeybee sting challenge. Before immunotherapy, all patients had experienced systemic allergic reactions to a honeybee sting, with a mean severity of 3.5 +/- 0.5 according to the Müller classification. After the sting challenge, 10 patients (reactors) reacted again with a systemic allergic reaction, whereas 10 patients (nonreactors) did not. No differences were observed between reactors and nonreactors in total serum IgE and specific IgE to honeybee venom at the time of challenge. For immunoblot, honeybee venom (RELESS) was separated on 7.5-20% SDS-PAGE. For detection of specific IgE, IgG, IgG1, IgG4, and IgM, an alkaline phosphatase-linked second antibody was used. Both groups showed 11 antibody-binding bands: at 52, 46, 40, 31, 18.7, 16.9, 13, 11, 10, 9, and 8 kDa; however, the antibody-binding pattern was individual. The reactors differed from nonreactors in showing intense IgE and less IgG4 binding to at least one single component of the venom extract. For nonreactors, the inverse relationship was observed. The hypothesis, "intensity of IgE > or = IgG4 leads to allergic symptoms", was highly significant (P = 0.00026; chi-square). These immunoblot findings could offer predictive value in distinguishing reactors from nonreactors.

Platelet binding and protein adsorption to titanium and gold after short time exposure to heparinized plasma and whole blood

Protein adsorption from human plasma and platelet binding and activation were studied at short blood-titanium/gold contact times. The protein adsorption was studied by ellipsometry-antibody techniques in situ, and adhering platelets were visualized with fluorescein isothiocyanate-labelled anti-CD 61 antibodies. Adhering platelets were quantified by counting labelled cells in microscopic image fields. The spreading of platelets was studied by scanning electron microscopy. The results show that after 1 min of plasma exposure, fibrinogen, IgG and albumin were detectable with antibodies on both surfaces. The amount of deposited fibrinogen and complement decreased with time on titanium, and the amount of adsorbed anti-high molecular weight kininogen increased. No complement was detected on gold surfaces after plasma incubation, and the antibody binding pattern also remained unchanged after prolonged plasma exposure. The surface-bound platelets were found to spread on the gold but not on titanium surfaces. C1q has been shown to induce the expression of Pselectin, i.e. cause secretion reactions in platelets. In this study secreted platelet-microvesicles were found on gold, but not on the titanium surfaces that bound significant amounts of C1q. Thus, the results of the present study indicate that the mixture of fibrinogen, C1q and kininogens, whilst causing adhesion and aggregation, does not result in the activation and microvesicle secretion of platelets. Platelet activation on biomaterial surfaces thus seems to be governed by the mixture of proteins present on that surface, and no one particular protein need cause a known reaction in platelets as obtained when platelets are exposed only to that particular protein.

Royal jelly–induced asthma and anaphylaxis: Clinical characteristics and immunologic correlations

temperature difference could be perceived either directly by elevated blood temperature affecting cells in the hypothalamic preoptic area, or indirectly by blood temperature first affecting peripheral neuronal receptors, which in turn stimulate the preoptic area. It would have been tempting to assume that direct heating of the blood could bypass peripheral neuronal receptors. However, because sequential skin temperatures were not recorded along with oral temperatures, this assumption cannot be established. Nevertheless, this case is a unique example of the temperature difference needed to be perceived by the central temperature regulation system in order to provoke the common efferent reflex leading to hives in CU.