Cells can be altered or damaged by immunological reactions in many ways. Some of these are indirect because the antibody reaction is not di rected against the tissue cell or its components. These reactions include acute anaphylaxis (1), the Arthus (2) and the Auer (3) reactions, delayed hypersensitivity (4), and serum sickness (5). In general, each of these im munopathological processes involves a response of blood and lymph vessels as well as inflammatory cells; and in some instances, at least, they are brought about by the release of inflammatory materials, including esterases as well as histamine and other stored perivascular chemicals (1). Distinct from these indirect mechanisms by which cell injury is pro duced immunologically are the effects which have as their basis the direct interaction of specific antibodies with tissue cells and their components. The purpose of this paper is to review the current state of our knowledge concerning these specific antibodies and their actions. Means of evaluating cell damage .-There are various ways of evaluat ing the effects of these cell-specific antibodies. The term cytotoxic is best applied to the in vivo or in vitro alterations visible with light microscopy in the antibody-treated cells. This term does not ade quately describe the subtle changes which may occur when specific anti bodies interact with such widely studied tissue components as renal glom erular basement membrane, thyroglobulin, coHagen, ground substance, and platelets. In a sense, these reactions also may be considered to be cyto toxic but their evaluation is often more difficult and the changes are usually described in other terms. Electron-microscopic alterations in chemical components as shown by histochemistry and cytochemistry, as well as changes in function, are all useful in evaluating the damage produced by specific antibody. A correla tion of new knowledge of ceHular structure, composition, and function fol lowing antibody action appears to be a particularly promising way to gain understanding. For example, correlation of proteinuria, electron-microscopic changes in the glomerulus, and in vivo labeling of the glomerular compo nents offers a new dimension to our study of the effects of nephrotoxic se rum (6). Similar correlative studies are proving to be particularly helpful in
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