"etters apgr,~ach to study interactions within the human immune system.

The availability, therapeutic effi- cacy and safety of IVlg treatment has urged chn~cians ~-~ and immu- nologists "-- to reassess the roi~-? of lgs in autoimmune diseases. For example, in multiple sclerosis (M.S), conventional wisdom has assumed that lgs pla.v a role in the putative ~mmune-mediated injury, although the specificity of the oligoclonal Ig~ observed n cerebrospinal fluid anet MS l,,~sion:: remains endetermined. Furthermore, their i:athogenicity has not been pr-wen despite exten- sive investigaiion s. B~ contrast, experiments us;ng the Theiler's nmrine virus model of ,X!S have established that no~vclonal lgs directed :',gainsr sp:mai cord anti- gens can promote remvdmation in the central nervous svstem'. In addition, improvement in visual functions has been observed fol- lowing IVlg therapy in MS patients with stable, stercid-u,remonsive, severe optic neuritis, and this is probably due to remydination 4. Therefore, whereas some lgs may contribute to disease pa.:hogenesis, others may have therapeu6c potential.

C!assicallv. Igs have been con- sidered deleterious molecules in autoimmune diseases, whereas they I | t l ~ k t v l . ~ . l l " ) l l l lX , Y I I l lkJ I l d ~ , ' U i l p r o [ c [ -

tire function during producti,:: immune responses ie.g. clearing

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infectious agents). Within this para- digm, the existence and function of naturally occurring aumantibodies in the 'resting' immune syslem is not vet fully understood 9qI. Re- cent immunological theories and hypotheses <-'~q2 suggest that thLse ubiquitous natural autoantibodies have various potential biological roles. They may establish an exten- sive dynamic network that con- tributes to the normal homeostasis of the organism. In accordance with these ideas, autoimmune dis- eases may be successfully treated nat by supp. -ssing the immune net- wgrk, but by strengthening it - sach as by the administration of I71g. This suggestion is in agree- ment with the frequent association of autoimmunity x:ith immunode- ficit'ncy-. IVlg may neutralize exist- ing autoantibodies% which may acco,mt tcr the immediate effect of such treatment. Some have specu- lated hat, in the long term, a large dose :ff normal immuae compo- nents ~aay restore normal organiz- ation to the abnormal immune network% These views may provide a framework for understanding the therapeutic effects ol IVlg in a var- let 3' of autoimmune diseases.

In conclusion, we think that until more-specific treatments are avail- able, polyclonal IVIg temporari!y

I aesctves a place m the new and promising discipline of immunopharmacology.

Baziei G.M. van Engelen *t* David J. Miller t

Moses Rodriguez* T

Depts of Neurology* and Immunology t, Mayo Clinic,

Rochester, MN 5S90S, USA, and Dept o[ Neurology *,

University Hospital Nijnleg~.n, 6500 KB Nijmegen,

The Netherlands.

References I Dwy¢r, J.M. (1992} New Engl. J. Med. 326, 107-116 2 Hcdden, J. and Kishimoto, T. (1993) hnn'u,ml. Today 14, 242 3 Rcdriguez, M. and Lennon, V.A. (1990) bin. Neuroi. 27, 12-17 4 can Eagele,:, B.G.M., Hommes, O.R., Pinckers, '~., Cruysberg, J.R.M., Barkhof, F, and Rodriguez. M. {1992) Ann. Neurol. 32, 834-8i':5 5 Tenser, R.B., Hay, K.A. and Aberg, J.A ' t993)Arch. NeuroL 50, 417-420 6 Varda. F.J. and Coutinho, A. (1991) hmnunol. Today 12, 159-166 7 Coutinho, A. (1989) lmmunol. Rev. 110, 63-87 8 Trotter, J.L. and van der Veen, R.C. ( 1990) in Handbook of Multiple Sclerosis (Cook, S.D., ed.), pp. 151-179, Marcel Dekker 9 Avrameas, S. ( 1991) Immured. Today 12, 154-159 10 Grabar, P. {1983) lmmttnol. Today 4, 337-340 11 Cohen, I.R. and Young, D.B. (1991) lmmunol. Today 12, 105-110 12 Cohen, I.R., (1992) mmunol. Today 13,490-~94

book reviews

Postgraduate Study in the Biological Sciences: A

Researcher's Companion

by Robert 1. Bevnon, Portland Press, 1993. £9.,~0/$17.00 (xi + I50 pages) ISBN 1 85578 009 7

The main aim of this book is to help postgraduate students to help themsd~,es during what can be the most difficult period of their scien- tific careers. A fresh-out-of-college graduate student is at the bottom of a steep learning curve that can look insurmountably daunting at the beginning, and this book helps

to bridge the gap betweep, college life and becoming a research ~cien- tist. !t does this by p,"-viding a comprehensive guide to destgning experiments, managing time con- straints, giving good seminars (anyone who has sat through a bad seminar, no matter how good the data, will appreciate how im- portant this is!) and even hints on how to fit into the (often) close working environment that i5 a modern laboratory.

Each of these topics, and more, are tackled in a helpful user-friendly manner. The first chapter, 'Starting out', begins with suggestions on how to choose a suitable project and

insrii.ution, alt!'ough this is only reall) helpful i)efore becoming a postgraduate. However, the author quickly moves on to that most crucial of aspects: the student- supervisor relationship. This is possibly one of the most important factors in pc,s',graduate study; a bad supervisor can do more to turn student-s away from a future in s&:nce than a hundred failed experi,nents, and the author's per- ception and advice are excellent.

The chapters on developing research skills are c!eo.r!y written and, without being patronizing, are intended to encourage the reader to think for themselves in a logical

~,,,,,,,,,,olog:, r,,J,,~, 342 Vo~ ,5 r:,, 7 ~ 9 4

fashion. Indeed, with hindsight, many of these chapters seem to be common sense but, of course, hindsight is something that a PhD student (unfortunately) does not possess. Also, the chapters dealing with how to make a scievtific pres- entation, either in oral or written form, are full of hints that some more-senior scientists would do well to observe. As not every super- visor feels it necessary to teach their students such nonscientific skills, this book c mid be extremely useful. However, perhaps the best part of this guide is the introduc- tion to computing. After stressing

kaleidoscope

the necessity for computer literacy among gradtmte students, the book then cuts a swathe through off- putting "techvo lingo", explaining in clear terms the concepts behind hardware and software, including some commonly used scientific programs.

The book finishes with sections on safety, without which the book would not be strictly complete (although the author admits to being "uneasy" about this in- clusion), postgraduate teaching and what to do after the dreaded viva. The book is rounded up well and , ncompasses most issues that could

book reviews arise during the ,,,uric ,6 a l'hl). q he main criticism i, &at the lay- out of the book is t~,~ much like a textbook but, in spite of this, it would be a worthwhile addition to an}' laboratory.

Catherine Cunningham

Laboratoly . f Celhdar lmmunolog).,

National Institute for Medical Research,

The Ridgeway, Mill Hdl, London,

UK NW7 IAA.

Endocrine Ophthalmopathy:

Molecular, Immunological and

CEnicai Aspects edited by George Kahaly, Karger, 1993. £90.00/$144.00 (viii +~,154 pages) ISBN 3 8055 5722 1

This book is Volume 25 of the Developments in Ophthahnology

Immunohistochemistry' chapter, which would have enhanced the clarity of the text. Similarly, there are only three illustrations in the chapter on 'Orbital Connective Tissue in EO', although these are of high quality. Each chapter is complete in itself and can be read independently of the others, in some, such as those contributed by R. van dcr '-" . . . . K. Badenhoop, R. Winand, M. Schuier, C. Hansen and E. Otto, concise descriptions of the techniques used in the studies

_cries and takes the :orm of a are also helpfully provided. collection of papers presented at the meeting 'Molecular Aspects of Endocrine Autoimmunity' whi~ch

I.,~1 A ; ~ ;;'a~ . . . . . . . . Germa::.v in 19~2. There are two sections in this bodk:

t h e first covers the pathogenesis !:of endocrine ophthalmopathy (EO), and occupies ,wo-thirds of the text; the second :: mcentrates on the clini- cal manageme~lt of this disease. For the reader unfamiliar with this subject, a more ",;formative title might have b,en ' l'hyroid-A~.ociated Ophrhalmopathy, since the ti,yrmd is the only gland that induces EO.

q-he section en the pathogenesis of EO provides a fairly comp!cte coverage of the main ~.icas of res, arch in this field, and includ,? cha~:ers on retrobulbar histolog 7 and immunohistochemistry, immuno- genetics, T-cell reactivity, orbital connective tissue, glycosamino- glycans, adipose tissue and eye- muscle autoantigens. Unfortunately, there are no histological illustrations in the 'Retrobulbar Histology and

In Chapter 12, R. Volpe reviews the development of EO and dis- cusses the relationship between EO aad Graves' hyperthyroidism. As with any paper of this kind, it is important for the reader to bear in mind that it is written from the author's point-of-view, and that it should be read in the context of the preceding presentations. For instance, there is now sufficient evi- dence to support the idea that eye muscles constitute the primary target in EO, despite the author's claims to the contrary. Fur- thermore, no mention i~ made of the role of l !ymphocytes in orchestrating the pathogenesis of the disease. This is despite the increasing data that support the rote of T cells in the generation and/or perpetuanon of the inflam- matory changes of the extraocular muscles, the site of the initial dis- ease process.

In the section on clinical man- agement, the essay on 'Immuno-

suppression' makes important coln- ments on the natural history, activity, and severity of this condition. The surgical management is necessarily brief and mentions only one method of orbital decompression. However, more emphasis could have been given by ~aq. Lieb to the timing and sequence of surgical intervention.

In conclusion, this Look succeeds on severai counts, it shouid satisfy immunologists and ophthalmol- ogists since it describes the scientific and clinical aspects of this complex subject in a form that is easily understandable by scientists from both fields. The text is well struc- tured, with excellent bibliographies for those interested in pursuing individual areas in greater depth. There are several lucidly written and up-to-date chapters, and the book is also compact and inexpen- sive. Inevitably in such a multi- author book, there are a few dis- crepancies between chapters with regards to style, content and clarity. However, the book has a sufficient number of ex,:remely good points to merit its recommendation to any individual interested in this pa- ticular area.

Virginia Calder Anastasia Pappa

Dept of Clinical Science, Institute of Ophthahnolog3',

London, UK EC1V 9EL.

,,,,,,,,,,o;,,gr rod,,>, 343 vol. 15 No. 7 !994