Clinical studies on cell-mediated immunity in gestational trophoblastic disease: nonspecific cellular immunocompetence in patients with hydatid mole and trophoblastic neoplasia

The nonspecific cell-mediated immunocompetence of 51 patients with gestational trophoblastic disease (GTD), including 16 patients with hydatid mole (HM), 24 with nonmetastatic trophoblastic neoplasia (NTN) and 15 with metastatic TN (MTN), was studied with the use of both in vitro and in vivo parameters of cell-mediated immunity (CMI) such as lymphocyte blastogenic response to phytohemagglutinin (PHA), subpopulation constitution, and delayed cutaneous hypersensitivity responses to 2,4-dinitrochlorobenzene (DNCB) and to purified protein derivative of tuberculin (PPD). The pretreatment cell-mediated immune status of patients with HM developing no malignant sequelae was shown to be essentially similar, in terms of both in vitro PHA and in vivo DNCB reactivities, to that of normal women and of patients with benign gynecological diseases. In patients with TN, however, there was a significant depression in the blastogenic lymphocyte response to PHA before evacuation of the mole, which was persistently demonstrated after uterine evacuation and more marked throughout the course of disease in patients with MTN, than in those with NTN, with a tendency to return to normal in remission. Moreover, patients with TN had a significant depletion of T lymphocytes as determined by rosette-forming cell procedures before treatment, which was most evident in patients with MTN. Plasma from the MTN patients was also shown to have an inhibitory effect on PHA responsiveness of lymphocytes from normal women. There was an increased incidence of impaired reactivity to DNCB in patients with TN (higher in MTN than in NTN), compared with HM and benign diseases, while no such difference in incidence was observed in response to PPD. On the basis of these findings, a preliminary characterization of altered immunocompetence in patients with TN and its mechanism are discussed.     

Transfer factor: therapy in patients with deficient cell-mediated immunity and deficient antibody-mediated immunity

The effect of transfer factor therapy on the clinical and laboratory abnormalities of six patients with various antibody and cell-mediated immunodeficiency disorders was evaluated. Clinical improvement occurred in three patients. Conversion of previously negative delayed hypersensitivity reactions occurred in the same three patients. One patient demonstrated an increased in vitro lymphocyte response to phytohemagglutinin. No change in antibody mediated immunity was observed in any patient.     

Effects of zinc on cell-mediated immunity in chronic hemodialysis patients

Thirteen healthy subjects and 20 hemodialysis patients were studied to observe the delayed hypersensitivity skin tests (DHSTs) and phytohemagglutinin (PHA)-stimulating lymphocyte blastogenesis. Significant differences were observed between the groups. Controls had a higher proportion of positive skin reaction than hemodialysis patients in relation to Escherichia coli (p<0.01) and tuberculin (PPD) (p<0.05). Regarding lymphocyte blastogenesis stimulated by phytohemagglutinin (PHA), cell proliferation was more accentuated in controls than hemodialysis patients (p<0.05). On the other hand, serum zinc was elevated in controls (78 +/- 8 microg/dL) in comparison to hemodialysis patients (71 +/- 33 microg/dL) (p<0.05). Of the 20 hemodialysis patients, 8 patients were maintained on long-term hemodialysis before and after zinc therapy, with the aim of studying DHST and PHA-stimulating lymphocyte blastogenesis. There was a significant improvement of DHST response to E. coli antigen after 100 d of zinc treatment (p<0.01), and with the discontinuation of therapy, the DHST responses decreased back to the initial values (p<0.05). Zinc administration also increased the lymphocyte proliferation induced by PHA from 31386 +/- 3974 to 42480 +/- 5242 cpm (mean +/- SD) (p<0.05). These results indicated that zinc therapy improved in vivo and in vitro DHST and lymphocyte function of hemodialysis patients and that its discontinuation suppressed all of the benefits observed.     

Suppression of cell-mediated immunity in experimental Chagas' disease.

The effect of acute infection with the Tulahuén strain of Trypanosoma cruzi on the cellular immune response in Swiss mice was studied. Mice were immunized with either Freund's complete adjuvant or oxazolone, a skin sensitizing agent, and subsequently skin-tested with either BCG protoplasm or oxazolone to detect delayed hypersensitivity. Depression of the response to these antigens was observed in infected mice during the stage of marked parasitemia. Mice which were responsive to oxazolone before infection lost their ability to respond as the infection progressed. When immunized with live attenuated T. cruzi before infection with virulent organisms, mice developed a greater than normal sensitivity to oxazolone and survived infection. These experiments do not conclude whether immunosuppression due to infection with T. cruzi is directed toward induction or expression of the cell-mediated immune response to the antigens employed.     

In vivo and in vitro evaluation of cell-mediated immunity in patients with paracoccidioidomycosis

The cellular immune response to specific and nonspecific agents was investigated. both in vivo and in vitro, in 19 patients with paracoceidioidomycosis. In addition, the immunologic study of an investigator aceidentally inoculated with P. brasiliensis was included in this study. Nearly half of the patients showed depressed cell-mediated immune responses, as evaluated by intradermal tests with an antigenic preparation from P. brasiliensis (P.b.Ag.), ubiquitous antigens, and by the ability to develop sensitization to 2,4-dinitrochlorobenzene. A similar proportion of impaired responses was observed when the patients' lymphocytes were cultured with phytohemagglutinin (PHA). C'. albicans antigen and P.h.Ag. A factor was detected in the plasma of some patients which reduced the ability of patients' and normal lymphocytes to undergo blastic transformation. A positive correlation was found between the ability to develop delayed cutaneous hypersensitivity reactions to P.b.Ag. and other ubiquitous antigens, normal in vitro responsiveness to PHA and the absence of humoral blastogenic inhibitory factor. The inhibition of leukocyte migration, but not lymphocyte transformation, correlated positively with delayed hypersensitivity. The percentage of T lymphocytes was significantly reduced in the group of patients, being the absolute number and percentage of B cells bearing receptors tor complement normal. Two polar immunological patterns emerged. One characterized by positiveness in the skin test to P.b.Ag. and lack of significant abnormalities in cellular immunity, and another anergic to P.b.Ag., with cell mediated immunity severely depressed. Between the two polar groups, there were patients with intermediary patterns of immune response. This paper also includes the results obtained with the administration of transfer factor and levamisole to some of the patients.     

Effects of phenytoin on cell-mediated immunity

Summary The effects of phenytoin on cellular immunity were examined in murine models. Fresh splenocytes were obtained from mice which had received 1 mg/day of phenytoin i.p. for 28 days. The serum concentration of phenytoin in these animals was 10–10 g/ml. The proliferative response of splenocytes to mitogens was assessed by ³H-thymidine incorporation. The cytotoxic activities of cells such as natural killer (NK) cells, cytotoxic T lymphocytes (CTL), and lymphokine-activated killer (LAK) cells were estimated by a 4-h ⁵¹Cr release assay. The ³H-thymidine incorporation of splenocytes was reduced significantly (P<0.01) in phenytoin-treated mice. The NK and CTL activities of splenocytes from phenytoin-treated mice were significantly suppressed. However, the LAK activity of phenytoin-treated mice was equal to that of control mice.     

In vitro studies of cell-mediated immunity in rabbits sensitized withMycobacterium kansasii andMycobacterium tuberculosis

Rabbits, sensitized withM. kansasii, responded by a profound inhibition of migration of macrophages elicited by both antigens: the migration index for homologous antigen was 0.51 in the direct test and 0.65 in the indirect test; for heterologous antigen the indexes were 0.53 and 0.67. However, significant differences in reactivity were found in rabbits sensitized withM. tuberculosis. In the homologous system, high reactivity was maintained and the migration index reached the value of 0.53 in the direct and 0.63 in the indirect test. On the other hand, the heterologous antigenM. kansasii influenced the migration in both direct and indirect assays significantly less, the migration indexes being 0.62 and 0.72. The differences were statistically significant at 1 % and 5 % levels.     

Cell-bound antiglial immunity in patients with malignant tumors of the brain

Peripheral blood lymphocytes from patients with malignant brain tumors were found to have a cytotoxic effect against cultured autologous tumor cells as well as normal adult and fetal glial cells obtained from 18- to 20-week surgical abortions. In a blind series of 32 patients, five of nine patients with a malignant glioma could be detected by using ⁵¹Cr-labeled fetal glial cells as targets and appropriate controls. Lymphocytes from patients with “benign” gliomas, nonglial, or metastatic tumors were characterized by a low or absent cytotoxicity.The results are interpreted to show a development of cell-bound immunity against normal glial antigens in patients with destructive infiltrating glial tumors carrying the antigenic determinants through the immunological barrier normally isolating the central nervous tissues.     

Staphylokinase-specific cell-mediated immunity in humans.

Staphylokinase is a highly fibrin-specific clot-dissolving agent that constitutes a promising drug for clinical development. It is of bacterial origin, and the majority of patients develop neutralizing Ab after its administration. Several antigenic regions, recognized by these Ab, have been identified, but the underlying immunogenic features of staphylokinase remain unknown. In this study, we show that staphylokinase is a T cell-dependent Ag, and that an immunological memory may be acquired, even without administration of staphylokinase. Thrombolysis with staphylokinase provokes the proliferation of staphylokinase-specific T lymphocytes, which remain elevated over 10 mo posttreatment. Interestingly, analysis of a large number of staphylokinase-specific T cell clones isolated from 10 unrelated donors revealed only six distinct immunogenic regions in the molecule. Moreover, five of the six regions are recognized by T lymphocytes from several individuals, indicating that these regions are not restricted to a single HLA-DR allele. Therefore, these new insights can guide the design of variants with a lower immunogenic profile in humans.     

Cellular immunity in patients with malignant melanoma and their household contacts

Summary Immune reactivity was measured in control subjects and in 86 patients with malignant melanoma using four tests of cellular immunity. In addition, cellular immune reactivity to melanoma extract was studied in 13 household contacts of patients with melanoma. Thirty percent (4/13) of the household contacts showed reactivity to melanoma extract as determined by lymphocyte stimulation as compared to 20% of patients and 5% of controls. Seventy-two percent (8/11) household contacts showed reactivity as measured by the indirect MIF test, compared to 38% of patients and 23% of normal controls. As determined by the leukocyte migration inhibition test, 71% (5/7) of household contacts showed reactivity to melanoma extract versus 20% of patients and 22% of controls. The number of household contacts studied was low; however, it was observed that these subjects showed responses to melanoma extract with considerably greater frequency than did normal control subjects, and the frequency of positive responses in patients with melanoma was intermediate between that of the household contacts and the normal controls.This work was supported in part by grants AI-10495, AI CA-10686, and CA 13671 from the U.S. Public Health Service. Dr. Spitler is supported by a National Institutes of Health Career Development Award (AI-43012).     

Usefulness of Multitest CMI for the measurement of cell-mediated immunity in patients with bronchial asthma

Cell-mediated immunity has been measured in vivo in 30 patients with allergic-infectious bronchial asthma with the use of Multitest CMI (Merieux). A decrease in the immunological reactivity has been showed in the asthmatic patients. It was expressed by means of the arithmetic mean value of the positive reactions, and was particularly significant in patients who require long-term corticotherapy. The obtained results suggest that Multitest CMI is a new, valuable device in the diagnosis and monitoring the treatment in asthmatic patients.     

Modelling the cell-mediated immunity in homograft rejection

Lymphocytes which become sensitised at the periphery travel to the regional lymph nodes where they initiate an immunological response by increasing the production of immuno-competent lymphocytes. These lymphocytes migrate into the tissues via the blood stream and bring about the destruction of target cells. These notions, in the present analysis, are translated into a simple mathematical model. The model specifically considers the lymphocyte memory and increased secondary response.     

In-vitro studies of granulocyte phagocytosis in patients with malignant tumors

Investigations are presented about granulocyte phagocytosis with rice starch in patients with clinically curable malignant tumours and with those treated palliatively. A significantly reduced granulocyte efficiency of phagocytosis indicating a bad prognosis of the disease can be found in those patients being in the advanced tumour stage.     

Changes in cell-mediated immunity in kidney transplant recipients with active CMV infection

This study was aimed at determining (a) the extent of proliferation of peripheral blood mononuclear cells (PBMC) in response to stimulation by cytomegalovirus (CMV)-infected fibroblasts and (b) the levels of Th1 and Th2 cytokine production in kidney transplant recipients with and without active CMV infection. Thirty patients with, and 39 without active CMV infection, diagnosed by a CMV antigenemia assay (AA), were studied. PBMC of patients with active CMV infection showed significantly lower proliferation than those without ongoing CMV infection (P<0.0001). The levels of Th2-type cytokines (interleukin (IL-) 4 and IL-10) in AA-negative and AA-positive kidney transplant recipients were similar but the levels of the Th1-type cytokines interferon-gamma, tumor necrosis factor-alpha (P<0.05) and IL-2 were significantly lower in AA-positive kidney transplant recipients (P<0.0005).     

Correlates of cell-mediated immunity in nestling house sparrows

Cell-mediated immunity is an important vertebrate defense against pathogens, but components of this response may vary in quality. Such variation could arise through the effects of ecology on optimal immunocompetence. We used injections of phytohaemagglutinin (PHA) to measure the factors influencing T-cell proliferation in nestling house sparrows (Passer domesticus). Bivariate analyses revealed positive associations with nestling mass and size, but no effect of ectoparasites. The response to PHA was, however, strongly affected by brood identity. A mixed model with brood identity as a random factor and nestling mass, size, number of ectoparasites, parental feeding rate, clutch size, brood size at hatching, and date uncovered significant positive correlations between PHA response and both nestling mass and the brood size at hatching. Because many of these variables are related hierarchically, we used path analysis to explore the relationships in more detail. We found that a nestling immune response was affected by several indirect paths. Brood size at hatch had both positive and negative paths, and date in the season had several indirect negative effects through its effect on brood size and nestling mass. The approach used and the results obtained offer some new ideas for incorporating immune responses into life history theory.     

In vivo protection against syngeneic Gross virus-induced lymphoma in rats: comparison with in vitro studies of cell-mediated immunity.

Spleen cells at various times after inoculation of W/Fu rats with a syngeneic Gross virus-induced lymphoma, (C58NT)D, were tested for their in vivo activity in adoptive transfer experiments and for their in vitro reactivity in a 4-hr 51Cr release cytotoxicity assay and in a mixed lymphocyte-tumor cell interaction assay. In adoptive transfer, the best protection against tumor growth was observed with immune spleen cells taken at 30 days after tumor cell inoculation (the peak of reactivity in the mixed lymphocyte-tumor cell interaction assay) whereas cells taken at 10 days (the peak reactivity in the 51Cr release cytotoxicity assay) gave only partial protection. The protection detected in the adoptive transfer experiments was specific for (C58NT)D associated antigens, and this correlated well with the specificity observed in the in vitro cell-mediated immunity assays. T cells, but not complement receptor-bearing cells or macrophages, were essential for the protection against tumor growth in vivo, and also for the in vitro reactivity in the 51Cr release cytotoxicity and the mixed lymphocyte-tumor cell interaction assays.     

Passive transfer of cell-mediated immunity in xenogeneic animals

Cell-mediated immunity (delayed hypersensitivity) to 1-chloro-2,4-dinitrobenzene (DNCB) was passively transferred from sensitized guinea pigs to mice. Transfer was accomplished by subcutaneous injection of peritoneal exudate cells of sensitized guinea pigs.