Lymphocyte Populations and Cellular Immune Reactions in Juvenile Rheumatoid Arthritis

Ten patients with juvenile rheumatoid arthritis and age- and sex-matched healthy controls were investigated in pairs. The patients were found to have both normal proportions and normal absolute numbers of T lymphocytes, B lymphocytes, and the Fc-receptor-bearing lymphoid cells in peripheral blood. No abnormality of mitogen-induced lymphocyte transformation was observed. Lymphocyte-mediated cytotoxicity induced by phytohemagglutinin (PHA) or anti-target cell antibodies was also found to be normal. As in an earlier study, impaired delayed hyper-sensitivity by skin testing was observed in the patient group, thus indicating a dissociation between in vivo and in vitro parameters of lymphoid cell function.     

T cell defect in essential mixed cryoglobulinaemia.

Peripheral blood lymphocytes from untreated patients with essential cryoglobulinaemia were studied for their surface markers and for their in vitro mitogenic reactivity. No differences in lymphocyte subpopulations were observed between cryoglobulinaemic patients and normal controls. Cultures of separated lymphocytes were stimulated with different concentrations of phytohaemagglutinin, Con-A and pokeweed mitogen. Incorporation of [3H]-thymidine in patients' cultures was compared with that of normal controls. Significantly decreased reactivity to phytohaemagglutinin and Con-A, but not to pokeweed mitogen, was found in all patients studied. The depressed mitogenic reactivity to phytohaemagglutinin and Con-A might be referred to a qualitative T cell defect.     

The immunological profile of mycosis fungoides.

The immune reactivity of 25 patients with mycosis fungoides was studied twice with a 6 month interval using a panel of T lymphocyte surface markers and functional tests. Patients with clinically inactive disease (stage I + II) had normal T lymphocyte biology. Patients with clinically active disease (stage II-IV) had T lymphopenia, alterations in T cell subpopulations (T gamma and T mu) and a reduced lymphocyte reactivity in vitro following mitogen (PHA, Con A, PWM) and antigen (PPD) stimulation. They also had a reduced secretion of immunoglobulin in vitro after PWM stimulation, apparently due to the alterations in their T lymphocyte subpopulations. The observed changes in the peripheral blood T lymphocyte population and the in vitro function of lymphocytes were not shared by lymphocytes from histologically affected lymph nodes. The natural killer cell activity in blood lymphocytes was found to be normal in all patients.     

Cellular immune function in uremia: altered cytotoxic and suppressor cell responses to an immunomodulating heptapeptide

Hemodialysates of uremic patients have been shown by T. Abiko, M. Kumikawa, and H. Sekimo (Biochem. Biophys. Res. Commun. 86, 945, 1979) to contain a heptapeptide which inhibits E-rosette formation by human T cells. This heptapeptide also corresponds to a fragment of beta 2-microglobulin and may play an immunoregulatory role in uremia. We investigated the potential for induction of cytotoxic and suppressor cells by the synthetic heptapeptide (HP) in blood lymphocytes of normal donors and uremic patients. Cytotoxic activity of normal lymphocytes was significantly enhanced by low concentrations of HP while high concentrations depressed it. Two patterns of responsiveness were observed among uremic patients: a high responder group reacted similarly to normals, whereas a low responder group showed little reactivity to HP. Removal of the NH2-terminal histidine of the heptapeptide strongly diminished its enhancing activity on normal cytotoxic cells while maintaining activity on uremic lymphocytes. When HP and des-His-HP were studied as possible inducers of suppressor cell activity, only the latter was found to be active on normal cells. Lymphocytes from uremic patients failed to respond to either HP or des-His-HP in suppressor cell generation. It is suggested that continuous interaction between lymphocytes and high concentrations of HP or des-His-HP in uremia may have altered their sensitivity to the immunomodulatory effects of the peptides and may be instrumental in the immune deficiency associated with renal failure.     

Acid phosphatase and alpha-naphthyl acetate esterase in neoplastic and non-neoplastic lymphocytes. A statistical analysis

Acid phosphatase and alpha-naphthyl acetate esterase reaction patterns were evaluated in lymphocytes from patients with a variety of neoplastic and non-neoplastic conditions: leukemia, 59; NHL, 53; and reactive follicular hyperplasia, 23. Fifteen individuals with normal peripheral blood were also studied. For both enzymes, statistical analysis showed a strong correlation between a globular reaction pattern and T lymphocytic origin in both non-neoplastic lymph nodes and normal peripheral blood specimens (P less than 0.0001). A similarly strong correlation was found between a granular acid phosphatase pattern and T lymphocytic origin in cell isolated from non-neoplastic lymph nodes (P less than 0.0001) but not in those obtained from normal peripheral blood where this pattern was observed with equal frequency in B, T, and "null" lymphocytes (P = 0.415). A granular alpha-naphthyl acetate esterase pattern was correlated with non-T lymphocytes from normal peripheral blood (P less than 0.0001), but was observed with equal frequency in B, T, and "null" lymphocytes fron non-neoplastic lymph nodes (P = 0.76). In the eight T cell neoplasias studied, a globular pattern was evident in the majority of cells for both enzymes. In the majority of the B cell neoplasias, however, a granular pattern was observed for both enzymes.     

Rosette formation with mouse erythrocytes by lymphocytes from normal donors and patients with various diseases.

Rosette formation of human lymphoid cells with mouse erythrocytes has recently been proposed as a marker for a subpopulation of B lymphocytes. In this work we studied the percentage of mouse rosette forming cells (MRFC) in normal and pathological conditions and compared them to the percentage of sheep rosette forming cells (SRFC) a marker for T lymphocytes. Peripheral blood lymphocytes (PBL) from normal donors contained 6.2 +/- 1.1% (mean +/- 1 S.D.) MRFC. High percentages of MRFC were found in CLL patients, and a slight increase was observed in patients with systemic lupus erythematosus. MRFC were absent in Bruton's type agammaglobulinaemia, but were normally present in patients with T cell defects. Cryopreservation of lymphocytes in 10% DMSO did not significantly affect the mean percentages of SRFC and MRFC, though a slight increase of the former and a small reduction of the latter was observed. Double binding experiments on peripheral blood lymphocytes showed a predominant association of MRFC with cells staining for surface IgM and/or IgD. In all samples tested, we also observed a small population of MRFC negative for sIgM or sIgD and a few sIgM or sIgD positive cells that did not rosette with mouse erythrocytes.     

Helper and suppressor T lymphocyte function in severe alcoholic liver disease.

The immune regulatory T cell status of patients with severe alcoholic liver disease (ALD) was investigated. Using monoclonal antibodies to identify lymphocyte subsets in 22 patients, a significant decrease in the percentage of T suppressor/cytotoxic cells (P less than 0.01) and increase in the percentage T helper/inducer population (P less than 0.05) was observed when the results were compared with 20 normal controls. However, when absolute numbers of these lymphocyte subsets were calculated the patient group did not differ significantly from the controls. Further studies revealed T immunoregulatory cell function to be normal. Concanavalin A induced suppressor cells resulted in equivalent inhibition of autologous cell mitogen responsiveness in the patient and control groups. In addition, purified patient T lymphocytes were demonstrated to provide normal help to and manifest normal suppression of IgG, IgA and IgM synthesis by allogeneic B cells. When spontaneous immunoglobulin synthesis by circulating mononuclear cells was investigated, a significant increase in IgA synthesis was found in the ALD patients (P less than 0.05). These results suggest that T cell immunoregulation is normal in patients with ALD and a defect in this system is not responsible for the increased synthesis of immunoglobulin observed in ALD.     

Disorders of regulatory T cells in patients with selective IgA deficiency and its relationship to associated autoimmune phenomena

In vitro lymphocyte function of 13 patients with selective IgA deficiency was studied. IgG, IgA and IgM secretion by pokeweed mitogen-stimulated peripheral blood lymphocytes from normal donors and IgA deficient patients was measured by an enzyme-linked immunosorbent assay. Addition of concanavalin A or hydrocortisone and co-cultures of B and T cell enriched populations from patients and normal donors, allowed us to investigate B cell Ig production and T cell regulatory abnormalities. IgA production by these patients' B cells was either absent or very low, as compared to their total Ig production, even in the presence of optimal T cell help. Several T cell immunoregulatory abnormalities were seen in different patients. A moderate increase in suppressor activity selective for IgA production was observed in some, but does not appear to play a major role in the pathogenesis of the IgA deficiency. In others, with associated autoimmune phenomena, a decrease in suppressor T cell function was found.     

Hypogammaglobulinaemia associated with abnormalities of both B and T lymphocytes in patients with chronic lymphatic leukaemia

The underlying basis for hypogammaglobulinaemia in patients with chronic lymphatic leukaemia (CLL) was investigated by measurement if immunoglobulin produced in vitro in cultures of pokeweek mitogen-stimulated B and T lymphocytes. B and T cells were separated by sheep red blood cell rosette techniques and, by culture of these cells from CLL patients in various combinations with B or T cells from normal subjects, it was possible to measure independently the function of B lymphocytes and the helper or suppressor function of T lymphocytes. By these methods it was found that the B lymphocytes of six of eight patients failed to produce immunoglobulins in vitro. B lymphocytes from two patients appeared to produce immunoglobulins in vitro. T lymphocytes from five of the eight patients had low or undetectable helper T cell function and in six patients their T lymphocytes had excessive suppressor activity in comparison to T lymphocyte populations from normal subjects. Whether the primary abnormality in the CLL T cell populations was a deficiency of helper T cells or excess of suppressor T cells was uncertain from these studies. These results suggest that immunoglobulin production by B lymphocytes from most patients with CLL was abnormal but also that T cells from CLL patients may be abnormal in respect to their role in immunoglobulin production at an early stage of the disease. These findings may assist in understanding the pathogenesis of this disease and lead to new approaches in treatment.     

Silver-stained nucleolar organizer regions in bone marrow cells and peripheral blood lymphocytes of Philadelphia chromosome-positive chronic myelocytic leukemia patients

Silver-stained nucleolar organizer regions (Ag-NOR) in bone marrow cells and/or phytohemagglutinin-stimulated peripheral blood lymphocytes were compared between six normal healthy persons as controls and 22 Philadelphia chromosome (Ph)-positive chronic myelocytic leukemia (CML) patients, to examine if any disease associated changes occur in the expression of Ag-NOR. Although the frequency of Ag-NOR-positive cells and the number of Ag-NOR per cell were generally greater in lymphocytes than in bone marrow cells in both controls and CML patients, the Ag-stainability of these cell types in CML patients was considerably heterogeneous, compared with that found in controls. The peripheral lymphocytes of CML patients in the chronic phase, but not in the blastic phase, exhibited a significantly lowered Ag-stainability when compared with those of controls. while no such difference was observed between bone marrow cells of controls and leukemia patients in both phases of CML. In the blastic phase, however, the occurrence of Ag-NOR on the Ph of CML bone marrow cells was significantly less than expected. The present findings are discussed in relation to the existing data on the Ag-NOR expression in both normal and neoplastic cells.     

Cell volumes of normal and malignant mononuclear cells.

The cell volumes of mononuclear cells, T lymphocytes, B lymphocytes, and monocytes from the peripheral blood of 20 normal individuals were compared to neoplastic lymphoid cells from 14 patients with chronic lymphocytic leukaemia (CLL), 20 individuals with acute lymphocytic leukaemia (ALL), and 18 cases of non-Hodgkin''s lymphoma (NHL). Normal T cells were obtained by rosetting mononuclear cells with sheep erythrocytes followed by centrifugation on a gradient composed of Ficoll and diatrizoate salts. Monocyte populations were prepared by adhering mononuclear cells to plastic dishes and B cells were obtained by the depletion of T lymphocytes and monocytes from a mononuclear cell population. Cell volumes were determined on a Coulter Counter Model H4 Channelyzer. In normals, the average mean cell volume (MCV) of T lymphocytes was smaller than B lymphocytes and the average MCV of B lymphocytes was smaller than the average MCV of monocytes (p less than 0.05). The average MCV of lymphocytes from patients with CLL was smaller than the average MCV of normal B cells (p less than 0.01). The average MCV of lymphoblasts from cases of ALL was larger than the average MCV of normal peripheral blood lymphocytes (p less than 0.01). In addition, the size of lymphoblasts showed great variation within and among cases of ALL. The MCV of lymphocytes from most cases of NHL was larger than the MCV of lymphocytes from reactive lymph nodes and from the peripheral blood of normal individuals. An association was observed between the MCV of neoplastic cells and the classification according to Rappaport. We believe that the measurement of lymphoid cell volumes may be helpful in the diagnosis and prognosis of patients with a variety of lymphoproliferative disorders.     

Senile Cardiac Amyloidosis: Evidence of Two Different Amyloid Substances in the Ageing Heart

Lymphocytes were eluted from the synovial tissue of seventeen patients with rheumatoid arthritis (RA) and one with ankylosing spondylitis. In eight of these patients immunoglobulin production by synovial lymphocytes in the presence and absence of pokeweed mitogen was studied. In nine patients T lymphocytes were isolated from the eluted cells, and the T helper and suppressor cell functions were evaluated in an allogeneic co-culture system. Peripheral blood lymphocytes (PBL) from twenty-eight normal donors were also studied for comparison. Immunoglobulin produced by synovial lymphocytes was higher than in PBL of normal donors. However, the stimulation index of synovial tissue lymphocytes was lower. Most of the normal donors had suppressor cell activity in their peripheral blood, whereas in synovial tissue lymphocytes a statistically significant number of patients did not have any suppressor cell activity. In contrast, the synovial tissue lymphocytes showed helper activity not differing significantly from that of the T lymphocytes from peripheral blood of normal individuals.     

Cytotoxic Effector Cells from Infectious Mononucleosis Patients in the Acute Phase Do Not Specifically Kill Epstein-Barr Virus Genome-Carrying Lymphoid Cell Lines

We describe a study in which we investigated the cytotoxic activities of thymusderived (T) lymphocytes and natural killer cells against Epstein-Barr virus (EBV) genome-carrying lymphoid cell lines. Purified subpopulations of lymphocytes from eight patients with infectious mononucleosis and six healthy normal EBV-seropositive donors were tested. Enriched T-cells were obtained by passing purified whole blood lymphocyte preparations through human immunoglobulin-anti-immunoglobulin-coated glass bead columns. The cytolytic activity of effector cells was determined by the ability of these cells to lyse human target cells that were internally labeled with (51)Cr. These targets included cells from both EBV genome-carrying and EBV genome-negative lymphoid lines derived from malignant tumors, as well as from lymphocytes transformed in vitro by EBV, and were chosen to represent a wide spectrum of EBV-associated membrane antigens. We found that cytotoxic T-cells from patients with infectious mononucleosis showed no EBV-related specific cell killing per se, although a trend for increased killing of cell lines derived from spontaneous in vivo growing tumors, EBV genome carrying or not, was noted; however, this trend was not observed with cell lines derived from cord blood lymphocytes after EBV infection in vitro. In addition, our data suggest that natural killer cells may play an important role in controlling EBV infection in patients with infectious mononucleosis in the acute phase of the disease, particularly since T-cells (obtained after removal on immunoglobulin-anti-immunoglobulin columns of natural killer cells presumably bearing Fc receptors) were less efficient killers than whole blood lymphocytes; furthermore, lysis by whole blood lymphocytes was also greatest against cell lines derived from malignant tumors (as opposed to in vitro EBV-transformed cord blood lymphoid lines), irrespective of whether these targets were EBV genome positive or negative.     

T and CR+ lymphocyte profile in leprosy and the effect of treatment.

Thymus-derived lymphocytes (T lymphocytes) and complement receptor-bearing lymphocytes (CR+ lymphocytes) were estimated by using erythrocyte rosettes and erythrocyte-antibody-complement rosettes as markers in untreated lepromatous and untreated tuberculoid patients and in healthy controls. Treated lepromatous cases were also investigated. Ten cases of untreated lepromatous patients were reassessed 6 months or more after therapy commenced. A significant decrease in both percentages and absolute numbers of CR+ cells in the untreated lepromatous leprosy subjects was observed. This decrease showed a return to normal levels after treatment. The percentage of T cells in the untreated lepromatous cases was normal; however, the absolute numbers of T cells and the total lymphocyte count showed a significant decrease. After therapy, the T cell population was unchanged but the total number of lymphocytes increased significantly with treatment. The absolute number of T and CR+ cells was significantly less in the untreated than in the treated lepromatous patients.     

Lymphocyte Stimulation by a Mammary Carcinoma Associated Glycoprotein

A glycoprotein was isolated from 3M KC1 extracts of mammary carcinoma. Addition of an optimal amount of the carcinoma associated glycoprotein induces proliferation of both peripheral blood lymphocytes from normal donors and from patients with mammary carcinoma. RNA-dependent DNA-polymerase levels were found to be markedly increased in glycoprotein-untreated lymphocytes from patients with mammary carcinoma and in glycoprotein-treated lymphocytes of both normal donors and tumor-bearing patients. A factor (“Blocking Factor”) was eluted at pH 3.1 from the cell membrane of the mammary carcinoma cells. Addition of an optimal amount of this factor inhibits the glycoprotein induced stimulation of the RNA-dependent DNA-polymerase activity in glycoprotein-treated lymphocytes of both normal donors and tumor-bearing patients.     

Lymphocyte stimualtion by a mammary carcinoma assoicated glycoprotein.

A glycoprotein was isolated from 3M KCl extracts of mammary carcinoma. Addition of an optimal amount of the carcinoma associated glycoprotein induces proliferation of both peripheral blood lymphocytes from normal donors and from patients with mammary carcinoma. RNA-dependent DNA-polymerase levels were found to be markedly increased in glycoprotein-untreated lymphocytes from patients with mammary carcinoma and in glycoprotein-treated lymphocytes of both normal donors and tumor-bearing patients. A factor ("Blocking Factor") was eluted at pH 3.1 from the cell membrane of the mammary carcinoma cells. Addition of an optimal amount of this factor inhibits the glycoprotein induced stimulation of the RNA-dependent DNA-polymerase activity in glycoprotein-treated lymphocytes of both normal donors and tumor-bearing patients.     

T and B lymphocytes in patients with enteric fever.

Estimation of T and B lymphocytes was done in 50 patients of enteric fever, 50 duration matched non enteric fever patients and 50 normal healthy individuals. The difference in both early and late rosette forming T lymphocytes was found to be statistically significant in enteric versus non-enteric patients. Significant difference was also observed in enteric versus normal individuals in case of late rosette forming T lymphocytes.     

Lymphocyte Stimulation by a Mammary Carcinoma Associated Glycoprotein

A glycoprotein was isolated from 3M KC1 extracts of mammary carcinoma. Addition of an optimal amount of the carcinoma associated glycoprotein induces proliferation of both peripheral blood lymphocytes from normal donors and from patients with mammary carcinoma. RNA-dependent DNA-polymerase levels were found to be markedly increased in glycoprotein-untreated lymphocytes from patients with mammary carcinoma and in glycoprotein-treated lymphocytes of both normal donors and tumor-bearing patients. A factor (“Blocking Factor”) was eluted at pH 3.1 from the cell membrane of the mammary carcinoma cells. Addition of an optimal amount of this factor inhibits the glycoprotein induced stimulation of the RNA-dependent DNA-polymerase activity in glycoprotein-treated lymphocytes of both normal donors and tumor-bearing patients.     

Apoptosis-related changes in plasma membrane glycoconjugates of peripheral blood lymphocytes in rheumatoid arthritis

Control of apoptosis (apo) is very important for diagnosis, prognosis and treatment of rheumatoid arthritis (RA). Recently, we found that an appearance of specific cell surface GC is attributable to apo and developed lectin-induced agglutination test for apo evaluation. The aim of current study was to estimate changes in surface GC expression in peripheral blood lymphocytes (PBL) of normal healthy donors (NHD) and patients with RA, measured by cell agglutination with the galactose-specific VAA lectin and by lectin-cytochemical analysis. In parallel, these changes in apo incidence were evaluated by the detection of cells with sub-G1 DNA content. The data revealed an increased level of apo in lymphocytes of RA patients (n = 29), and increased cell surface GC expression in lymphocytes of NHD (n = 18). A correlation (R = 0.708) was observed between these two indicators. Specific changes in cell surface GC can be effectively used for the detection of apo cells in RA and other autoimmune disorders.     

The Effect of Levamisole on Peripheral T-Lymphocytes of Patients with Malignant Lymphomas

The effect of various concentrations (0.015-10 μg/ml) of Levamisole (LMS) on the peripheral lymphocytes of patients with malignant lymphomas (ML) and normal donors was investigated in vitro. The parameters studied include : E rosettes forming cells (total T lymphocytes), active E rosettes (early T lymphocytes) and DNA synthesis induced by pitogens PHA and Con A.

LMS improved significantly lymphocyte response both in patients with ML and normal donors when the cells were stimulated by Con A. In both groups no significant effect was observed on the response to PHA nor on the percentage of E-rosettes, whereas the mean number of active E rosettes was significantly increased on all concentrations of the drug.

While in the normal subjects a positive statistical correlation between active E-rosettes and Con A response was observed, in patients with ML an inverse correlation was found. This latter correlation was partially reversed by LMS.