Immune studies in human immunodeficiency virus infection with myasthenia gravis: a case report

A patient with human immunodeficiency virus infection had cellular and humoral immune responses studied longitudinally from the onset of generalized myasthenia gravis. Progressive decline in CD4+, CD45R+ and CD4+, CDw29+ T-cells, cellular immune responses to alloantigen and mitogen stimulation, and acetylcholine receptor antibody titers were associated with clinical improvement of all myasthenic symptoms.     

人胸腺和脐血造血干/祖细胞联合移植对裸鼠细胞免疫功能的影响

背景：T细胞在抗感染、抗肿瘤和免疫调节等中起重要作用,但T细胞分化发育机制尚未完全阐明。 目的：观察人胸腺、人脐血联合移植后裸鼠体内T细胞分布及免疫功能的重建。 方法：Balb/c nu/nu裸鼠30 只,随机分为2组：实验组肾被膜下移植胸腺组织,2周后将新鲜分离的脐血CD34+细胞悬液经小鼠静脉输入,对照组不经胸腺移植直接给予CD34+细胞移植,两组小鼠饲养至60 d时检测免疫功能。 结果与结论：人胸腺在裸鼠肾被膜下存活并且表达CD3、HLA-DR分子,胸腺与CD34+细胞联合移植组小鼠脾脏可见点块状分布的CD3+细胞。实验组CD3+细胞、CD4+细胞、CD8+细胞及CD4+CD25+细胞比例均显著高于对照组。实验组裸鼠对移植人胃癌BGC823细胞有排斥作用,而对照组没有。结果显示胸腺和CD34+细胞联合移植能使裸鼠获得T细胞介导的细胞免疫功能,具有抗肿瘤能力。     

Humoral and cellular immunologic study of cerebrospinal fluid in a patient with Beh?et encephalitis.

To study the immunopathogenesis of neuro-Beh?et syndrome, we performed serial cerebrospinal fluid (CSF) examinations in a patient with Beh?et's syndrome and involvement of the central nervous system. Before and after immunosuppressive treatment, we measured the CSF indexes of immunoglobulins (Ig), and the third (C3) and the fourth (C4) component of complement, and quantified immune complexes and lymphocyte subsets in CSF and peripheral blood. During active encephalitis, humoral abnormalities were intrathecal production of IgM and, to a lesser degree, IgG and IgA, presence of immune complexes in CSF but not in peripheral blood, intrathecal C3 production, and elevated CSF C3 and C4 concentrations; lymphocyte subset analysis showed an increased CSF CD8+ T-cell percentage, in combination with slightly increased PB CD3+ and CD8+ T-cell subsets. After effective immunosuppressive treatment, humoral and cellular CSF values were normal. We conclude that intrathecally produced immunoglobulins, immune complexes, and C3 as well as CD8+ T cells are likely to participate in the development of Beh?et encephalitis.     

Lamotrigine Hypersensitivity in Childhood Epilepsy

Summary: Purpose: To evaluate the effect of lamotrigine (LTG) on several humoral and cellular immune functions in children with epilepsy and the change in immunological status in patients with LTG-induced rash.
Methods: Sixteen children with epilepsy of unknown origin or secondary to various etiologies undergoing treatment with LTG participated in the humoral and cellular immunological study. Of these, 2 patients developed a rash during LTG treatment and are described in detail.
Results: No modifications of humoral or cellular immunity (measured at 1 and 3 months) were noted in 14 of the 16 patients during this treatment. In the 2 children who manifested rash, basal immune function was normal. In both, immediately after the skin rash appeared, there was a high increase in the percentage of activated T-helper lymphocytes (CDCDR) and activated T-suppressor lymphocytes (CDS-DR), a slight increase in percentage of B lymphocytes (CD19), and a greater increase in serum concentration of IgE. In 1 of the 2 patients, reevaluation of immunity 20 days after the rash appeared and after LTG suspension showed normal percentages of CDCDR, CDS-DR, and CD19, whereas the serum concentration of IgE had decreased.
Conclusions: The observed immunological results indicate that LTG-induced rash may be considered an immune-mediated hypersensitivity reaction.     

The role of asymmetry of nervous and immune systems in the formation of cellular immunity of (CBaxC57Bl/6) F1 mice

We have previously shown the existence of functional asymmetry of the immune system and the role of brain hemispheres and different lobes of thymus in the development of humoral immune response in (CBA x C57Bl/6) F1 mice. The role of asymmetry of the nervous and immune systems in the formation of the cellular immune response [delayed-type hypersensitivity (DTH) reaction] in these mice has been studied in our work. In order to test the influence of asymmetry of the primary immune organs, thymus, on the cellular immune response, mice were thymectomized and then we studied the effect of the injection of cells from contralateral thymus lobes of right-dominant and left-dominant donors by motor asymmetry on how pronounced the DTH reaction in the back left paw was. The injection of thymocytes from right-dominant donors appeared to result in significant differences in DTH reaction between left- and right-handed mice. At the same time, our experiments failed to discover any pronounced role of thymus asymmetry in the formation of DTH reaction. In order to test the influence of asymmetry of peripheral immune organs, regional lymph nodes, on the regulation of cellular immune response, we compared the DTH reaction in left and right paws of mice. We found that the intensity of the DTH reaction to sheep red blood cells in the front paws of (CBA x C57Bl/6) F1 mice depends not only on whether the antigen is injected into the left or right paw but also on the motor asymmetry of the hemispheres. While comparing the DTH reaction in the back left and right paw of mice we showed that in both right- and left-handed mice it was much more pronounced in the left paw than in the right one. The data obtained testify to the functional asymmetry of bilateral lymph nodes located near the forming cellular immune reaction. Thus, the results obtained show that the intensity of DTH reaction in (CBA x C57Bl/6) F1 mice depends on the functional asymmetry of regional lymph nodes and motor of brain hemispheres. The thymus functional asymmetry is of slight importance in DTH reaction.     

EAE大鼠胸腺CD4~+ CD25~+ Foxp3~+ Treg细胞的动态变化及α-硫辛酸的干预作用

目的探讨实验性变态反应性脑脊髓炎(EAE)大鼠不同病程中胸腺CD4+CD25+Foxp3+Treg细胞变化情况及α-硫辛酸对EAE大鼠胸腺的干预作用。方法取不同时期对照组、自然病程EAE组及α-硫辛酸EAE组大鼠的胸腺组织做流式细胞学,动态检测CD4+CD25+Foxp3+Treg细胞的变化情况。结果 EAE组大鼠急性期、复发期CD4+CD25+Foxp3+Treg细胞较同时期对照组明显减少(P<0.05),缓解期有所上升;α-硫辛酸组与同期EAE组相比CD4+CD25+Foxp3+Treg细胞无明显变化;半年期三组大鼠胸腺CD4+CD25+Foxp3+Treg细胞都明显下降,各组间无统计学差异。结论 CD4+CD25+Foxp3+Treg细胞参与了EAE的发病,与病程的发展密切相关;α-硫辛酸对EAE大鼠的干预作用并非通过CD4+CD25+Foxp3+Treg细胞发挥其治疗作用;随着年龄的增长,胸腺不再是机体的主要免疫器官。     

Thymic involution: where endocrinology meets immunology

The decline in immune function with aging represents a major clinical challenge in many disease conditions. It is manifest in many parameters but is essentially linked to the adaptive immune responses. The prediction would be that abnormalities in both T and B lymphocytes underlie the loss of cellular and humoral capacity, respectively. Somewhat surprisingly, this is not reflected in numerical losses but more in alterations at the population and single cell levels. There is a major reduction in na?ve T cells with a proportional increase in memory cells, and also a generally reduced function of these cells. While bone marrow function reduces with age, the most obvious reason for the T cell defects is the severe atrophy of the thymus. This is closely aligned with puberty, thereby implicating a major aetiological role for sex steroids in both thymus and immune system deterioration with age. Accordingly surgical or chemical castration (utilizing luteinizing hormone-releasing hormone) blocks sex steroids resulting in profound rejuvenation of the immune system.     

Effect of chronic ethanol feeding on 24-hour rhythms of mitogenic responses and lymphocyte subset populations in thymus and spleen of peripubertal male rats

This work analyzes the effect of chronic ethanol feeding on the 24-hour variation of mitogenic responses and lymphocyte subset populations in thymus and spleen. Animals were maintained under a 12:12-hour light/dark photoperiod and they received a liquid diet for 4 weeks, starting on day 35 of life. The ethanol-fed group received a similar diet to controls except that maltose was isocalorically replaced by ethanol. Ethanol replacement provided 36% of the total caloric content of the diet. Rats were killed at 6 time intervals around the clock, beginning at Zeitgeber time (ZT) 1 (ZT 0 = lights on). Under ethanol intake the splenic and thymic weight decreased. In addition, mean values of the thymic, but not of the splenic T cell number decreased, and mean values of the thymic and splenic CD8+ and CD4+CD8+ number increased. Consequently, the thymic T/B ratio and the thymic and splenic CD4+/CD8+ ratio decreased in ethanol-fed rats. At the same time there was a significant increase in the response of the thymic cells to LPS. The ethanol diet modified the 24-hour rhythmicity of thymic and splenic T, B and CD4+CD8+ cells, thymic CD4+ and splenic CD8+ cells, thymic and splenic T/B and CD4+/CD8+ ratios, as well as of mitogenic responses in both tissues. Chronic ethanol administration presumably affects the endogenous clock that modulates the circadian variation of immune responsiveness in growing rats.     

Enhanced humoral response in kappa-opioid receptor knockout mice

Opiates are major analgesics and addictive drugs described also as immunomodulators. Here, we investigated the contribution of kappa-opioid receptor (KOR) activity in immunity in vivo by studying immune responses in KOR knockout mice. These animals displayed a modest reduction in thymus cellularity and CD4(+) cell ratio, parallel to a slight increase in immature CD4(+)CD8(+) lymphocytes. In spleen, KOR null animals showed augmented cell number with no change in cell distribution. T and B lymphocyte proliferative capabilities in vitro, Natural Killer activity and steady-state Ig levels were unchanged in KOR-/- mice. We immunized the mice with the antigen keyhole limpet hemocyanin (KLH). Compared to wild-type (WT) mice, KOR-/- animals produced significant higher levels of antigen-specific total Ig, IgM, IgG1 and IgG2a antibodies. This enhancement of humoral activity was not observed in mu-opioid receptor and delta-opioid receptor knockout animals. These results show that endogenous activation of kappa-opioid receptors may exert a tonic inhibition of antibody (Ab) response.     

Pathological mechanisms of human T-cell lymphotropic virus type I-associated myelopathy (HAM/TSP)

The recent studies have greatly improved our understanding of the pathological mechanisms of human T cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The pathological mechanisms of HAM/TSP based on the histopathological, immunological, and molecular analysis with emphasis on the longitudinal alterations of the disease will be discussed. Immunohistological examination revealed the existence and the activation both of HTLV-I-infected CD4+ cells and HTLV-I-specific CD8+ cytotoxic T lymphocytes in the spinal cord lesions, which suggest that they play an important role in the pathogenesis. Increased expression of several cytokines, Fas/Fas ligand, adhesion molecules, and molecules influencing T cell migration in the lesions have been reported. These cell infiltrates and cytokines they secrete in the lesions may damage bystander neural tissue. Furthermore, longitudinal alterations in the affected spinal cords suggest that the inflammatory process is gradually decreased. Epidemiological studies show that less than 5% of infected individuals develop HAM/TSP and indicate that increased proviral load of HTLV-I is a strong predictor for the development of HAM/TSP. A recent study has shown that the autoantibody for the ribonuclear protein-A1 can cross-react with HTLV-I Tax protein and inhibit neuronal firing ex vivo, indicating that a molecular mimicry of the humoral immune response may be involved in the pathogenesis of HAM/TSP. Based on these studies, two hypotheses can be proposed for the pathogenesis of HAM/TSP, where cellular and humoral immune responses both play important roles.     

Human myoblast transplantation in immunodeficient and immunosuppressed mice: Evidence of rejection

Normal human myoblasts were cloned and transplanted in the tibialis anterior of immunodeficient nude and SCID mice and in mdx mice under different immunosuppressive treatments (cyclosporine A, CsA; antilymphocyte serum, ALS) or not immunosuppressed. This permitted us to show the interaction of the immune system in the myoblast transplantation. The graft success was assessed by verifying signs of humoral and cellular immune reactions and the presence of dystrophin produced by the fusion of the donor myoblasts. This study showed that clones of human myoblasts were able to fuse and produce dystrophin in injected muscles of immunodeficient mice and mdx mice receiving an effective immunosuppressive treatment (i.e., ALS + CsA). However, the same pool of human myoblasts injected in mdx mice inadequately immunosuppressed (i.e. CsA alone or ALS alone) triggered an immune reaction and was rejected. Cells expressing CD4 and CDS antigens were observed in the injected muscles of mice treated with CsA alone. Therefore, evidence of humoral and cellular rejection was observed following human myoblast transplantation. © 1994 John Wiley & Sons, Inc.     

Immunoprotection against toxic biomarkers is retained during Parkinson's disease progression

The aim was to ascertain any possible linkage between humoral immune responses to principal biomarkers (α-synuclein monomers, its toxic oligomers or fibrils, dopamine and S100B) and cellular immunity in Parkinson's disease development. There were elevated autoantibody titers to α-synuclein monomers, oligomers plus fibrils in 72%, 56%, and 17% of Parkinsonian patients respectively with a 5-year disease duration. Additionally, there were increased titers to dopamine and S100B (96% and 89%) in the 5-year patient group. All of these values subsided in 10-year sufferers. Furthermore, CD3+, CD4+, CD8+ T-lymphocyte and B-lymphocyte subsets declined in the patient cohort during Parkinsonism indicating disease associated reductions in these lymphocyte subsets.     

Exposure to forced swim stress alters morphofunctional characteristics of the rat thymus

The aim of this study was to investigate whether chronic stress, induced by repeated daily swimming during 21 days, alters the morphofunctional parameters in the thymus of adult rats. Our results showed that chronic stress reduced thymus mass, total number of thymocytes, volume of the thymus compartments and numerical density of thymocytes within thymus inner cortex and medulla. However, the percentage of apoptotic cells and the level of corticosterone were significantly increased. The percentages of CD4-CD8-TCRβ^low/high and CD4-CD8+TCRβ^-thymocytes were significantly increased, while the percentage of the least mature CD4+CD8-SP TCRβ⁻ thymocytes was significantly decreased.

These results show that recurred swimming procedure induces thymus hypotrophy and elevated percentage of DN TCRβ⁺ cells.     

Enriched environment regulates thymocyte development and alleviates experimental autoimmune encephalomyelitis in mice

Environmental and social factors have profound impacts on immune homeostasis. Our work on environmental enrichment (EE) has revealed a novel anti-obesity and anticancer phenotype associated with enhanced activity of CD8⁺ cytotoxic T lymphocytes in secondary lymphoid tissues. Here we investigated how an EE modulated thymus and thymocyte development. EE decreased thymus mass and cellularity, decreased the double positive thymocyte population, increased the proportion of CD8⁺ T cells, reduced the CD4:CD8 ratio, and downregulated CD69 expression in T cells. In a model of multiple sclerosis: experimental autoimmune encephalomyelitis (EAE), EE alleviated symptoms, inhibited spinal cord inflammation through regulation of type 1 T-helper cells mediated by glucocorticoid receptor signaling, and prevented EAE-induced thymic disturbance. Our mechanistic studies demonstrated that hypothalamic BDNF activated a hypothalamic-pituitary-adrenal axis mediating the EE’s thymic effects. Our results indicate that a lifestyle intervention links the nervous, endocrine, and adaptive immune system, allowing the body to adapt to internal and external environments.     

Paraneoplastic and non-paraneoplastic autoimmunity to neurons in the central nervous system

Autoimmune central nervous system (CNS) inflammation occurs both in a paraneoplastic and non-paraneoplastic context. In a widening spectrum of clinical disorders, the underlying adaptive (auto) immune response targets neurons with a divergent role for cellular and humoral disease mechanisms: (1) in encephalitis associated with antibodies to intracellular neuronal antigens, neuronal antigen-specific CD8⁺ T cells seemingly account for irreversible progressive neuronal cell death and neurological decline with poor response to immunotherapy. However, a pathogenic effect of humoral immune mechanisms is also debated. (2) In encephalitis associated with antibodies to synaptic and extrasynaptic neuronal cell surface antigens, potentially reversible antibody-mediated disturbance of synaptic transmission and neuronal excitability occurs in the absence of excessive neuronal damage and accounts for a good response to immunotherapy. However, a pathogenic effect of cellular immune mechanisms is also debated. We provide an overview of entities, clinical hallmarks, imaging features, characteristic laboratory, electrophysiological, cerebrospinal fluid and neuropathological findings, cellular and molecular disease mechanisms as well as therapeutic options in these two broad categories of inflammatory CNS disorders.     

Overview of the cellular immunity against JC virus in progressive multifocal leukoencephalopathy

The human polyomavirus JC (JCV) infects most healthy adults without causing any disease. In the setting of severe deficit of cell-mediated immunity, such as in acquired immunodeficiency syndrome (AIDS), malignancies or in organ transplant recipients, JCV can reactivate and cause progressive multifocal leukoencephalopathy (PML), a deadly demyelinating disease of the central nervous system. The humoral immune response, measured by the presence of virus-specific immunoglobulin G (IgG) in the blood or by intrathecal synthesis of IgG in the cerebrospinal fluid (CSF), is unable to contain the progression of PML. CD4+ T lymphocytes recognize extracellular viral proteins that have been degraded into peptides through the exogenous pathway and presented on major histocompatibility complex (MHC) class II molecules at the surface of antigen-presenting cells. Consistent with their underlying immunosuppression, the proliferative response of CD4+ T lymphocytes to mitogens or JCV antigens is reduced in PML patients. CD8+ cytotoxic T lymphocytes recognize intracellularly synthesized viral proteins that have been degraded into peptides through the endogenous pathway, and presented on MHC class I molecules at the surface of virus-infected cells. One of such JCV peptide, the VP1(p100) ILMWEAVTL, has been characterized as a cytotoxic T lymphocyte (CTL) epitope in HLA-A *0201 + PML survivors. Staining with the corresponding A *0201/JCV VP1(p100) tetrameric complex showed that VP1(p100)-stimulated peripheral blood mononuclear cells (PBMCs) of 5/7 (71%) PML survivors had JCV-specific CTL, versus none of 6 PML progressors (P = .02). This cellular immune response may therefore be crucial in the prevention of PML disease progression and the tetramer staining assay may be used as a prognostic marker in the clinical management of these patients.     

Self-stimulation behavior: consequences upon immunity?

A variety of behavioral and emotional factors can affect the immune response by changing the brain immunoregulatory mechanisms, resulting in immunosuppression or immunopotentiation. This experiment deals with the effect of chronic self-stimulation behavior on the immune response and lymphoid tissue. Male rats were stereotaxically implanted with bipolar electrodes into the lateral hypothalamus and 7 days after surgery were screened for self-stimulation behavior. Lateral hypothalamus self-stimulating rats (LH-SS) were allowed to self-stimulate for 60 min/day for a period of 9 consecutive days: 5 days before and 4 days after immunization with 5 x 10(9) sheep red blood cells (SRBC). The animals were sacrificed and plaque-forming cell assay (PFC), microhaemmagglutination reaction with SRBC, and differential blood leucocyte counts were performed. The thymus, spleen, and inguinal lymph nodes were weighed and processed for histological examination. In the LH-SS group, an enhanced PFC response and increased anti-SRBC antibody titer were observed when compared to controls. The thymus and spleen of LH-SS rats were smaller in size in comparison with controls, but only with moderate changes in splenic cellular make-up. The relative number of lymphocytes was increased in peripheral blood of LH-SS rats when compared to intact animals. The results obtained suggest that chronic self-stimulation behavior can modulate some parameters of humoral immune response and affect the relative weight of lymphoid organs in the rat.     

Magnetic fields, brain and immunity: effect on humoral and cell-mediated immune responses.

Magnetic fields (MF) can influence biological systems in a wide range of animal species and humans. We report here on the influence of static MF, locally applied to the brain area, on immune system performances in the rat. In the first series of experiments two AKMA micromagnets (M) with the influx density of 600 Gauss were bilaterally implanted (with "N" polarity facing the cranial bones) and fixed to the skull posterior to the fronto-parietal suture (parietal brain exposure). Rats implanted with iron beads (I) and sham-operated (SO) rats served as controls. Animals were exposed to MF or I during different periods of time before and after immunization with several soluble or cellular antigens. We report here on the in vivo immunoregulating effects of centrally applied MF on plaque-forming cell (PFC) response, local hypersensitivity skin reactions and experimental allergic encephalomyelitis. The selective influence of MF applied to different brain regions on PFC response was evaluated, as well. For this purpose, two M were bilaterally implanted in the area of (a) frontal, (b) parietal and (c) occipital brain regions. Rats were under the influence of MF for 20 days before and 4 days after immunization with sheep red blood cells. Groups of nonimmunized rats were exposed for 14, 24 and 34 days to parietally implanted M or I, and the number of peripheral blood CD4+ and CD8+ cells determined by mouse anti-rat W3/25 and MRC OX 8 monoclonal antibodies. The results show an overall in vivo immunopotentiation of humoral and cell-mediated immune responses in rats exposed to MF. Furthermore, these immunomodulating effects of centrally applied MF depend on at least two basic parameters, time of exposure and brain region exposed. The highest immune performance was obtained after exposure of the occipital brain region for a total period of 24 days. The results provide further evidence of the complex interrelationship between the environment, the central nervous system and the immune system.     

Neonatal capsaicin treatment affects rat thymocyte proliferation and cell death by modulating substance P and neurokinin-1 receptor expression

Herein we provide evidence that substance P (SP) and its neurokinin-1 receptor (NK-1R) expressed on thymocytes counteract thymus depletion induced by neonatal capsaicin (CPS) treatment by affecting thymocyte proliferation and apoptotic death. SP administration reversed the CPS-mediated inhibitory effects on the total thymocyte number and subset distribution, namely CD4+ and CD4- CD8- cells, through its interaction with NK-1R as shown by concomitant NK-1R (SR140333) antagonist administration. SP-induced enhancement of thymus cellularity parallels its ability of inhibiting the thymocyte apoptotic program. Indeed, exogenously administered SP completely nullified CPS-induced apoptosis, and SR140333 abrogated the SP-mediated protective effect. SP administration also stimulated concanavalin A (Con A)-induced thymocyte proliferation of CPS-treated rats, completely reversing the CPS-induced inhibition. The SP-mediated stimulation of Con A-induced thymocyte proliferation was NK-1R dependent as shown by concomitant administration of SP and SR140333 to CPS-treated rats. Our results also demonstrate that CPS treatment induces a marked decrease of thymocyte PPT-A mRNA level and endogenous SP content as evaluated by quantitative RT-PCR, in situ hybridization and cytofluorimetric analysis. By contrast, NK-1R mRNA levels were increased in thymocytes from CPS-treated rats. Exogenous SP administration augmented PPT-A, SP and NK-1R thymocyte expression in CPS-treated rats, and this enhancement was antagonized by SR140333 administration. Overall, our results strongly suggest that the immunomodulatory effects of neonatal CPS treatment on rat thymocyte functions are dependent on vanilloid-mediated regulation of SP and NK-1R functional expression by neuronal and immune cells.     

Increase in differentiated type of T lineage cells in the myasthenic thymus: two-color fluorocytometric analysis

We made use of two-color flow cytometry to examine thymic lymphoid cells from patients with myasthenia gravis. The CD4+CD8- cells and the CD4-CD8+ cells were significantly increased in the thymus from the patients, compared with findings in the control samples. Conversely, the CD4+CD8+ cells were significantly decreased. Significant increases in CD1-CD3+ cells and significant decreases in CD1+CD3- cells were noted. The percentage of CD45R+ cells also increased. There were no increases in activated T lymphocytes, defined as CD4+DR+ cells, CD8+DR+ cells, or IL2R+ cells. We conclude that the proportion of T lineage lymphocytes that are differentiated is increased in the thymus of patients with myasthenia gravis, and could reflect accelerated differentiation.