Diagnostic immunology最新文献

Thirty-two melanoma patients treated with lymphoblastoid alpha interferon (Wellferon) were studied for augmentation of five putative parameters of natural immunity including natural killing (NK), antibody-dependent cellular cytotoxicity (ADCC), cell-mediated inhibition of growth in culture of a murine tumor (GIA), and the size of the OKTIO+ and Leu 7+ subpopulations of peripheral blood mononuclear cells (OKTIO and Leu7). This study confirms and extends our previous conclusions that interferon increases GIA and OKTIO. The increases occurred at 24 hr after interferon, both early and late in the course of treatment, and were dose dependent. NK, ADCC, and Leu7 were activated in many patients individually and mean values for NK and Leu7 were increased in the population as a whole. Two patients with complete remission showed dramatically increased natural immunity by the parameters studied, but the pattern of increase was very different for each patient. The current study of lymphoblastoid alpha interferon demonstrates the immunomodulatory potential of interferon given to melanoma patients, but it fails to support the hypothesis that augmentation of these parameters of natural immunity by interferon may result in tumor responses.

The usefulness of the mouse rosette (MR) assay in differentiating among various "well to intermediate differentiated" lymphoproliferative disorders (LPD) is presented. Thirty patients with a suspected LPD were studied. By standard histologic, cytologic, immunologic (surface immunoglobulin and monoclonal antibody markers), and clinical criteria, the following diagnoses (independent of MR data) were made: chronic lymphocytic leukemia (CLL) (n = 12), CLL in transformation (n = 2), well-differentiated lymphocytic lymphoma (WDLL) (n = 5), intermediate-differentiated lymphoma (IDL) (n = 2), hairy cell leukemia (HCL) (n = 3), prolymphocytic leukemic (PLL) (n = 1), poorly differentiated lymphocytic lymphoma (PDL) (n = 1), and no disease or reactive lymphocytosis (n = 4). There were 11 B-CLL cases and one T-CLL case. The percent of MR in all cases of B-CLL ranged from 26 to 76% (m = 62%); 10/11 cases had greater than or equal to 50% MR. The case with 26% MR was atypical in that it occurred in a 26-year-old patient. The percent of MR ranged from 0 to 42% (m = 16%) in the cases of well to intermediate differentiated lymphomas. Similar to previous reports intermediate proportions of MR were seen in HCL (12-41%); and low values were seen in PDL (4%) and PLL (4%). In summary, the MR assay may be a useful tool for differentiating CLL from other well to intermediate differentiated LPD involving the peripheral blood. Also, since the MR receptor is normally found only on functionally immature cells, this differential mouse rosetting capability suggests that CLL arises from a less mature cell than WDLL or IDL.

The object of this study was to develop a flow-cytometric procedure for measuring terminal transferase (TdT) in leukemic cells by indirect immunofluorescence. We demonstrated the presence of TdT in an average of approximately 80% of the cells from 12 patients with ALL, one with CML in lymphoid blast crisis, and one with T-lymphoblastic leukemia. These results compared favorably to a separate slide test for TdT using an immunofluorescent or immunoperoxidase method. In the 21 patients with nonlymphocytic leukemias and in six normal donors we studied, less than a mean of 3% of the cells were TdT+. In 11 of 12 patients with ALL, the TdT+ cells also carried the HLA-DR antigen and in 8 of 12 cases of ALL the TdT+ cells also expressed the CALLA antigen. We concluded that the flow-cytometric method facilitates the measurement of TdT and may significantly increase the ability to diagnose residual and recurrent ALL leukemias.

Studies of the immunoglobulin class of circulating anti-Candida antibodies in patients with vaginal candidiasis were undertaken with the aim of answering the question of whether these antibodies are predominantly IgA or IgG. Earlier work resulted in conflicting data that we felt would be clarified by the use of a quantitative technique, FIAX fluoroimmunoassay, which could objectively measure the relative amounts of antibody of each class. Results using this assay and the indirect immunofluorescence assay on whole Candida cells demonstrate that the immunoglobulin class distribution of the circulating anti-Candida antibodies of these patients is similar to that seen in other forms of Candida infection, the predominant antibody class being IgG.

Immunological responses of patients with recurrent herpes genitalis (RHG) were assayed in comparison to those of patients affected by recurrent herpes labialis (RHL) and to those of normal seropositive and seronegative controls. Total T cells were normal while a significant (p less than 0.001) reduction of cells with helper phenotype was found only in people with RHG, who were also lacking specific cell-mediated immunity (CMI) to herpes simplex virus (HSV) antigen. HSV-type 2 was demonstrated in their active lesions. Number of human NK-1 positive (HNK-1 +) cells was increased in RHG showing an inverse correlation with depressed natural killer (NK) activity. These abnormalities were found irrespective or not if tests were carried out during the active phase of the disease or during quiescence and were confirmed during the 2-year follow-up period to which patients were submitted. Similar abnormalities were found in RHL only during the active phase and reversed to normal during quiescence. Our data indicate the presence of specific cellular and NK unresponsiveness in subjects with severe and long-lasting herpes genitalis.

Upon comparing several polyclonal anti-IgE antisera (specific for the Fc epsilon fragment) for their ability to release histamine, we observed a marked heterogeneity of response for the same antiserum in different cell donors as well as for different antisera in the same cell donor. Additional studies with monoclonal antibodies directed against various epitopes of the D1 and D2 regions revealed several possible explanations: broad specificity of the polyclonal antisera, lack of availability of some epitopes on the cell-bound IgE (which were available on soluble IgE), microheterogeneity among IgE molecules from different patients, and failure of some donors' cells to respond to anti-IgE antibodies. We conclude that selection of appropriate antisera is an important consideration in comparing IgE-mediated histamine release among individuals.

A patient with alcoholism-related illness was found to have a rarely encountered biclonal gammopathy with IgM-kappa and IgM-lambda components. The para-protein bands were readily identified by immunofixation electrophoresis but were not by conventional immunoelectrophoresis. This patient is most appropriately classified as a biclonal gammopathy of undetermined significance, since no cause for this abnormality was found. The literature on biclonal IgM-kappa-lambda gammopathy is reviewed.

The relationship between T cell receptor (TCR) beta and gene immunoglobulin heavy chain locus was investigated in 25 cases of unselected human lymphomas as well as in normal and non-neoplastic lymphoid tissues. Hybridizing our blots with Jurkat 2, a clone specific for the beta chain gene of TCR, did not demonstrate extra bands in non-neoplastic tissues composed of 50-95% T-cells. On the contrary, rearranged bands were detected in six out of six cases of T-cell lymphomas. No TCR beta gene rearrangements were detected in 11 B-cell lymphomas, which in turn presented modification of the immunoglobulin heavy chain gene germline configuration. Our results suggest that TCR beta chain gene rearrangements are a good marker for human T-cell neoplasias in humans and complement the analysis with immunoglobulin genes probes. Eighth samples were devoid of any rearrangements: this group comprises cases of Hodgkin's disease T-lymphoblastic lymphomas in clinical remission and malignancies of unknown origin, as discussed in the text. We conclude that the analysis using DNA probes specific for TCR beta and IgH genes can be of aid to the pathologist in the diagnosis and classification of human lymphomas.

The serological response to treponemal infections in men before and after specific treatment is analyzed. From the described observations several consequences and possibilities for a specific immunological diagnosis are discussed. In particular, it is shown that early diagnosis of syphilis in need of treatment can be achieved by demonstration of T pallidum-specific IgM antibodies. Finally, new insights into the role of antibody correlations between serum and cerebrospinal fluid are mentioned that have established the detection of asymptomatic neurosyphilis.

Human serum albumin (HSA), coupled to filter paper discs, was used in the radioallergosorbent test (RAST) to evaluate nonspecific binding which results from high levels of total serum IgE. Binding of 125I-labelled anti-IgE to HSA coated discs was significantly correlated with total IgE levels. A significantly better correlation was seen, however, using HSA chemically treated under alkaline conditions prior to coupling with the disc. Use of HSA as a control for individual serum samples in the RAST is discussed.