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Biomedical subjects

G Dighiero

Publications and source records attributed to G Dighiero.

At least 19 recordsLinked to original sources

Impaired proliferative capacity and abnormal cytokine profile of naive and memory CD4 T cells from HIV-seropositive patients.

Purified naive and memory CD4 T cells from healthy donors, HIV+ asymptomatic carriers and AIDS patients were examined for their proliferative activity and their pattern of cytokine secretion (IL-4, IL-6, interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha)) upon stimulation with phytohaemagglutinin (PHA), phorbol myristate acetate (PMA) and cross-linked anti-CD3 MoAb, in the presence of recombinant IL-2 (rIL-2). We found a decrease in the proliferative capacity of naive CD4 T cells following stimulation with PHA and PMA, and a sharp decline in this response upon cross-linked anti-CD3 stimulation in both subsets, although it predominated in the naive subpopulation. In AIDS patients, less pronounced impairment of thymidine uptake by the naive subset was found upon PHA and cross-linked anti-CD3 MoAb stimulation. In addition, an altered secretion pattern of the different cytokines was observed, consisting of abnormal secretion of IL-6 by both naive and memory cells, an abnormal pattern of IFN-gamma secretion and frequent loss of detectable IL-4 production by HIV patients. These abnormalities were even more pronounced in AIDS patients than in the asymptomatic carriers. Overall, our results extend previous reports indicating functional impairment of memory CD4 subsets in HIV+ subjects by showing that this impairment involves naive CD4 T cells.

Acquired Immunodeficiency Syndrome

Natural killer (NK) cell activity during HIV infection: a decrease in NK activity is observed at the clonal level and is not restored after in vitro long-term culture of NK cells.

NK cell activity is impaired in HIV-infected patients. The mechanisms behind the altered NK functions are not clear, and conflicting data concerning NK and antibody-dependent cellular cytotoxicity (ADCC) activity have been reported. In order to investigate whether this impairment is also observed at the clonal level and whether it is related to a defect at the target cell binding and/or the post-binding level, we evaluated highly purified NK cell lines and cloned NK cells obtained from 22 HIV-infected patients at different stages of disease and compared them with normal controls for their ability to: (i) kill K-562 and U-937 cell lines using a 51Cr release assay; (ii) bind and kill K-562 and U-937 cells at the single cell binding level; (iii) release NK cytotoxic factor (NKCF), tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma); (iv) kill anti-IgM preincubated Daudi cell line (ADCC activity). This study with cloned NK cells or NK cell lines from HIV-infected individuals showed: (i) a decrease in their lytic capability against target cell lines; (ii) a low ability to form conjugates with K-562 and U-937 cell lines with respect to controls; (iii) a decreased ability to kill bound target cells; (iv) low levels of released NKCF, TNF-alpha and IFN-gamma after incubation with U-937 cells. Taken together, these findings suggest that the impaired NK cell function during HIV infection is also observed at the clonal level and is related to defects both at the target and post-binding levels. However, the precise mechanisms remain to be determined. The inability to restore normal NK activity after long-term culture in the presence of high levels of recombinant IL-2 is in agreement with the hypothesis of a 'general anergic process' during HIV infection.

Acquired Immunodeficiency Syndrome

Autoantibody activity and V gene usage by B-cell malignancies.

Autoreactive B cells account for a substantial part of the B-cell repertoire. They frequently secrete polyspecific natural autoantibodies, which probably bind with low affinity to the different antigens they recognize and which express germinal genes. The role of this pre-immune repertoire still remains to be defined but it has been suggested that it participates in the elimination of cell breakdown products, serves as a first barrier of defense or acts as a template upon which antigen driven selection and somatic recombinations could induce the emergence of high affinity induced antibodies. The present study, reviews the evidence favouring the idea that this autoreactive B-cell repertoire, which expresses a restricted set of V genes, frequently undergoes malignant transformation. This evidence arises from the study of the autoantibody activity and V gene usage in three different models of B-cell malignancies namely monoclonal immunoglobulins; chronic lymphocytic leukemia; and follicular non-Hodgkin's lymphomas.

Animals

Evaluation of residual disease in B-cell chronic lymphocytic leukemia patients in clinical and bone-marrow remission using CD5-CD19 markers and PCR study of gene rearrangements.

We evaluated minimal residual disease (MRD) in 23 CD5 + B-chronic lymphocytic leukemia (CLL) patients who achieved clinico-hematological remission confirmed by bone-marrow biopsy. MRD was evaluated by dual marker analysis flow-cytometry using CD5 and CD19 markers, and by the study of Ig heavy chain gene rearrangements using the fast polymerase chain reaction (PCR). According to our laboratory conditions patients were considered to be in complete phenotypic remission when total CD19+ cells were < 25% and the ratio of CD5 + CD19 + /CD19 + cells was < 25%. According to these strict criteria only 9 of the 23 patients were in complete phenotypic remission. In order to evaluate the sensitivity of the above method, PCR analysis of the configuration of the Ig heavy chain gene region was performed in 12 of these patients. Five of 7 patients in complete phenotypic remission retained a detectable monoclonal rearrangement of the Ig heavy chain gene. For the remaining 5 patients in partial phenotypic remission, only one failed to show a monoclonal band and this is probably explained by the presence of an unusual gene rearrangement. In conclusion, this study suggests that PCR is more sensitive than dual marker flow-cytometry for evaluation of residual disease and that it is indeed possible to achieve complete remission at the molecular level, in B-CLL. Nevertheless, we suggest a word of caution as this was a retrospective study, and samples were not assessed before treatment. Thus the possibility that apparent molecular remission might correspond to unusual gene rearrangements cannot be completely excluded in these cases.

Adult

Autoantibody activity of immunoglobulins isolated from B-cell follicular lymphomas.

Previous work with monoclonal Igs (MIgs) has demonstrated that a high proportion of paraproteins bind to self-antigens such as the Fc fragment of IgG, Ii blood group antigens, cytoskeleton proteins, DNA, and myelin-associated glycoprotein (MAG). Recent work in CLL indicates that CD5+ B lymphocytes are frequently committed to production of autoantibodies. We have examined the antibody specificity of MIgs derived from the tumor cells of 31 different patients with CD5- B-cell lymphomas. Our results indicate that the tumor cells from 8 of these 31 patients (25.8%) express Igs with autoantibody activity. In two cases antibody activity was multispecific. In four cases, antibody activity was exclusively directed against the Fc fragment of IgG, whereas the two other cases bound to both Fc fragment of IgG and nuclear antigens. Most non-Hodgkin's lymphomas (NHL) are derived from CD5- B cells. These results indicate that like CLL, NHL also express Igs that frequently have autoantibody activity.

Antibodies, Monoclonal

Serum levels of IL-2, IL-1 alpha, TNF-alpha, and soluble receptor of IL-2 in HIV-1-infected patients.

Serum levels of the interleukins (IL-1 alpha, IL-2), tumor necrosis factor-alpha (TNF-alpha), and soluble receptor of IL-2 (sIL-2R) were studied by enzyme-linked immunosorbent assay (ELISA) in 12 normal healthy controls and 52 HIV-1 seropositive patients. Results indicated that: (1) sIL-2R levels were significantly increased in most HIV-1 seropositive patients. This increase appeared to be correlated with low CD4 cell counts and with the presence of detectable levels of p25 antigen. Furthermore, initially high levels of sIL-2R appeared to be correlated with progression of disease. (2) IL-2 levels were found to be increased in about 43% of asymptomatic carriers (ASY) and subjects with lymphoadenopathy-associated syndrome (LAS) compared with 12% in the case of AIDS-related complex (ARC) and AIDS patients. (3) There was a positive correlation between serum levels of TNF-alpha and IL-1 alpha in nearly all patients. Detectable levels of both cytokines were found in 34% of ASY and LAS patients and only rarely were detectable in ARC and AIDS patients. (4) Sixteen patients in whom progression of disease was observed were studied initially and at the moment they upstaged. No significant modification of serum levels of the three cytokines and sIL-2R studied could be evidenced. It was concluded that sIL-2R could be a useful marker of disease activity and progression, though a prospective study is necessary. For IL-2, IL-1 alpha, and TNF-alpha, this study indicated the presence of variable alterations in serum levels in HIV-1-infected patients.

AIDS-Related Complex

Serial study of CD5+ and CD5- B cell subpopulations in 335 HIV seropositive patients.

B cell subpopulations, as defined by double-labelling techniques with CD5 and CD19 monoclonal antibodies (MoAbs), were serially studied in 335 HIV-1 seropositive patients. At the time of the first consultation, no important modifications in either CD5+ or CD5- subpopulations were observed, whatever the stage of the disease. However, in 18 out of the 335 patients (5.37%), a sharp increase in B cells exceeding 20% and 300/mm3 was observed. This increase in B cells was mainly accounted for CD5-CD19+ B cell subpopulations and was associated with: (i) evolution of the disease, since only four patients presented it at their first consultation (one lymphadenopathy-associated syndrome (LAS) and three AIDS); (ii) advanced stages of disease since, at the time of B cell augmentation, two patients were staged as LAS, four as ARC and 12 as AIDS; (iii) a high incidence of non-Hodgkin's lymphomas (NHL) since three out of the 18 patients presented a histologically confirmed NHL and three others a clinical pattern compatible with this diagnosis. However, in three patients with B hyperlymphocytosis, polymerase chain reaction (PCR) studies of immunoglobulin gene rearrangement revealed the existence of a polyclonal expansion of B cells. These results justify inclusion of a pan-B cell marker in routine phenotypic studies of HIV-infected individuals, as well as the search for NHL among patients presenting this abnormality.

Antigens, CD

Extensive analysis of lymphocyte subsets in normal subjects by three-color immunofluorescence.

In the present work, 30 normal controls were studied with 11 combinations of 3 monoclonal antibodies in order to define CD20, CD4, CD8, CD16 and CD56 subsets as well as their activation status. Our results indicated that among B cells, CD5- cells predominated (about 92%), the minor CD5+ fraction showed variations between individuals but sometimes was as high as 20% in B cells; the CD45RA+CD29- subset (naive cells) accounted for 31.56 +/- 10.03% in CD4 cells, as compared to CD4+CD29+CD45RA- (memory cells) (46.54 +/- 10.35%), while CD4+CD29+CD45RA+ (transition cells between naive and memory state) represented 9.6 +/- 5.3% as compared to double-negatives (12.3 +/- 5.24%). Some uncertainties persist in defining CD8 subsets. NK CD8 cells accounted for about 20% of total CD8 according to CD16 and CD56 expression. Cytotoxic T lymphocytes could be delineated by S6F1 (76.22 +/- 11.28% within CD8 cells), though this marker appeared to be expressed by both cytotoxic and NK cells. Phenotypic definition of suppressive CD8 cells remains uncertain despite the fact that suppressor activity was found among CD8 lymphocytes expressing CD11b and probably CD57. NK cells coexpressed CD16 and CD56 markers in about 5% of all lymphocytes, while NK cells expressing CD16 alone accounted about 6%. Exclusive expression of CD56 was found in about 5%. Finally, while activated cells characterized by DR expression represented about 4% of CD4 and 9% of CD8 cells, CD25 appeared to be poorly represented among CD4, CD8 and CD20.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Monoclonal

Establishment of long term cell lines from 2 patients with large granular lymphocyte lymphocytosis displaying an unusual phenotype.

Two long-term cell lines obtained from two cases of large granular lymphocyte lymphocytosis (LGLL) displaying an unusual phenotype are reported here. Patient n. 1 was CD2+ CD3- CD16+ CD8+ CD56- CD57- CD29+ CD45RA+, whereas patient n. 2 was CD2-CD3+ CD8+ CD16+ CD56- CD57+ CD29+ CD45RA+. The cells were large granular lymphocytes by light and electron microscopic criteria and displayed strong antibody-dependent cell mediated cytotoxicity (ADCC) and NK activity. Northern blot analysis revealed aberrant transcripts of TCR beta chains for patient n. 1, and full length TCR alpha and beta transcripts for patient n. 2. In both cases, we were able to establish a long term cell line which functionally revealed strong ADCC and NK activity. Functional implications of these 2 subpopulations are discussed.

Aged

Evidence that chronic lymphocytic leukemia B lymphocytes are frequently committed to production of natural autoantibodies.

CD5+ B lymphocytes have been postulated to be primarily involved in autoantibody production. To investigate whether CD5 B lymphocytes from chronic lymphocytic leukemia (CLL) patients display the same function, we fused B lymphocytes from 23 CD5+ B-CLL with nonsecreting murine myeloma X-63 cells. Hybrids were derived from 18 of the 23 patients, but only hybrids from 13 patients were found to secrete immunoglobulin (Ig) (IgM kappa 4, IgM lambda 8, and only kappa light chain 1). Supernatants of these hybrids were tested against an extensive panel of antigens by enzyme-linked immunosorbent assay, indirect immunofluorescence, and hemagglutination. At the same time, peripheral blood mononuclear cells (PBMC) from 15 of these patients, including most patients from whom secreting hybrids had not been obtained, were stimulated with phorbol myristate acetate (PMA). Our results indicated that secreting heterohybrids from CLL B lymphocytes are frequently obtained; however, this is highly dependent on the light chain phenotype, since 8 of 9 lambda-expressing CLL produced hybrids secreting complete Igs, as compared with 4 of 12 kappa-expressing CLL. In addition, B lymphocytes of most patients from whom we failed to derive secreting hybrids also failed to secrete Ig on PMA stimulation. Secondly, CD5+ B-CLL lymphocytes were frequently committed to the production of natural autoantibodies, since in 8 of 15 cases (including hybrids and PMA stimulation) anti-Fc activity was found; three of these also displayed a multispecific binding pattern.

Aged

CD5 and immunoglobulin V gene expression in B-cell lymphomas and chronic lymphocytic leukemia.

We studied the expression of CD5 and immunoglobulin variable gene families in a panel of monoclonal Epstein-Barr virus (EBV) transformed lines, chronic lymphocytic leukemias (CLLs) and CD5+ and CD5- B-cell lymphomas. The CD5 gene expression was in all cases identical to that of T-cell malignancies. The utilization of the various VH and VK gene families was roughly proportional to the estimated gene family size in EBV lines obtained from adult healthy subjects. In contrast we found a statistically significant biased usage of VH6 in CLL and VH5 in CD5+ lymphomas as compared with EBV lines, and of VKIII in both CLL and CD5+ lymphomas as compared with EBV lines. Some differences in the variable gene usage were also noted when comparing CD5+ and CD5- lymphomas. These findings are analyzed in the context of possible mechanisms involved in the malignant transformation of CD5+ B cells.

Antigens, CD

Ly1 and V-gene expression among hybridomas secreting natural autoantibody.

This report presents evidence that multispecific natural autoantibodies (NAAb) arise from both Ly-1+ and Ly-1- B lymphocyte subsets based upon detection of mRNA transcript of Ly1 gene by Northern blotting among hybridomas from several mouse strains. Newborn Xid mice also possess B cells transcribing the Ly-1 gene that secrete multispecific NAAbs. Different VH and VK gene families were expressed at random in both Ly-1+ and Ly-1- hybridoma clones secreting NAAbs. Certain VK gene families VK1, -8, -9, -10 and -19, were preferentially used by NAAbs. No particular VH:VK pairings were observed among NAAbs multispecifically reactive with DNA and cytoskeleton proteins. The NAAbs reactive with BrMRBC exhibited predominant pairing between VH11:VK9 gene families, although, for the first time, we noted the participation of VK1, -10 and -19 gene families in encoding this autoantibody specificity.

Animals

Platelet antibodies in serum of patients with human immunodeficiency virus (HIV) infection.

Between 10 and 15% of human immunodeficiency virus (HIV) seropositive individuals develop an immune thrombocytopenic purpura; however, the mechanism involved in platelet destruction is not yet established. In the present work, we have analyzed 208 sera from HIV seropositive individuals, including 85 thrombocytopenic patients, for the presence of autoantibodies against platelet proteins by using the Western blot technique. Our results indicate that: (1) antibodies against platelet proteins were found in 8 of 123 (6.5%) nonthrombocytopenic patients, as compared with 17 of 85 (20%) of thrombocytopenic patients (p less than 0.03); (2) these antibodies appeared to be more frequently found in advanced stages of disease (p less than 0.02); (3) the reactivity of positive sera with antigenic determinants implicated several distinct platelet proteins; (4) antigens thus recognized are unrelated to the major membrane glycoproteins IIb and IIIa, as well as absent in vero cells and trypsin-sensitive cells. Such results underscore the difficulties in establishing the mechanisms involved in platelet destruction during HIV infection.

Autoantibodies

Sera with high levels of anti-smooth muscle and anti-mitochondrial antibodies frequently bind to cytoskeleton proteins.

Using ELISA methods, 54 sera from chronic active hepatitis (CAH) patients displaying high levels of anti-smooth muscle antibodies (SMA) and 18 sera from primary biliary cirrhosis (PBC) patients with high levels of anti-M2 antibodies were examined for the presence of high antibody levels against actin, tubulin, myosin, tropomyosin, troponin, vimentin and desmin. Our results showed that: (i) in CAH with high SMA activity, increased antibody levels were found in 51.9% of sera for actin, 31.5% for myosin, 35.2% for tubulin, 34.0% for tropomyosin, 11.3% for troponin, 22.6% for vimentin and 43.4% for desmin, compared with natural antibody levels in 21 normal sera; (ii) Similar high levels of these antibodies were found in the case of PBC; (iii) in most cases, sera simultaneously bound to several antigens of the panel; and (iv) approximately 26% of the CAH sera were found to be negative with the seven antigens examined while 22% were reacted with a cytoskeleton protein (CP) other than actin. These results indicate that current opinion associating SMA with anti-actin activity in CAH is confirmed for only 50% of cases and that although a good correlation between SMA and anti-CP antibodies can be obtained, there is still a significant percentage of SMA for which the putative antigen recognized needs to be determined.

Animals