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Biomedical subjects

I J Forbes

Publications and source records attributed to I J Forbes.

At least 73 records · Page 4Linked to original sources

Studies of the human lymphocyte-mouse erythrocyte bond.

A subpopulation of human B lymphocytes forms rosettes with mouse erythrocytes through a glycoprotein-dependent bond. Further studies of this bond show that the lymphocyte receptor is not immunoglobulin, although the binding of antisera or staphylococci to surface immunoglobulin inhibits the formation of mouse rosettes. Rosette formation could not be induced in thymocytes by enzymatic modification of the surface, or in T cells by lectin-induced transformation. The capacity to bind mouse erythrocytes was lost after incubation in a serum-free medium of lymphcytes from most patients with chronic lymphocytic leukaemia (CLL) and normal subjects. This loss could be prevented by the addition of a variety of sera and glycoprotein-containing substances to the medium, including fetuin. Conditions conductive to the subsequent restoration of rosetting capacity could not be found, indicating that the loss of this capacity was not due to the shedding of a cell-surface receptor which could be re-synthesized. It is suggested that the functional receptors in B1 lymphocytes are held in aggregates by cross-linking peripheral glycoprotein molecules; disaggregation and consequent loss of the capacity to form rosettes with mouse erythrocytes occurs during incubation in serum-free media, and during maturation of lymphocytes to the B2 stage.

Animals↗

Maturation in B lymphocytic leukaemia.

Surface markers were studied serially in two cases presenting as acute B cell lymphocytic leukaemia. The leukaemic lymphocytes in both cases had the mouse erythrocyte receptor (MER) and surface immunoglobulin (SIg) with lambda light chain. Changes interpreted as an increase in immunological differentiation were observed in both, during the course of the disease and its treatment. These changes were loss of MER, increase in density of SIg, and the acquisition of SIgA. Selection of therapy to influence differentiation may ultimately afford better control of the lymphocytic leukaemias.

Adult↗

Erythroderma, an unusual manifestation of B cell lymphoma.

A case is described in which the initial manifestation of a malignant lymphoma was an erythematous skin rash over the face, scalp and trunk. Immunological surface marker analysis showed the malignant cells to be of B lymphocyte origin with a homogeneous secretion of IgM-K. Repeated skin and lymph node biopsies and finally post mortem documented the progression of the lymphoma from that of a mixed lymphocytic-histiocytic type with a nodular pattern of growth to a diffuse histiocytic lymphoma with frequently bizarre cells. The theory of ecotaxis or homing of lymphocytes to the skin and other non-lymphoid organs of the body is discussed in an attempt to explain the occurrence of cutaneous involvement as a primary manifestation of lymphoma.

Adult↗

B cell leukaemia distinguished from chronic lymphocytic leukaemia by surface markers.

Four cases of lymphocytic leukaemia were distinguished from CLL by surface marker analysis. CLL cells have relatively little SIg and have the mouse erythrocyte receptor. Cells in these cases had denser Slg and lacked the mouse erythrocyte receptor. The group presented a fairly uniform picture with onset in sixth or seventh decade, very high lymphocyte counts, splenomegaly (gross in three), heavy infiltration of marrow, relative resistance to chemotherapy and response to splenectomy. The lymphocytes were somewhat larger than those usually found in CLL and histological examination showed a quasi-nodular pattern in lymph nodes with diffuse infiltration of the spleen. Difficulties of classification are discussed. The addition of surface marker analysis to clinical and morphological parameters allows these cases of B-lymphocytic leukaemia (mouse erythrocyte-negative B leukaemia) to be distinguished clearly from chronic lymphocytic leukaemia. The mouse erythrocyte receptor is particularly useful in making this distinction.

Aged↗

Immunologic abnormalities in an animal model of chronic hypoplastic marrow failure induced by busulfan.

The immunology of chronic hypoplastic marrow failure (CHMF, aplastic anemia) was studied in an experimental murine model of the disease induced by busulfan. B lymphocytes of peripheral blood, spleen, and bone marrow were reduced to 30%-40% and T lymphocytes of thymus, spleen, marrow, and blood were decreased to 20%-70% of control values. IgG and IgM antibody titer to sheep red blood cells were reduced to one-third of control levels, and splenic IgG, but not IgM, plaque-forming cells were fewer on day 7 after antigen stimulation. The proliferative responses to phytohemagglutinin or concanavalin A were reduced in cultures of peripheral blood lymphocytes, splenic lymphocytes, and thymocytes, and cutaneous delayed-type hypersensitivity induced by dinitrofluorobenze was not detected in mice with CHMF. The results demonstrate disturbance of a variety of cellular and humoral functions and suggest that the disturbance was due to quantitative and possibly qualitative abnormalities of the cell types subserving these functions. The results suggest that residual cell injury, the lesion underlying experimental CHMF, is not confined to the myeloid stem cell but also involved cells of the lymphoid series.

Anemia, Aplastic↗

Changes in lymphocyte function during pregnancy.

A gradual increase in spontaneous lymphocyte DNA synthesis was demonstrated in each trimester of pregnancy. Autoradiographic studies indicated that lymphocytes were primarily responsible for this activity. PHA-induced lymphocyte transformation in both fetal calf serum and autologous serum was significantly reduced in the second and third trimesters of pregnancy. Spontaneous lymphocyte DNA synthesis was significantly reduced in patients with mild pre-eclampsia. However, no significant differences were seen in patients with severe pre-eclampsia in the third trimester of pregnancy compared with the normal control subjects. No evidence was adduced to implicate inhibitory humoral factors affecting the peripheral blood lymphocytes in pregnany patients in experiments in which washed lymphocytes were cultured in medium containing heterologous serum. In vitro experiments demonstrated that cortisol, progesterone and HPL caused a significant reduction in lymphocyte DNA synthesis, and HGH and HCG had a variable effect. However, only cortisol was regularly inhibitory at physiological concentrations. The progesterone effect was dose-related, producing 90 per cent inhibition of activity at a concentration of 10 mug/ml. No synergism could be shown between HPL and progesterone on lymphocyte transformation. The increase in activity of circulating immunoreactive cells during pregnancy and its depression with the onset of pre-eclampsia is discussed.

Chorionic Gonadotropin↗

A subpopulation of human B lymphocytes that rosette with mouse erythrocytes.

A proportion of human peripheral blood lymphocytes form rosettes with mouse erythrocytes (M-RFC). It is confirmed that the proportion of such rosette-forming cells is high in chronic lymphocytic leukaemia (CLL). Analysis of normal lymphocyte populations revealed that M-RFC belong to the B-lymphocyte subclass exclusively. Analysis of their surface markers showed: (a) complement receptors in 50% as compared to 71% of the total B-cell population; (b) a distribution of surface immunoglobulins G, A, M and E typical of the lymphocyte sources; (c) lack of sheep erythrocyte receptor. No differences in the ratio of M-RFC to total B cells was found between lymphocyte population from tonsils, bone marrow and peripheral blood although a significantly higher ratio was seen in cord blood and in chronic lymphocytic leukaemia. Investigation of the properties of mouse erythrocyte rosette formation revealed the following: (a) incubation of lymphocyte mouse erythrocyte mixtures at 37degreesC before centrifugation inhibited rosette formation when CLL lymphocytes were used; (b) treatment of mouse erythrocytes with neuraminidase or trypsin increased their adhesiveness to lymphocytes; (c) treatment of lymphocytes with neuraminidase promoted M-rosette formation but trypsin treatment had an inhibitory effect; (d) cyanide and fluoride at concentrations which strongly inhibited E-rosette formation had no inhibitory effect on M rosettes; (e) M-rosette formation was inhibited by anti-immunoglobulin serum but not by anti-lymphocyte serum; and (f) M-rosette formation was also inhibited by the presence of staphylococci. E-rosette formation was unaffected. The nature of the bond in mouse rosettes is discussed in the light of these findings. The evidence indicates that the lymphocyte receptor may be a part of an immunoglobulin molecule.

Animals↗

Increased resistance to helminth infestation in an atopic population.

Faecal egg counts were compared in three groups in an area of universal hookworm infestation. Egg counts were lower in asthmatic and atopic non-asthmatic subjects than in a non-atopic population. The atopic population was defined by skin testing for immediate hypersensitivity responses. It is suggested that the atopic state may confer increased resistance to helminth infestation.

Adolescent↗

Humoral and cellular immunity in asthma.

Parameters of humoral and cellular immunity have been measured in 91 asthmatic patients. Mean serum levels of IgG and IgE were raised. IgG levels were higher in those with a family history of asthma. IgE levels were higher in those with a past history of atopic eczema, but intrinsic and extrinsic asthma could not be differentiated on the basis of IgE levels. Thirteen of 74 patients failed to respond to tetanus immunization, while only 1 failed to respond to Salmonella typhi H antigen. Tetanus nonresponders had a raised mean serum IgA level, reduced spontaneous lymphocyte tritiated thymidine uptake, and reduced thymidine uptake in fetal calf serum. Eight of 87 patients failed to mount delayed hypersensitivity reactions to a battery of five intradermal antigens. The tritiated thymidine uptake of lymphocytes stimulated with phytohemagglutinin was normal in autologous serum, but reduced in fetal calf serum. The data support the hypothesis that asthma may be associated with immunodeficiency states.

Adolescent↗

Humoral and cellular immunity in atopic eczema.

Parameters of humoral and cellular immunity were measured in thirty-five patients with atopic eczema. The mean serum IgE level was raised but levels of the other major immunoglobulin classes were normal. Ten per cent of patients failed to respond to tetanus immunization. All patients responded to S. typhi H antigen. Fourteen per cent of patients failed to mount delayed hypersensitivity reactions to a battery of three intradermal antigens. The phytohaemagglutinin-stimulated uptake of 3H thymidine by lymphocytes was normal in the presence of autologous or of fetal calf serum, as was the spontaneous lymphocyte uptake. T and B lymphocyte numbers in the peripheral blood were normal. These results are similar to those found in asthmatic patients and support the hypothesis that, in some patients, atopic eczema is associated with an immunodeficiency state.

Adolescent↗

Phenytoin sensitivity in a case of phenytoin-associated Hodgkin's disease.

The case of a patient who developed Hodgkin's disease three years after commencement of therapy with phenytoin is presented. Humoral and cellular immunological capacity were significantly depressed. Phenytoin caused a striking increase in DNA synthesis when lymphocytes were culture in the presence of this drug, in contrast to significant inhibition in the lymphocytes of control subjects. These findings are consistent with the hypothesis that both chronic antigenic stimulation and immunosuppression by phenytoin and involved in the induction of lymphoma.

Adult↗

Serum IgE levels in paraproteinaemia.

Serum IgE levels were measured by radioimmunoassay with a 'Phadesbas test kit' in 45 patients with multiple myeloma or macroglobulinaemia. As with other immunoglobulin classes, low serum levels of IgE were found.

Bence Jones Protein↗

Impaired humoral immunity in PNG Highlanders.

Immunological function was investigated in 42 adult Papua New Guinea villagers and 38 adult males who had been inmates of the Goroka prison for more than three months. Serum IgG, IgA, IgM and IgE levels were all significantly elevated in both Papua New Guinea groups when compared to Australians. Antibody responses to tetanus toxoid immunization were greatly impaired in both Papua New Guinea (PNG) groups. The impairment was greater in the villagers. Antibody responses to immunization with typhoid vaccine were also impaired in both P.N.G. groups compared with Australians. Some evidence was obtained to indicate that unresponsiveness was associated with lower serum albumin levels, suggesting a relationship to protein deprivation. Antibody response after first immunization was predominantly in the IgM class for both tetanus and typhoid vaccines, with conversion to the IgG class on re-immunization. This indicates that most P.N.G. highlanders have not been exposed to these antigens previously. The prevalence of autoantibodies (mitochondrial, gastric parietal cell and antinuclear) was similar to that of a normal Australian population. The prevalence of smooth muscle antibodies, although higher, was probably not remarkable. Australia antigen was found in 9%, compared with less than half of 1% in the Australian population. Cellular immune function, as measured by delayed hypersensitivity reactions, was not impaired. The implications of these findings for mass immunization programmes are discussed.

Adult↗

Immune reactions in acute viral hepatitis.

Serial studies of PHA-induced lymphocyte transformation, serum autoantibodies, immunoglobulins and complement were performed in seventeen patients with hepatitis A and nine patients with hepatitis B. In both types of hepatitis PHA-induced transformation was markedly impaired during the 1st week after the onset of jaundice and there was less marked but prolonged impairment for a further period of 6-10 weeks. A group of eleven subjects with a previous history of hepatitis had values which were similar to those of healthy persons. Serum from patients with hepatitis A and hepatitis B contains an inhibitor of lymphocyte response to PHA. The inhibitor depresses the function of both patients' and normal lymphocytes and is only detectable during the acute phase of the illness. Washing lymphocytes free from autologous serum did not restore the PHA response to normal but the markedly impaired response present during the first 2 weeks of the illness was improved. A serum factor or factors may therefore be responsible for at least part of the impaired response of lymphocytes to PHA during the acute phase of hepatitis but does not appear to account for the more prolonged impairment of the PHA response. The protracted lymphocyte defect is possibly induced by hepatitis virus. The incidence of autoantibodies and the changes in immunoglobulin levels were similar to those reported by other workers.

Antibody Formation↗

Depression of immune competence by phenytoin and carbamazepine. Studies in vivo and in vitro.

Depression of one or more parameters of cellular and/or humoral immune responses was found in 60% of general hospital patients treated with phenytoin and 47% of patients treated with carbamazepine. Phenytoin-treated patients failed to manifest delayed hypersensitivity (DHS) reactions to common antigens, and to make antibody to Salmonella typhi and tetanus toxoid. Serum levels of IgA and IgM, DNA synthesis in circulating leucocytes, and phytohaemagglutinin (PHA) induced deoxyribonucleic acid synthesis were also low. Depression of IgA, DHS reactivity and antibody responsiveness to S. typhi were shown to develop after the commencement of phenytoin therapy in a study of eleven patients. The presence of immunological defects was independent of the dosage of drug, its serum concentration, the duration of therapy and the sex of the subject. Studies in vitro provided evidence that immunosuppression was the result of a direct effect of phenytoin on the metabolism of lymphoid cells. Carbamazepine was shown to have a similar but less potent direct effect. Pharmacological concentrations of phenytoin caused a significant depression of DNA synthesis in PHA-stimulated and non-stimulated blood cell cultures in vitro. High concentrations in addition caused depression of cell counts, lymphocyte blastogenesis, ribonucleic acid and protein synthesis. Phenytoin was not cytocidal at concentrations of up to 125 mug/ml. Depression of DNA synthesis by phenytoin was maximal when phenytoin was added within 4-8 hr of the addition of PHA. PHA-induced DNA synthesis was not significantly affected by pre-incubation with phenytoin. In vivo, the presence of immunological defects was not related to phenytoin-induced folic acid deficiency. High concentrations of carbamazepine, but not phenobarbitone or diazepam caused a significant depression of PHA-stimulated DNA synthesis in blood cell cultures. The data show that immunosuppression is a common side-effect of phenytoin therapy, and that lymphoma is rare. They suggest that in the presence of phenytoin-induced immunosuppression another factor, or factors are required to induce the formation of lymphoma.

Adolescent↗