[Hairy cell leukemia or leukemic reticuloendotheliosis. A clinical review based upon 7 cases].
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Biomedical subjects
Publications and source records attributed to J Ellegaard.
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In 15 healthy individuals the ATP-ase activity of circulating B-lymphocytes was found to be significantly higher than of T-lymphocytes. Two different methods were used for the purification of B- and T-lymphocytes and the result was independent of which one of these methods was used. The demonstration of different ATP-ase activities of unstimulated B- and T-lymphocytes corresponds well with previously published histochemical findings in lymphatic tissues examined for ATP-ase activity. It is concluded from the present study that because of overlapping values determination of the lymphocyte ATP-ase activity cannot serve as a single marker for the B- and T-cell nature of human lymphocytes, but demonstration of an unusual high ATP-ase activity in unstimulated lymphocytes will serve as additional identification of these as belonging to the B-lymphocyte population.
Immunostimulation with levamisole was attempted in eight patients with juvenile periodontitis and six reference patients with gingivitis but without loss of periodontal attachment. The following parameters were studied before and after levamisole treatment: gingival status, the concentration of serum immunoglobulins and complement, T and B lymphocyte ratio, leukocyte migration inhibition and lymphocyte transformation responses by dental plaque bacteria, PPD or PHA, and lymphocyte ATP-ase activity. In juvenile periodontitis cell-mediated immunity to dental plaque antigens seemed to be impaired, but the response was not restored by treatment with levamisole. There was no evidence of a broader suppression of cell-mediated immunity in juvenile periodontitis and there was no significant clinical effect of levamisole treatment. It is suggested that the apparent suppression of in vitro cell-mediated immunity to dental plaque bacteria in juvenile periodontitis is a secondary change, caused by a long-standing chronic infection.
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Morphological alterations in the spleen, liver, lymph nodes, thymus, bone marrow and blood were studied in DBA and Balb/C mice treated with Corynebacterium parvum. The spleen lymph nodes and liver increased in size and weight, whereas thymus showed decrease in weight compared to the control group. A marked, early proliferation of monocytes in the bone marrow preceded infiltrations by macrophages in lymph nodes, spleen and liver. These infiltrations were closely related to the vascular structures, became nodular and decreased around day 12 after the injection. A rapid increase in the number of monocytes and transformed lymphocytes of the peripheral blood were noted almost immediately after the administration of the vaccine. No relationship between the degree and duration of the histological changes, strain of mice, and number of inoculations was found. It is suggested that the increase in size and weight of the lymphoid organs and the liver is primarily caused by invasion of macrophages, perhaps secondary to a preceding proliferation of monocytes in the bone marrow.
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Transfer factor therapy was applied in three patients with severe atopic dermatitis and given at regular intervals for 1 1/2 years. Clinically, slight improvements were seen, attacks of impetigo ceased and admissions to hospital were not necessary. However, IgE concentrations in serum remained constantly high in all cases and the absolute number of T and B lymphocytes was continuously subnormal despite treatment. The in vitro cellular reactivity to PPD as assayed by a leucocyte migration test was not significantly altered in the patients, although a slight increase was found early on in the therapy. Finally, a serum factor inhibiting leucocyte migration and appearing simultaneously with attacks of impetigo disappeared during treatment. In conclusion, no convincing effect of transfer factor therapy was encountered in immune parameters and no major alterations were found in the status of the patients' atopic dermatitis.
In a number of experiments it was demonstrated that in the E-rosette assay for human T-lymphocytes using sheep red blood cells, the ATP-ase activity of the lymphocytes increased in proportion to the number of rosettes being formed. Also, after increasing the number of rosettes by treatment of the sheep red blood cells (SRBC) with neuraminidase and after diminishing the number of rosettes by treatment of the lymphocytes with antilymphocyte globulin (ALG), change in the ATP-ase activity was proportional to alterations in the number of rosettes being formed. ALG itself stimulated the lymphocyte ATP-ase activity, possibly through activation of the same receptor sites as used by SRBC.
Lymphocytes from twenty-five patients with atopic dermatitis were investigated for their in vitro reactivity to stimulation with tuberculin (PPD), lipopolysaccharide (LPS), phytohaemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM). The response to a low dose of Con A was increased, and the reactivity in unstimulated cultures tended to be lower than similar cultures from the control group. Addition of inactivated autologous plasma to the cultures had an inhibitory effect, when the plasma came from patients with high levels of IgE. The patients' in vitro reactivity to PPD in a leucocyte migration test was equal to that found in normal persons and no effect was observed after addition of autologous serum. The mean percentage of E rosette forming cells was significantly reduced in patients with high levels of IgE. The number of EAC rosette forming cells was within normal range. It is hypothesized that the observations could reflect the existence of suppressor mechanisms in patients where the immune system is strongly stimulated.
A 71-year-old woman presented with acutely developed symptoms of generalized lymphadenopathy, intermittent maculo-papular skin rash, pruritus, weight loss, hepato-splenomegaly, pleural exsudate and alternating breast swellings. The histopathological picture of biopsies from a lymph node and from the skin was diagnostic for immunoblastic lymphadenopathy, and the serum concentrations of IgG and IgA were increased. Delayed cutaneous hypersensitivity reactions to various antigens were totally extinguished and the number of T-lymphocytes in the peripheral blood was consistently very low. The number of both T- and B-lymphocytes further decreased during cytostatic treatment and the patient contracted numerous infections. During intermittent treatment with Levamisole the infectious episodes ceased, the cellular immune response was reestablished and the pathological hyperimmuneglobulinaemia suppressed. It is suggested that the primary immunological defect in this disease could be a failing cellular immunity, and that the hyperplasia and hyper-reactivity of the B-cell system are a secondary phenomenon.
In vitro parameters of cellular immune reactions were followed by 10 healthy individuals during administration of levamisole. Leucocyte migration tests, lymphocyte transformation tests and ATP-ase activity of peripheral blood lymphocytes were investigated. Levamisole did not influence resting human lymphocytes of the stimulation response of lymphocytes. The metabolic activity of lymphocytes expressed by their ATP-ase activity was not significantly changed after levamisole administration.
The ATP-ase activity was determined in lymphocytes isolated from peripheral blood in 41 patients with Hodgkin's disease and 50 healthy controls. All patients were previously treated with irradiation or cytostatic drugs and 17 patients were under maintenance therapy at the time of investigation. A significantly increased ATP-ase activity was found in lymphocytes from patients with Hodgkin's disease. The individual activities were unrelated to the clinical stage of the disease, but correlated to the histological classification of the lymphatic tissue. Significantly lower lymphocyte ATP-ase activity was found in patients under maintenance treatment with immunosuppressive drugs, especially if the patients had previously been irradiated. It is suggested that the ATP-ase activity of circulating lymphocytes is related to the immunological activity against the presence of the malignant cells in Hodgkin's disease.
Elevated lymphocyte Adenosine Tri-Phosphatase (ATP-ase) activity was found in 23 och 28 patients with cervical uterine carcinomas of various stages. Treatment with external irradiation and radium insertion was followed by a decline in the lymphocyte ATP-ase activity in 22 patients, while the activity remained unchanged in one patient. No correlation between the tumour stage and the lymphocyte ATP-ase activity was demonstrated. In 24 patients the clinical effect of the treatment was well correlated with the decline in ATP-ase activity. It is suggested that the determination of lymphocyte ATP-ase activity could be valuable in screening for cervical carcinoma and for follow-up after radical treatment.
In 13 out of 26 patients with urinary bladder carcinomas in various stages of malignancy, the ATP-ase activity of circulating lymphocytes was found significantly elevated. A decline in the ATP-ase activity was demonstrated in 14 of 17 patients re-investigated after treatment, while the activity remained unchanged in 2 and rose in 1 patient. No correlation between the clinical tumour stage and the lymphocyte ATP-ase activity was found, but the activity was closely correlated to the histological grade of malignancy. In 11 of the 17 patients the clinical effect of the treatment was closely correlated to a decline in ATP-ase activity. Determination of lymphocyte ATP-ase activity is suggested as an additional and simple help in the diagnosis of bladder carcinoma and in the follow-up control after treatment of patients with this disease.
Transfer factor (TF) was given to intensify the cell-mediated immune reactions in an atopic patient with generalized vaccinia. The patient showed marked reactivity of peripheral blood lymphocytes to stimulation with phytohaemagglutinin and pokeweed mitogen, but also in nonstimulated cultures. However, later tests with mitogen stimulation of lymphocytes indicated a defective cellular defence mechanism. The addition of autologous plasma to lymphocyte cultures depressed the reactivity of PHA-stimulation considerably. Initially, the patient also showed a normal T-lymphocyte count in peripheral blood, but six months after her vaccinia, extremely high serum IgE levels and a decreased percentage of T-lymphocytes was observed. Although an evaluation of the clinical effect of transfer factor injection is difficult, it should be noted that the patient's temperature immediately fell to normal, and her general health improved following treatment.
The role of T- and B-lymphocytes and serum IgE was studied in 22 patients with mycosis fungoides. The distribution of B-cells in peripheral blood was normal, while the mean percentage of T-cells was significantly lower than in 14 healthy controls. Four patients with mycosis fungoides in stages I to IV had a highly elevated serum IgE, while serum IgE in remaining patients was slightly elevated, normal, or subnormal. The mean serum IgE level was not significantly elevated. Our results tend to show that a reduced ability to react with cellular immunity may be an important factor in mycosis fungoides. This may have therapeutic aspects.
Increased mitochondrial ATP-ase activity was found in circulating lymphocytes from 5 out of 8 patients with carcinoma of the oral cavity or oropharynx and from 5 out of 10 patients with carcinoma of the larynx. In a majority of these cases changes in the ATP-ase activity after treatment paralled to the clinical result of treatment. It is suggested that determination of ATP-ase activity of circulating lymphocytes is of diagnostic value in patients with oral, oropharyngeal and laryngeal carcinomas as well as prognostic value after treatment of the patients.