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Biomedical subjects

M Theobald

Publications and source records attributed to M Theobald.

10 recordsLinked to original sources

Allorecognition and graft-versus-host disease.

The development of graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (BMT) is mediated by alloreactive donor T lymphocytes infused with the bone marrow (BM) inoculum. Over the past few years, knowledge about the molecular basis of antigen (Ag) recognition, tolerance induction and activation of alloreactive T lymphocytes has increased remarkably. Recent observations also challenged the traditional view of the role and significance of various alloreactive T cell subsets and their particular effector cell functions involved in the generation of GVHD. New information which emerged from these studies has a major impact in understanding the immunobiology of GVHD. It also has important practical consequences, such as the successful prediction of GVHD before allogeneic BMT by the measurement of recipient-specific alloreactivity. The current concepts of the molecular basis of allorecognition, tolerance induction and T cell activation could be important in developing strategies to avoid GVHD while preserving a graft-versus-leukemia response.

Animals

Successful therapy with donor buffy coat transfusions in patients with relapsed chronic myeloid leukemia after bone marrow transplantation is associated with high frequencies of host-reactive interleukin 2-secreting T helper cells.

Six patients treated for relapsed chronic myeloid leukaemia after allogeneic bone marrow transplantation with donor buffy coat transfusions were investigated. In the 5 patients who achieved molecular remission high frequencies of host-reactive interleukin 2-secreting T helper cell precursors (Th-p) were detectable by limiting dilution analysis. In four of the patients the presence of Th-p was associated with a clinical syndrome similar to transfusion GVHD suggesting a T cell response to minor histocompatibility antigens (minor H) expressed by both malignant haemopoiesis and host tissues. In the fifth responding patient no GVHD or bone marrow hypoplasia was observed. The nature of the antigens recognised by these donor Th-p remains unknown. No host-reactive Th-p were detectable in the non-responder and host-reactive cytotoxic T cell precursors (CTL-p) were not consistently detectable in the responding patients.

Adult

Presence of host-specific interleukin 2-secreting T helper cell precursors correlates closely with active primary and secondary chronic graft-versus-host disease.

We investigated the role of interleukin 2 (IL-2)-secreting T helper cell precursors (Th-p) in primary and secondary chronic graft-versus-host disease (GVHD). Twelve patients with chronic GVHD (8 primary and 4 secondary chronic GVHD) and 8 patients without chronic GVHD were investigated using a sensitive limiting dilution assay. High frequencies of host-reactive interleukin 2-secreting T helper cell precursors were detectable in all patients with chronic GVHD irrespective of the mode of onset. Host-reactive IL-2-secreting T helper cell precursors disappeared in patients whose GVHD resolved. Host-reactive IL-2-secreting T helper cell precursors were never found in the control patients without chronic GVHD. Host-reactive cytotoxic T cell precursors (CTL-p) were not consistently detectable in patients with chronic GVHD and were occasionally found in patients without GVHD. No autoreactive IL-2-secreting T helper cell precursors or cytotoxic T cell precursors were detectable in either group. The absence of autoreactive IL-2-secreting T helper cell precursors in patients was confirmed by clonal specificity analysis in 4 patients. These data suggest a role for host-reactive IL-2-secreting T helper cell precursors in the initiation and maintenance of chronic GVHD as previously shown for acute GVHD.

Adolescent

Host-specific interleukin-2-secreting donor T-cell precursors as predictors of acute graft-versus-host disease in bone marrow transplantation between HLA-identical siblings.

BACKGROUND: Acute graft-versus-host disease (GVHD) is a serious complication of allogeneic bone marrow transplantation from an HLA-identical sibling. There is no practical test before transplantation that gives sufficient information to predict the degree of allogeneic reactivity between HLA-identical siblings. METHODS: We determined the frequency with which host-specific interleukin-2-secreting donor T-cell precursors occurred in 16 consecutive pairs of HLA-identical siblings before they underwent marrow grafting. The results were correlated with the development of acute GVHD after transplantation. RESULTS: High frequencies of host-specific T-cell precursors (> or = 1 per 100,000) were detectable before transplantation in eight donors whose siblings later had severe (grade II or III) acute GVHD. Among the donors to eight patients with mild (grade 0 or 1) acute GVHD, low frequencies (< 1 per 100,000) were found. CONCLUSIONS: Analysis of the frequency of such cells before transplantation may be a useful predictor of severe acute GVHD in allogeneic bone marrow transplantation between HLA-identical siblings. It is possible that the patients at risk for serious acute GVHD after marrow grafting may benefit from some alternative form of immunosuppressive therapy.

Acute Disease

Comparative analysis of in vivo T cell depletion with radiotherapy, combination chemotherapy, and the monoclonal antibody Campath-1G, using limiting dilution methodology.

We have investigated the efficacy of standard conditioning regimens for bone marrow transplantation in depleting functional T lymphocytes in vivo and have compared it with the efficacy of the monoclonal antibody Campath-1G. Using limiting dilution techniques the frequencies of proliferating T cell precursors (PTL), cytotoxic T cell precursors (CTL-p), helper T cell precursors (HTL-p), and mature helper T cells (HTL) were determined before and after treatment. Both total body irradiation and combination chemotherapy with busulfan/cyclophosphamide were highly efficient at depleting PTL, CTL-p, and HTL-p (0-4 days) but spared HTL to a variable extent (0-99.5%). In the majority of patients treated with Campath-1G a similar degree of PTL, CTL-p, and HTL-p depletion was achieved, and, in addition, HTL were effectively removed (greater than 95.5%). These results suggest that Campath-1G could be successfully employed in depleting radio- and chemotherapy-resistant host T lymphocytes prior to T-depleted bone marrow transplantation.

Antibodies, Monoclonal

Frequency, specificity, and phenotype of clonally growing human alloreactive interleukin-2-secreting helper T lymphocyte precursors.

Limiting dilution cultures were performed to detect allospecific IL-2-secreting helper T lymphocyte precursors (HTL-p) among human peripheral blood mononuclear cells, E-rosette-purified (E+) and cell-sorter-separated CD4+/8- as well as CD4-/8+ T cell subsets. Split-well cultures were set up prior to restimulation to assess the antigen specificity of the response. Frequencies of alloreactive IL-2-secreting HTL-p in fully HLA-mismatched responder/stimulator cell combinations ranged from 1/200 to 1/900 (among PBMNC), from 1/50 to 1/301 (among E+ T cells), from 1/36 to 1/220 (among CD4+ T cells), and from 1/38 to 1/450 (among CD8+ T cells). Allospecificity of effector T cells was demonstrated by a strong decline of frequencies obtained after restimulation against unrelated third-party antigens. In clonal segregation analysis, the vast majority of IL-2-secreting progeny (80-90%) were exclusively specific for the original stimulating alloantigen. Finally, the allele specificity of human alloreactive HTL-p was revealed by comparing frequency estimates obtained after restimulation with partially identical stimulator/third-party antigen combinations.

Alleles

Assessment of human allospecific IL-2-secreting helper T lymphocytes in limiting dilution cultures using restimulation and split well analysis.

A limiting dilution (LD) culture was established which allows the detection of allospecific interleukin-2 (IL-2)-secreting helper T lymphocyte precursors (HTL-p) among human peripheral blood mononuclear cells (PBMNC). HTL-p stimulated with allogeneic Epstein-Barr virus-transformed B lymphoblastoid cell lines (EBV-LCL) in the presence of exogenous recombinant IL-2 (r-IL-2) clonally developed into IL-2 secreting effector cells when restimulated against the original stimulating alloantigen. Split well cultures were performed prior to restimulation to assess the antigen specificity of the response. Frequencies of alloreactive IL-2-secreting HTL-p ranged from 1/100 to 1/800. Allospecificity of effector T cells was determined by a strong decline of frequencies obtained after restimulation against third-party antigens. In (clonal) segregation analyses the vast majority of IL-2-secreting progenies (80%) were specific for the original stimulating alloantigen. Allele specificity was disclosed by using class II MHC related third-party restimulator cells. By comparison with LD short-term cultures it became evident that exogenous r-IL-2 in the initial culture period was required to reveal optimal precursor frequencies of IL-2-producing T cells. Furthermore, successful antigenic restimulation was strictly confined to these culture conditions.

Antigens, Differentiation, T-Lymphocyte

Human chorionic gonadotropin levels in various compartments in disturbed early pregnancy.

The hCG level in the uterine cavity was higher than in peripheral blood in a case of choriocarcinoma and in patients with spontaneous expulsion of the conceptus. In two patients with missed abortion, the hCG concentrations in peripheral blood and in serum from the uterine cavity did not differ. In contrast, the hCG concentrations in PF in these patients were lower than in peripheral blood. The measurement of hCG in these compartments may provide evidence concerning the location of the trophoblast.

Biomarkers, Tumor

A case for autonomy.

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Nursing