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Results for “Monitoring, Immunologic”

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PubMed1990

Lymphocyte spontaneous blastogenesis as a monitor of renal allograft rejection.

Spontaneous blastogenesis (SB) of peripheral blood lymphocytes was studied by determining protein synthesis using 3H-leucine to establish an immunological monitoring method after renal transplantation. In acute rejection, the SB level was twice as high as those in ATN and in the quiescent state. A rise in SB level comparable to that in rejection was observed in patients with infection. The SB level was continuously determined postoperatively in eight patients undergoing renal transplantation. Of the eight patients, three showed acute rejection four times in total. Elevation of SB level was simultaneously observed at each rejection episode. Rejection was not noted in any of the other five patients. False positive elevation of SB level was observed five times. The cause of the false positive changes was unknown in three cases and due to infection in two cases. Elevation of SB level is considered to be nonspecific and represents total lymphocyte activity. Due to its simple procedure and quick results, this method should provide a useful clinical parameter of rejection.

Graft Rejection↗

PubMed1980

Automation of the leukocyte adherence inhibition assay. Counting live mononuclear cells with an automated light microscope system.

Adaptation of an automated light microscope system to the leukocyte adherence inhibition assay provides a rapid automated assay of cell mediated immunity. Comparison between the numbers of live mononuclear cells counted by eye and by machine yields no statistical differences in the per cent adherence or in the standard errors when performing either 10 or 20 replicate counts per antigen-cell mixture. Using the cell counter in a semi-automated mode, the counting is performed 10 times as fast in comparison to the manual method. A semi-automated system is described. The procedure requires from 4-6 X 10(5) mononuclear cells and from 2-3 micrograms crude KCl extract using a standard hemocytometer. The value of the technique lies in its availability as a rapid assay for both research applications and immunologic monitoring in the clinical laboratory.

Humans↗

PubMed1998

Monitoring of acute allograft rejection by cytological, immunocytochemical, and immunohistochemical studies following rat small-bowel transplantation.

We investigated the role of graft luminal fluid cytology for immunological monitoring of rat small-bowel allograft recipients. Allogeneic transplantation from WKAM (RT1u) to Lewis recipients and syngeneic transplantation using Lewis (RT11) rats were carried out. Twenty centimeters of the proximal jejunum was transplanted as a Thiry-Vella loop. The luminal fluid on days 0, 3, and 6 was examined cytologically using Papanicolaou, periodic acid-Schiff, and Giemsa staining, and immunocytochemically with monoclonal antibodies for macrophages (ED1 and ED2). Full thickness biopsies of graft tissue were evaluated by both immunofluorescence (ED1 and ED2) and by standard histological methods. The cytological examination on day 6 revealed an increase in the number of enterocytes, lymphocytes, and neutrophils, the presence of bacteria, and the depletion of goblet cells in the allografts. Histologically, significant morphological changes of acute rejection were first seen on day 6. Immunofluorescence predicted the acute rejection of the allografts earlier than a histological examination by showing an increase in the number of ED1- and Ed2-positive cells on day 3. Graft luminal fluid cytology and immunofluorescence analysis of ED1 and ED2 cells could thus be used to recognize early acute allograft rejection following small-bowel transplantation.

Animals↗

PubMed2006

Would monitoring CMV immune responses allow improved control of CMV in stem cell transplant patients.

BACKGROUND: Virological monitoring with sensitive assays and subsequent introduction of antiviral preemptive therapy has become a routine strategy in the management of stem cell transplant recipients. Several techniques have been used and each has advantages and disadvantages. OBJECTIVE: The objective of this review is to discuss the drawbacks of virological monitoring alone for the management of CMV in stem cell transplant recipients. STUDY DESIGN: Publications on the success of CMV viral load monitoring were reviewed with special emphasis on the timing of CMV disease after stem cell transplantation. RESULTS AND CONCLUSIONS: During recent years CMV disease has more frequently been documented later after transplantation and has been associated with the absence of CMV-specific immune responses. Repeated antiviral therapy carries the risk of toxicity and the development of resistance. Hence virological monitoring might be insufficient for optimal management of these patients. This realization has spurred interest in evaluating assays for immunological monitoring as a means of improving control of potential CMV disease after transplantation.

Cytomegalovirus↗

PubMed1991

Comparison of acute rejection in sensitized ("domino") and unsensitized donor hearts following heterotopic transplantation.

Right cervical heart transplantation was performed in 18 mongrel dogs. Three experimental groups (6 dogs in each) were set up. Group I and II dogs received unsensitized donor hearts, while Group III dogs received the potentially sensitized native hearts of Group I and II dogs, following final rejection episodes in those animals. We call the transplantation of a native heart out of a previous recipient "domino" transplantation. Immunosuppression consisted of standard triple-drug therapy in all dogs. Groups II and III received, additionally, high-dose steroids during acute rejection episodes. The donor hearts were assessed daily via transmural biventricular biopsy (graded according to Billingham's criteria), and these results were compared with results of daily cytoimmunologic monitoring (n=259 for activation-index), used as a noninvasive method. Supplementally, antimyosin scintigraphy (n=25, heart-to-lung ratio) was employed for rejection diagnosis. The rejection type was determined by calculating T-cell/B-cell ratios with the aid of fluorescein-conjugated monoclonal antibodies. The invasive data consisted of 587 transmyocardial biopsy results, which were used to establish the rejection kinetics. In the domino grafts of Group III, acute rejection had an earlier onset (an average of 3.2 days) and was permanent, despite repeated cortisonepulse therapy. In contrast, acute rejection followed a biphasic course in Group II (average rejection-free interval, 6.8 days) and was non-uniform in Group I (onset after an average of 5.7 days). Cytoimmunologic monitoring corresponded significantly (p < 0.001) with daily histologic findings in Groups I and II, but not with those in Group III (domino grafts). The T-cell/B-cell ratio increased in Groups I and II (to an average of 3.9), as would be expected during acute cellular rejection. In contrast, the T-cell/B-cell ratio decreased in Group III (to an average of 1.1). The heart-to-lung ratio, as determined by antimyosin scintigraphy, accurately revealed the various stages of acute rejection in all groups (p < 0.001). We conclude that the native heart appears to become sensitized during acute rejection episodes of a heterotopically transplanted heart. Cytoimmunologic monitoring and calculation of T-cell/B-cell ratios support this conclusion. In addition, we conclude that cyto-immunologic monitoring and antimyosin scintigraphy are highly specific and sensitive tools for diagnosis of cellular rejection.

Journal Article↗

PubMed1992

Role of immune response in the prognosis of carcinoma of the uterine cervix: can in vitro analysis provide a better framework for more effective management?

Cancer of the uterine cervix is the single largest female malignancy in India and also remains a major problem facing oncologists in other parts of the world. While advances in radiation therapy and surgical techniques have made the treatment of cervical carcinoma impressive, limitations to successful management still remain. In fact, the 5-year survival rate, stage for stage, has not improved in the United States or world wide in the past 40 years. With an estimated half a million women developing this disease annually, this lack of improved survival poses an international unresolved health problem. Immune response has been shown to be a major factor involved in the course of the disease for this cancer. Immunologic monitoring was also shown to be of effective value in assessing the prognosis for cervical carcinoma. We studied the various immunologic abnormalities in cervical cancer, the effects of radiation therapy on immune function, prospects of an immunologic staging system, the relationship between human papillomavirus infection and the immune response, and the possibility of using in vitro immunologic assessment to provide a better framework for more effective management of cancer of the uterine cervix.

Antibody Formation↗

PubMed1991

Cutaneous myiasis. Recent advances in biology, immunology and improvements of the control measures.

The evolution of the main topics of study related to the biology, the life-cycle and the distribution of insects causing cutaneous myiasis during the last century is presented. These subjects are still of interest and a synopsis of new data concerning Hypoderma tarandi, H. diana and Prezhevalskiana silenus is reported as well as the changes of distribution of some species such as Cochliomyia hominivorax. In the second part, an over view of what has been archived on myiasis immunology is reviewed. This is based on the work conducted on Lucilia cuprina and Hypoderma. The areas of research are serological diagnosis, disease monitoring, immunological mechanisms of host protection and parasite escape. The following topic reviewed the latest developments in chemotherapy, the problems associated with this approach to control the myiasis and the part played by these chemicals in successful eradication programs. In the last topic the latest results obtained with the use of biological measures to control C. hominivorax and H. bovis and H. lineatum are reported.

Animals↗

PubMed1996

Consideration of potential immunological problems in the application of xenogenic hybrid liver support.

Hybrid liver support systems (LSS) for the use of pig liver cells are under development for extracorporeal therapy of acute liver failure and for bridging to liver transplantation. A literature overview about possible immunological side effects of a clinical application is given. The data summarised from experimental studies and those clinical applications of porcine cells reported so far, suggest that clinical use of LSS utilising porcine cells and an immuno-isolation membrane should not be compromised by severe immunological complications. The reported data suggest that clinical application should be conducted in conjunction with carefully planned immunological monitoring. Only after such applications of LSS have been carried out and further data have been evaluated, might one be able to judge the immunological consequences of broader application of hybrid liver support.

Animals↗

PubMed2002

Correlation between major histocompatibility complex class I molecules and CD8+ T lymphocytes in prostate, and quantification of CD8 and interferon-gamma mRNA in prostate tissue specimens.

OBJECTIVE: To investigate the immunology of host-tumour interaction, critical for the development of immunotherapy against cancers, by assessing the major histocompatibility complex (MHC) class I expression in both benign and malignant prostate disease, and the relationship between their expression and degree of tumour-infiltrating lymphocytes. MATERIALS AND METHODS: Direct serial analysis of gene expression in tumours is an extremely sensitive and powerful tool for monitoring immunological changes in the immunotherapy of solid tumours. Most previous monitoring protocols rely mainly on the analysis of patient's peripheral blood but in the present study the direct molecular analysis of small tissue samples was used, and its accuracy compared with that of conventional immunohistochemical analysis. Twenty-four formalin-fixed, paraffin-embedded prostate samples (11 benign and 13 carcinoma) were used for the immunohistochemical analysis of CD8+ T lymphocytes and MHC class I expression. CD8+ T lymphocytes were counted using an ocular grid and MHC class I measured using digital image-analysis software. Twenty-seven frozen prostate tissue samples (12 benign and 15 carcinoma) were used for direct gene measurements of CD8 and interferon-gamma using a quantitative real-time polymerase chain reaction. RESULTS: There were significantly fewer CD8+ T lymphocytes in prostate carcinoma nests than in benign prostate. There was a significant correlation between the number of CD8+ T lymphocytes and MHC class I expression in the prostate. There was a strong correlation between the immunohistochemical estimates of CD8+ T lymphocytes and CD8 gene by polymerase chain reaction, but no significant difference between benign prostate and prostate carcinoma tissue in gene measurements. CONCLUSION: Down-regulation of MHC class I expression by prostate cancer cells is associated with fewer CD8+ T lymphocytes and hence might be important in cancer growth. In addition, the measurement of gene expression in small tissue samples might be useful for monitoring the efficacy of treatment throughout cancer therapy.

Aged↗

PubMed1993

[Role of osteoscintigraphy in postoperative monitoring of bone graft survival].

Osteoscintigraphy was conducted in three patients in the immediate and late-term period after transplantation of allobrephobone with revascularization in the recipient zone. The method is compared with the results of immunological monitoring and histological control. Radionuclide study in combination with other methods allowed judgement of the adequacy of blood circulation in the bone allobrephotransplant and its viability. It is suggested that osteoscintigraphy of the transplant in comparison with the corresponding intact segments of the skeleton may serves as a criterion for this transplant in various postoperative periods.

Adolescent↗

PubMedDate not supplied

[Evaluation of the treatment of chronic active hepatitis (HBsAg+) with isoprinosine. II. Immunological studies].

A two-month treatment of the chronic active hepatitis (HBsAg+) with isoprinosine produced quantitative and functional T-cells populations in patients with cellular response disorders. Immunological studies have shown that such an effect of isoprinosine lasted for about 4-5 months. Repeated administration of isoprinosine for one month normalized recurrent abnormalities in the monitored immunological parameters.

Adjuvants, Immunologic↗

PubMed1981

Long-term immunological investigation of malignant intracranial gliomas.

In this study, 118 consecutive adult patients with supratentorial gliomas underwent preoperative immunological monitoring, with particular regard to B-lymphocyte and T-lymphocyte markers. Most patients were treated surgically and with radiotherapy. Three months later, they were readmitted for postoperative immunological investigation and follow-up control. A total of 76 cases could thus be completely investigated and were statistically eligible for evaluation. A pronounced failure of T-cell-mediated immunity was observed: "E-active" rosette-forming cells and mitogen-induced blastogenesis tests turned out to be markedly depressed, with a slight postoperative recovery. Spontaneous cell-mediated cytotoxicity was significantly (p less than 0.01) increased both in preoperative and postoperative findings. The main immunodiagnostic patterns (immunoglobulins assay, surface immunoglobulins, "mouse" rosettes) concerning the B-cell-dependent "pool" were found to be within normal limits.

Adult↗

PubMed1994

Immunological response to intrathecal and systemic treatment with ganglioside antibody R-24 in patients with malignant melanoma.

Murine monoclonal antibody (MAb) R-24 reacts with the ganglioside GD3 that is highly expressed on malignant melanoma. 2 patients with melanosis of the meninges received MAb R-24 intrathecally. Regressive changes in tumour cells were observed in both patients after intrathecal application of MAb R-24 (1-10 mg, 8-10 h, over 5-6 weeks). The first patient suffered from brain metastases and died a few weeks later, whereas the second achieved a complete remission with no evidence of disease 6 years after intrathecal R-24 treatment. No R-24-related neurotoxicity has occurred to date. The administration of MAb R-24 caused an increase of inflammatory cells in the cerebrospinal fluid (CSF) of both patients. Cytotoxic lymphocytes, cultured from the CSF, showed high cytolytic activity against allogeneic melanoma cells in vitro. In addition, 15 patients with advanced melanoma, in which the brain was not affected, were treated with R-24 intravenously using high dose R-24 (5 or 10 mg/m2) or low dose R-24 (1 mg/m2). No remissions were registered in the high dose group, with only 1/6 patients experiencing a mixed response. In contrast, 2/9 patients treated with low dose R-24 achieved a partial remission, one achieving a minor response and the other a mixed response. Toxicity was related to the dose of R-24 administered. Urticaria, burning and pruritus were the prominent side-effects, mostly occurring at the high dose level. Immunological monitoring during and after intravenous treatment showed no significant changes in peripheral blood lymphocytes, natural killer cell activity or antibody-dependent cellular cytotoxicity, although transient changes were observed. There was no correlation between immunological parameters and clinical response.

Adult↗

PubMed1983

[Immunologic reactions following heart transplantation and their detection].

Transplantation antigens of the major histocompatibility complex are able to stimulate the rejection of the graft. Class I and class II antigens presented by dendritic cells to the host macrophages are found on parenchymal cells (class I) or combined on all passenger leucocytes. Humoral factors like interleukin 1 produced by the macrophages activate the helper-lymphocyte subpopulation. The cytotoxic effector cells but also antibody producing B-cells receive their signal (interleukin 2) from the helper cells. Cellular and humoral mechanisms attack the vascular endothelium and the endocard first. Typical perivascular infiltrates or antibodies on the sarcolemm of myocard fibres and the intima herald the two types of rejection. The activated lymphocytes and their blast forms recirculate in various amounts in the peripheral blood, reflecting the severity of the event. Hematological evaluation including differentiation of lymphocyte subsets by monoclonal antibodies according to their phenotype seem to be a tool to recognize these mechanisms at an early stage. It is suggested that the optimal therapy and the necessary biopsy can be adjusted even more precisely using this immunological monitoring.

Antibody Formation↗

PubMedDate not supplied

Application of flow cytometry in transplantation medicine.

Immunological rejection remains a major barrier to successful organ transplantation. Consequently, immunosuppressive intervention to prevent or control the rejection process renders the transplant recipient susceptible to infectious diseases. Flow cytometry has become a useful tool for monitoring immunological responses in transplant recipients. There are three areas of clinical transplantation immunology that may benefit from this technology. First, characterizing and classifying alloreactive antibodies by flow cytometry identifies high-risk donor and recipient combinations with greater precision. Second, the ability to detect subtle changes in the cellular components of the immune system cytometrically may facilitate the differential diagnosis of rejection, infection, and iatrogenic toxicity. Finally, the ease with which flow cytometry determines the adequacy or inadequacy of immunosuppressive therapy through T cell receptor analyses serves to maximize the beneficial effects of engraftment.

Flow Cytometry↗

PubMed1999

Indirect allorecognition in solid organ transplantation.

Recipient T cell recognition of donor major histocompatibility complex (MHC) alloantigens plays a central role in both acute and chronic rejection of human organ allografts. Two different pathways of T cell recognition of donor MHC alloantigens have been described. The direct pathway involves T cell recognition of intact MHC molecules expressed by donor antigen-presenting cells (APCs). The second, or indirect pathway, operates via T helper cell recognition of peptides derived from the processing and presentation of allogeneic MHC molecules on self-APCs. At the onset of primary acute rejection, recipient CD4+ T cell responses to donor HLA-DR alloantigens are limited to a single dominant determinant present on one of the disparate alloantigens and restricted by one of the responder's HLA-DR molecules. In allograft recipients with recurring episodes of rejection, and/or at the onset of chronic rejection, recipient T cell reactivity may spread to other epitopes within the allogeneic MHC molecule, as well as to other alloantigens expressed by graft tissue. Both quantitative and qualitative alterations in T cell allopeptide reactivity are associated with increased risk of cellular and/or humoral rejection. These studies provide a basis for the design of new therapeutic strategies and for immunologic monitoring of transplant recipients.

Animals↗

PubMedDate not supplied

Clinical and immunological study of 150 cases of adenocarcinoma of the lung.

An in-depth retrospective statistical analysis was performed on 150 consecutive cases of adenocarcinoma of the lung. One-hundred and twenty-eight patients (85%) underwent pulmonary resection; 15 (10%) had an explorative thoracotomy and 7 (5%) were considered inoperable. At the time of operation, 72 patients were classified as Stage I, 18 as Stage II and 50 as Stage III. Factors analyzed included age, sex, surgical treatment, staging, immunologic monitoring and survival. When compared with other histotypes of our series a statistically significant difference was found in the male: female ratio (p less than 0.05), surgical resectability (p less than 0.05), frequency of Stage I, and immunologic status evaluated by studies of delayed hypersensitivity skin tests, lymphocyte blastogenesis, antibody dependent cellular cytotoxicity (ADCC), blocking serum factors and intrastromal peritumoral lymphocyte infiltration. There were no significant differences due to age, cigarette smoking, mediastinal lymph node involvement, except for small oat-cell carcinoma or previous pulmonary diseases. In all stages, the five-year survival rate was lower for patients affected with adenocarcinoma than for those affected with other histological types, except small oat-cell carcinoma.

Adenocarcinoma↗

PubMed1991

Monitoring of mononuclear cell subsets isolated from the coronary sinus and the right atrium in patients after heart allograft transplantation.

The rejection of a transplanted heart leads to an accumulation of mononuclear cells in the cardiac tissue and to reactions of the antigen-recognizing cells with the foreign tissue. Consequently, during rejections immunologic changes, such as the number of mononuclear cells and the patterns of mononuclear cell subpopulations, should be detectable by analysis of mononuclear cells from the coronary sinus of transplanted hearts. Seventy-nine endomyocardial biopsies were performed in 37 patients. Severity of graft rejection was classified by the Billingham scheme. Thirty-two biopsy specimens showed no rejection, 33 mild, and 14 moderate rejection. After endomyocardial biopsy the coronary sinus was catheterized under x-ray guidance. Heparinized blood samples were obtained from the coronary sinus and the right atrium, and mononuclear cell counts and subpopulation pattern were compared. Patients without rejection and patients with mild rejection showed no significant differences in the patterns of mononuclear cell subpopulation identified in right atrium blood. However, a significant (1.56-fold) increase of mononuclear cells was assessed in the CS blood (p less than 0.01). Moderate rejections showed a 4.2-fold augmentation of mononuclear cells in the coronary sinus (p less than 0.005) compared with nonrejections. In addition, the T-helper/inducer (CD4) percentage increased from 27.1% in the right atrium to 41.2% in the coronary sinus (p less than 0.005), natural killer cells (CD16) from 17.7% to 31.8% (p less than 0.005), and the interleukin 2 receptor-bearing cells from 6.6% to 15.3% (p less than 0.005). Percentage of pan-T cells (CD3), T-cytotoxic/suppressor cells (CD8), and monocytes (CD14) showed no statistically significant changes. These findings correlated with grading according to endomyocardial biopsy. Using the ratio of values obtained from cells of the coronary sinus and the right atrium rendered the coronary sinus immunologic monitoring independent of changes in the administered immunosuppressive regimen. The specificity of the described method was as good as that of endomyocardial biopsy. It is concluded that the discrimination of the patterns of mononuclear cell subpopulations from right atrium versus coronary sinus blood samples is highly sensitive and allows the correct diagnosis of graft rejection within 1 to 2 hours.

Antigens, CD↗