[The immunological monitoring of lung cancer patients and its prognostic importance].
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Chi-Square Distribution↗
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Results for “Monitoring, Immunologic”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Cytokines and immunological monitoring.
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Clinical Trials as Topic↗
Additive value of immunologic monitoring to histologic grading of heart allograft biopsy specimens: implications for therapy.
BACKGROUND: Currently the sole method available for diagnosis of heart allograft rejection is endomyocardial biopsy. Although this procedure offers important criteria for treatment, it cannot always discriminate between mild episodes of rejection which might be self-limiting and forms which may progress. In an effort to monitor rejection, we have implemented a cellular monitoring strategy aimed at identifying episodes of rejection in biopsy specimens which may evolve into higher grades of rejection. The lymphocyte growth assay is based on the capacity of interleukin-2 receptor-positive T cells to expand in the presence of interleukin-2 and antigen provided by the biopsy fragment. In this study we investigated whether a positive lymphocyte growth assay correlated with and was predictive of subsequent histologic allograft rejection and the development of anti-human leukocyte antigen antibodies. METHODS: Lymphocyte growth assay was performed on 437 biopsy specimens from 76 patients. Patients with mild allograft rejection defined as grade 2 rejection were randomized to treatment according to the results of the lymphocyte growth assay. Anti-human leukocyte antigen antibodies was also measured monthly. Cells grown from the biopsy specimens were tested against the donor cells and allopeptides derived from the donor human leukocyte antigen-DR. RESULTS: A highly significant correlation was observed between the histologic grade of rejection and growth of graft infiltrating cells (p < 0.0001). Lymphocyte growth occurred in 10% of grade 0 versus 60% of grade 3A biopsy specimens. Only 4% of histologically negative cases with negative lymphocyte growth assay progressed to rejection in the next month. In the randomized study in which treatment was based on the lymphocyte growth assay results, progressive rejection occurred in three of four cases with positive lymphocyte growth assay versus only 1 of 11 with a negative lymphocyte growth assay (p < 0.001). A highly significant correlation was found between a positive lymphocyte growth assay and subsequent development of antihuman leukocyte antigen antibodies (p < 0.0006). This finding indicates that cellular rejection evidenced by lymphocyte growth assay ultimately results in humoral antihuman leukocyte antigen antibody mediated rejection. Limiting dilution analysis showed that although the direct recognition pathway prevails in early rejection, cells participating in the indirect pathway also proliferate vigorously in the graft during rejection. CONCLUSIONS: Monitoring of rejection with lymphocyte growth assay is a simple method which provides prognostic information on the outcome of cardiac allografts. Lymphocyte growth assay correlates with histologic rejection and is predictive of future histologic rejection episodes. Lymphocyte growth assay also predicts subsequent development of antihuman leukocyte antigen antibodies and thus may provide a useful method for ascertaining the onset of chronic rejection.
Adult↗
[Immunologic monitoring and immune reconstitution in recipients of allogeneic bone marrow].
The dynamics of different peripheral blood lymphocyte subpopulations (CD3+, CD4+, CD8+, CD22+, DR+, CD25+ and CD16+) and levels of serum cytokines TNFa and IL1 beta were evaluated in 10 patients with allogeneic bone marrow transplantation (BMT). It was established that initially low levels of practically all the lymphoid subsets studied came back to normal in patients with favorable post-BMT course, while, in unfavorable post-BMT course (GVHD or relapse), the levels of said lymphoid subsets remained unchanged or even dropped. Post-BMT increase in serum TN alpha level can be of prognostic value for GVHD development whereas serum IL1 beta level does not correlate with post-BMT course.
Bone Marrow Transplantation↗
[Immunological monitoring and the epidemiological characteristics of leptospirosis in Saint Petersburg].
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Animals↗
[Clinico-immunological monitoring of the condition of patients with multiple sclerosis].
The clinico-immunologic monitoring of 50 patients suffering from genuine multiple sclerosis by means of the clinical, neurophysiological and immunologic methods and NMR tomography attests to the relationship between changes in the clinical and immunologic characteristics. The changes in the immunologic characteristics were found to anticipate the clinical ones. The authors provide evidence for the possibility and necessity of the clinico-immunologic monitoring of the patients' status for predicting the further course of the disease.
Acoustic Stimulation↗
Immunologic monitoring during and after OKT3 therapy.
Immunologic monitoring should be undertaken during and for 6 weeks after OKT3 treatment. CD3 absolute cell determinations should be obtained three times per week during therapy. A progressive increase of the absolute CD3 cell count above 10/microL is suggestive of an inadequate OKT3 serum level, most often due to an early antimurine response. Weekly posttherapy antimurine response should be determined. The presence or absence of an antimurine response can be suggestive of a successful response to a second therapeutic course of OKT3.
Adult↗
Immunological monitoring of patients with melanoma after peptide vaccination using soluble peptide/HLA-A2 dimer complexes.
To facilitate the immunologic monitoring of a peptide vaccine trial, a novel, empty dimeric HLA-A2 molecule (A2 dimer) that could be loaded with peptides was produced. The dimer comprises the extracellular domain of HLA-A2 noncovalently linked to a fusion protein consisting of human beta2-microglobulin joined to the human IgG1 Fc domain. Peptide-loaded dimer complexes were used to assess the function of peptide-specific T cells. HLA-A2 gp100 peptide dimers stimulated interferon (IFN)-gamma production by the gp100-specific TIL-1520 cell line. Gp100/A2 dimer stimulation in combination with intracellular cytokine staining was used to analyze peptide-specific T-cell responses in patients with melanoma after vaccination with the modified gp100: 209-2M peptide in adjuvant. Titration analysis of the amount of peptide-loaded dimer required to stimulate gp100-specific T cells was used to estimate the functional avidity of effector/memory CD8+ T lymphocytes. The number of peptide-specific T cells detected in the peripheral blood of vaccinated patients using this assay was comparable to the number determined by staining with fluoresceinated gp100: 209-2M HLA-A2 tetramers. IFN-gamma production by T cells was comparable after stimulation with peptide-pulsed dimers, T2 cells, or autologous dendritic cells. Peptide-loaded A2 dimers could also be used directly to stimulate T cells in the ELISPOT assay.
Animals↗
OK432-induced killer cell activity: potential method for monitoring immunological complications after renal transplantation.
BACKGROUND: Various clinical and biochemical parameters are currently in use for monitoring allograft rejection. However, the mechanism of allograft rejection is complex and it is frequently difficult to obtain a prompt and accurate diagnosis. We examined the usefulness of OK432-induced killer cell activity as an immunological monitoring system for acute renal rejection after renal transplantation. METHODS: Twenty-four renal transplant recipients, seven patients on haemodialysis, and 10 normal volunteers were enrolled in our study. The killer cell activity of peripheral blood mononuclear cells was induced by culturing these cells with the immunopotentiator, OK432, a heat and penicillin-treated lyophilized powder of the Su-strain of Streptococcus pyogenes. RESULTS: The OK432-induced killer cell activity of renal transplant recipients without acute rejection (stable recipients) was significantly lower than in normal volunteers. In four renal transplant recipients with acute rejection, the killer cell activity was significantly higher than in stable recipients. In three recipients suffering from opportunistic infections, killer cell activity was significantly suppressed compared with stable recipients. CONCLUSIONS: Our new test utilizing OK432-induced killer cell activity is potentially useful for monitoring the immunological state and complications after renal transplantation.
Adjuvants, Immunologic↗
Immunologic monitoring studies in advanced cancer patients treated with recombinant human gamma interferon (IFN-gamma 4A).
Thirty-nine patients with a variety of advanced malignancies were treated with recombinant IFN-gamma 4A (AMGen, specific activity 1 to 5 x 10(7) U/mg protein). IFN-gamma 4A was administered at a dose of 10-2,000 micrograms/m2/d. Following a 2-week rest, a maintenance phase was continued with injections 3 d/wk. Immunologic monitoring studies were performed on patients' peripheral blood cells before administration of IFN-gamma 4A, then on Days 15 and 90. Flow cytometric analysis was used to determine the absolute number of CD 3+, CD 4+, CD 8+, CD 19+, and CD 16+ cells using a panel of monoclonal antibodies. Natural killer (NK) cell function was assayed by monitoring lysis of the K562 cell line in the Cr51 release assay. Changes from baseline were observed on Days 15 and 90 in all parameters studied, although the ratio of helper to suppressor cells seemed to remain within the normal range. Whereas there were no substantial changes in CD 3+ and CD 4+ cells on Day 15, IFN-gamma 4A had an enhancing effect on CD 8+, CD 19+, and CD 16+ cells. This trend continued at Day 90 only for CD 19+ and CD 16+ cells at the higher dose levels. An increase in functional NK cell activity at Day 15 was less noted on Day 90. Comparison of intravenous (IV) to intramuscular-subcutaneous (IM-SC) administration showed differences in the effect on lymphocyte subpopulations at 450 and 1,000 micrograms. The effect of IFN-gamma 4A on the equilibrium among lymphocyte subpopulations and the possibility of its role in combination therapy with other biologic response modifiers are discussed.
Antigens, CD↗
Immunologic monitoring and aspergillosis in renal transplant patients.
Three cases of pulmonary aspergillosis in a "high risk" population of renal transplant recipients are presented. The source of infection was traced to the forced air exhaust system of the Transplantation Unit. Early definitive diagnosis of the infection was very important for effective management. Immunologic monitoring was demonstrated to be instrumental in indicating the early presence of infection, and as a guideline to reduced immunosuppression during therapy. Bronchoscopy with brushings and endobronchial cavitary biopsy were valuable methods for obtaining the infected tissue. Amphotericin B was effective when therapy was started early. Adequate levels of the drug were obtained by varying the dose and frequency of administration according to serum inhibitory titers. Control of infection was aided by immunologic monitoring at regular intervals.
Aspergillosis↗
[Clinical indications for monitoring immunologic reactivity (immune status)].
The tests and the clinical indications for monitoring immunologic reactivity are discussed. From the viewpoint of reliability in relation to diagnosis and therapy for the single patient there are some basic indications: the primary and secondary immunodeficienceis, the immunoproliferative disorders and the monitoring during immunotherapeutic procedures. In autoimmune diseases and in cancer these investigations do not give sufficient information concerning immunoreactivity of the single patient. The differences are statistical significant only for groups. In the future antigenic specific tests seem to be more promising.
Autoimmune Diseases↗
Immunologic monitoring.
The development of reliable in vitro assays that could allow the quantitation and characterization of anti-donor alloimmune responses has always been a goal in clinical transplantation, both to predict presensitization to the transplanted tissue and to be able to identify rejection without resorting to more invasive tests. With recent development in our understanding of transplantation biology and therapeutics, there is a real expectation that these tests may be used to identify tolerance as much as to predict rejection. The traditional limiting dilution assays still have a contribution to make and are being complemented by an array of tools, such as ELISpot, flow cytometry-based techniques, and microarray analysis. The assays that have been informative, to date, are discussed in this review. This information will lead, at least, to a better understanding of how and when the rejection process occurs. More interestingly, the objective is to apply this information to evaluate tolerance-inducing strategies or to identify patients that have become tolerant to their graft and can be weaned of immunosuppression. Of course sensitive, accurate and specific immunologic monitoring has applications well beyond the field of transplantation.
Antigens↗
Immunological monitoring in organ transplantation and autoimmune disease.
The clinical manifestations of graft rejection or autoimmune disease represent the terminal phase in a complex sequence of inflammatory events. Although the spectrum of response to injury within each tissue is normally narrowly defined, the immune mechanisms involved may be heterogeneous, influenced by the immune status of the host, the nature of the stimulus (i.e. viral antigen, allostimulation, or aberrant recognition of self), and the use of exogenous immunosuppression. Within this framework, immunological monitoring is employed to distinguish the causative effector mechanisms, to characterize the disease course, to tailor therapeutic intervention, and to monitor treatment impact in individual immunological disorders.
Antibody Formation↗
The immunological monitoring of alloreactive responses in liver transplant recipients: a review.
The aim of this work is to review the current knowledge in the field of immunological monitoring of allogenic responsiveness in clinical liver transplantation. When compared to other solid-organ transplants, liver allografts are considered as immunologically privileged, and, accordingly, constitute a favorable setting to develop experimental as well as clinical strategies for minimization of immunosuppression and even induction of operational tolerance. The validation of simple, reliable, noninvasive assays exploring antidonor alloreactivity will constitute a crucial step toward implementing such approaches in the clinic. In contrast to research in rodents claiming the development of donor-specific tolerance in case of graft survivals of over 100 days without immunosuppression, it is impractical to confirm tolerance induction in this way in humans. Promising candidate assays include the detection of post-transplant immune deviation, of circulating precursors of dendritic cells subtypes, and of regulatory T cells. A conceptual framework for the development of tolerance assays in clinical liver transplantation is also proposed.
Biomarkers↗
Immunological monitoring in a controlled trial of immunotherapy in stage IIB malignant melanoma.
Fifteen patients undergoing surgery for Stage IIb malignant melanoma were randomly allocated either to a group who received a vaccine of BCG mixed with irradiated autologous melanoma cells, or a control group who received no further treatment. All patients were monitored sequentially for immunological competence and tumour-directed immunity, using a wide range of techniques, and the results were compared retrospectively with their clinical course. Three months after surgery, there was a trend towards inhibition of PHA-induced lymphocyte transformation by autologous serum in patients who developed recurrent tumour within 12 months after treatment. Serum from patients who remained tumour-free for 12 months did not inhibit stimulation of autologous lymphocytes by PHA. Apart from this test, no other immunological parameters correlated either with clinical course or with the type of treatment received.
Antibody Formation↗
Comparison of monoclonal antibodies used for immunological monitoring of renal transplant recipients.
To investigate the comparability of the OKT and Leu monoclonal antibodies (mAbs) used for immunological monitoring, T cell subpopulations in 360 blood samples from 35 renal allograft recipients were studied by flow cytometry using both series of mAbs. To identify the activated cells in the different subpopulations, those labeled with the Leu mAbs were double-labeled with an anti-HLA-DR mAb. The percentages of T cells that stained with the Leu3a and Leu2a mAb using a direct immunofluorescence technique were significantly lower than the percentages of cells that stained with the OKT4 and OKT8 mAb using an indirect immunofluorescence technique (47.6 +/- 12.8% and 14.5 +/- 9.1% [mean +/- SD] versus 50.5 +/- 11.2% and 18.3 +/- 8.0%, respectively; P less than 0.0001). Since the difference between the Leu2a+ and OKT8+ cells was relatively greater (21%) than that between the Leu3a+ and OKT4+ cells (6%), the mean Leu3a/2a ratio was significantly higher than the mean OKT4/8 ratio (6.64 +/- 9.7 versus 3.60 +/- 2.82; P less than 0.0001). The difference between the Leu2a+ and OKT8+ cells were not attributable to a difference in the sensitivity of the direct and indirect immunofluorescence technique. A large difference between the Leu2a+ and OKT8+ cells correlated with a high percentage of DR+ cells within the Leu2a population (P less than 0.001). No correlation was found for the difference between the OKT4+ and Leu3a+ cells and the DR expression in the Leu3a+ cell population. These observations suggest that activation of some T cells of the "cytotoxic-suppressor" phenotype leads to antigen modulation in which the OKT8 epitope is not affected but the Leu2a epitope disappears or cannot be detected with the present method.
Antibodies, Monoclonal↗
False positive 51Cr release tests during post-transplant immunological monitoring due to recipient serum radioactive contamination.
The occurrence of false positive 51Cr release test results in post-transplant immunological monitoring of human kidney graft recipients due to 131I carryover from renograms is described. False positivity was detected in 7 instances in 4 recipients, and suspected in 12 instances in 7 recipients, in a series of 46 consecutive transplant recipients. Technical methods and controls to detect and prevent such false positivity are described.
Antibody-Dependent Cell Cytotoxicity↗