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At least 163 records · Page 9Linked to original sources

[Immunologic monitoring of transplantation patients: study of the reactivity of cytotoxic precursor cells].

Proliferative and cytotoxic T-cell reactivity subsequent to in vitro stimulation by a lymphocyte pool were studied in ten patients with well-accepted cadaver renal allografts and eight healthy controls. Whereas the proliferative reactivity was about equal in both groups, the cytotoxic responsiveness was markedly reduced in the allograft recipients. We conclude from these results that immunosuppressive drugs as well as specific adaptation processes act preferentially on the cytotoxic precursor cell population.

Cell Division↗

Multifunctional immunological monitoring of HIV positive patients: a novel staging system.

A tri-functional in vitro evaluation has been utilized to analyze peripheral blood mononuclear cells (BMNC) from HIV-infected patients, which allows for the classification of these individuals into convenient stages, according to the number of in vitro parameters affected. The classifying functional parameters are: the mitochondrial metabolic activity of freshly isolated BMNC, measured by an MTT reduction assay, the detection of apoptosis in 72 hour cultures of these cells assessed by propidium iodide staining and dual parametric flow cytometric analysis, and their proliferative response to pokeweed mitogen. Our results indicate that HIV-infected patients at different stages of their clinical disease, can present dysfunctions in one, two or three of the above-mentioned parameters. Based on these results, patients can be classified into four newly-described stages which are Stage 0, including uninfected controls and all patients with unaffected parameters, and Stages 1, 2 and 3, including patients having one, two or all three parameters affected, respectively. This type of immunological evaluation and classification of HIV-infected patients has the potential of becoming a predictive tool in the longitudinal follow-up of their HIV infection.

Apoptosis↗

[Microbiological and immunological monitoring in polyarticular rheumatoid arthritis after total joint replacement].

HISTORY AND ADMISSION FINDINGS: A 51-year-old man with polyarticular rheumatoid arthritis since the age of 10 years, which had required three total joint replacements, presented in a generally good condition for replacement of the left elbow joint, which was swollen and had reduced movement. TREATMENT AND COURSE: The postoperative condition was without complication until the 7th day when arthritic signs set in, interpreted as part of the underlying disease, and cortisone was administered. After microbiological tests had been done and the patient's general state had deteriorated, antibiotic treatment with flucloxacillin and gentamycin as well as local irrigation and suction-drainage of all involved joints was started. Granulocyte and monocyte functions were analysed. Staphylococcal isolates from the patient induced reduced "respiratory burst" activity of the neutrophil granulocytes, apparently the cause of the septic dissemination. He was discharged on the 32. postoperative day, to be followed-up as an out-patient. CONCLUSION: Both adequate antibiotic administration and, especially, thorough local reduction of pathogens are needed for efficacious treatment. Rapid restoration of granulocyte function and of the "immunocompetence" of monocytes within normal limits are part of the reason for a good therapeutic response. This indicates the need for up-to-date preoperative immunological diagnosis in patients with suppressed immunity to assess the risk of infection and thus plan elective intervention.

Anti-Bacterial Agents↗

[Should immunologic monitoring of toxoplasmosis seronegative pregnant women stop at delivery?].

The authors report 2 cases of congenital toxoplasmosis fortuitously diagnosed in 2 newborn infants aged 12 and 35 days respectively whose mothers had no anti-Toxoplasma antibodies detectable at the time of birth. These cases prompted us to carry out, over an 18 months' period, a systematic postnatal control of all pregnant women who were still seronegative at the time of delivery. This enabled us to detect 4 cases of perinatal maternal infection with Toxoplasma contamination in 2 neonates. In view of these results, and in order not to miss any maternal infection at the very end of pregnancy, it seems advisable to complete the control of seronegative women by taking a last blood sample about 30 days after they have given birth.

Adult↗

[Immunological monitoring after renal transplantation from living donors].

Monitoring of immune responses were done in kidney recipients from living donors using the following assays: CH-50, alternative pathway of complement activation, circulating Ag-Ab complexes, cytotoxic antibodies. All patients had survived 3 to 5 years from transplant. While some alternations (fall of CH-50, cytotoxic antibodies, circulating Ag-Ab complexes) occurred after the episodes of chronic rejection in 2 patients, despite a well functioning allograft, the inhibition of alternative pathway of complement activation demonstrated a coincidental capability to predict rejection episodes. The blocking mechanism of the alternative pathway of complement activation during rejection is not fully understood. The enhancing role of B-lymphocyte antibodies and the function of circulating immunecomplexes were also discussed.

Antibodies↗

Immune RNA therapy for renal cell carcinoma: survival and immunologic monitoring.

Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eighty-six consecutive UCLA patients with metastatic renal cell carcinoma served as retrospective controls. Survival between subpopulations in each group matched by computer according to extent and location of metastases, age, sex, and interval between nephrectomy and occurrence of metastases were compared by Life Table Analysis. Survival was significantly greater in RNA-treated patients (P < .05) who had multiple metastases limited to the lungs when compared with matched controls. RNA therapy did not influence survival of patients with metastases to other sites (bone, brain, liver, lymph nodes, or skin) or multiple organ involvement. All nine MRD patients treated with RNA remained free of recurrence for a mean observation period of 18 months, range ten to 34 months. No significant toxicity was observed. Changes in skin test responses were related primarily to tumor burden. Increased lymphocyte mediated cytotoxicity in RNA recipients was associated with a somewhat improved survival period. Changes in absolute lymphocyte counts had no correlation with clinical course, and complement fixing antibody generally decreased after excision of tumor, was absent in patients with progression, and was present in low levels in patients with a favorable clinical response. RNA therapy may be of value in selected patients with metastatic renal cell carcinoma, and as an adjunct to definitive surgery.

Adenocarcinoma↗

Metastatic renal-cell carcinoma patients treated with interleukin 2 or interleukin 2 plus interferon gamma: immunological monitoring.

We investigated the biological response of 73 patients with metastatic renal-cell carcinoma (MRCC) treated by repetitive weekly cycles of high-dose interleukin 2 (IL-2) (protocol 1, 40 patients) or IL-2 plus interferon-gamma (IFN-gamma) (protocol 2, 33 patients). The objectives of this study were (i) to evaluate the effects of this IL-2 administration schedule on biological response, (ii) to compare the effects of IL-2 alone with those of IL-2 plus IFN-gamma, (iii) to search for any correlation between certain biological marker values and the clinical response to treatment. Mean CD56+ lymphocyte counts (i.e., NK cells) were significantly higher than those of CD3+ cells in the 2 protocols and a subpopulation of CD56bright cells in protocol 1 was found to be preferentially expanded in vivo. Cytotoxic activity against K562 and Daudi cell lines as well as TNF-alpha and sTNF-alpha R (but not IL-6) significantly increased following treatment. Comparison of the data obtained from patients treated with IL-2 alone vs. IL-2 plus IFN-gamma did not show any significant changes except for eosinophilia (higher in protocol 1). Therefore, addition of IFN-gamma did not affect either lymphocyte distribution or non-MHC-restricted cytotoxicity in vivo. No difference in cell subpopulation or cytotoxicity was detected between responders and non-responders. Pre-treatment sTNF-alpha R concentration, in contrast to IL-6 and TNF-alpha, was significantly higher in progressive than in stable and responder groups, suggesting that this parameter may be predictive of the clinical response.

Carcinoma, Renal Cell↗

Immunological monitoring and early prediction of rejection in renal allograft recipients.

Graft rejection remains the major problem complicating renal allograft transplantation. A reliable posttransplant predictor of impending rejection will be valuable to help maintain better graft function. We monitored 47 patients with end-stage renal disease treated by renal allograft starting 1 day pretransplantation and continuing for up to 90 days postgrafting. Peripheral blood mononuclear cells (PBMC) from both patients and 71 healthy subjects were compared for: (1) DNA synthesis in T and B lymphocytes in response to mitogens; (2) interleukin-2 (IL-2) production; (3) natural killer (NK) and antibody-dependent cell-mediated cytotoxic (ADCC) activities; (4) induced augmentation of NK and ADCC activities by the biological response modifiers (BRM), lymphoblastoid interferon, recombinant alpha-2-interferon, gamma-interferon and recombinant IL-2. During the 2 weeks preceding rejection we found lower than normal levels of IL-2 production (p less than 0.0005) and DNA synthesis (p less than 0.01) in concanavalin A-stimulated PBMC. IL-2 yield reached its lowest level on the day of rejection and increased sharply the following week after antirejection therapy was started. Mitogen-stimulated DNA synthesis rose in parallel with increasing levels of IL-2 production. Both NK and ADCC activities increased during rejection (p less than 0.05). The ADCC response to BRM activation measured during the first 2 weeks postgrafting was found to correlate with the stability of the graft. Recipients whose graft function remained stable had a minimal ADCC response to BRM.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibody-Dependent Cell Cytotoxicity↗

[Immunologic monitoring of patients with cystic fibrosis: value of different laboratory findings].

Cystic fibrosis (CF) is a common, serious, and frequently fatal autosomal recessive genetic disorder associated with the poor function of chloride channels. Chronic endobronchial inflammation and bacterial infection are main causes of morbidity and mortality due to CF. The study dealt with a relationship between progression and inflammation markers. Twenty one CF children with acute pulmonary exacerbation were examined. The signs of peripheral blood inflammation (responses of lymphocytes to PHA and their sensitivity to the antiproliferative effect of glucocorticoids) and in situ inflammation markers (sputum elastase activity, IL-8 and TNF-alpha, and protein concentrations in the same sputum specimens). These laboratory findings were used to calculate a "laboratory index" (LI). The clinical status of each patient was evaluated with a "clinical index" (CI), a parameter that includes respiratory secretion cultures, pulmonary function test results, nutritional status, and the presence of disease-related complications. There was a positive linear correlation between LI and CI. The presence of P. aeruginosa was strongly associated with the changes of inflammatory markers. CF patients with prolonged P. aeruginosa infection demonstrated extremely enhanced elastase activity and elevated amounts of sputum IL-8 and TNF-alpha as compared to uninfected subjects. The lung elastase activities, sputum protein contents, and TNF-alpha levels in individuals with short-term colonization were at or below those without P. aeruginosa infection. In patients with or without short-term colonization, the normalization of laboratory parameters was strongly related to evident clinical improvement. At the same time, antibiotic treatment failed to suppress an excessive inflammatory response in the lungs of patients with prolonged P. aeruginosa infection. The importance of individual inflammation markers is discussed in the paper.

Adolescent↗

Peripheral blood stem cell transplantation in multiple sclerosis with busulfan and cyclophosphamide conditioning: report of toxicity and immunological monitoring.

Multiple sclerosis (MS) is an immune-mediated disease that may be amenable to high-dose immunosuppression with peripheral blood stem cell transplantation (SCT) in selected patients. Five MS patients (all women, ages 39-47 years) received granulocyte colony-stimulating factor (G-CSF) for stem cell mobilization, CD34 cell selection for T-cell depletion, a preparatory regimen of busulfan (1 mg/kg x 16 doses) and cyclophosphamide (120 mg/kg), and antithymocyte globulin (10 mg/kg x 3 doses) at the time of stem cell infusion. Days required to recover absolute neutrophil count >500 were 12 to 14 and platelet count >20,000 were 17 to 58. Posttransplantation infectious complications in the first year after SCT occurred in 3 of 5 patients, and 1 patient died at day 22 after SCT from influenza A pneumonia. Neuropathologic study in this patient showed demyelinating plaques with surrounding macrophages but only rare T cells. In 2 patients, MS flared transiently with G-CSF. Magnetic resonance imaging gadolinium enhancement was present in 3 of 5 patients before transplantation and 0 of 4 after SCT. There were cerebrospinal fluid oligoclonal bands at 1 year after SCT, similar to the pretransplantation assays. Sustained suppression of peripheral blood mononuclear cell proliferative responses to myelin antigens occurred after SCT, but new responses to some myelin peptide fragments also developed after SCT. In 1 patient, enzyme-linked immunospot (ELISPOT) assays done 9 months after SCT showed a predominant T helper 2 (Th2) cytokine pattern. Neurological progression of 1 point on the extended disability status scale was seen in 1 patient 17 months after SCT. Another patient who was neurologically stable died abruptly 19 months after SCT from overwhelming S. pneumoniae sepsis. The remaining patients have had stable MS (follow-up, 18 and 30 months). In summary, our experience confirms the high-risk nature of this approach. Further studies and longer follow-up would be needed to determine the significance of new lymphocyte proliferative responses after SCT and the overall effect of this treatment on the natural history of MS.

Adult↗

Immunologic monitoring in breast cancer patients receiving postoperative adjuvant chemotherapy.

A group of 17 patients, having undergone modified radical mastectomy for breast cancer, received 12 cycles of chemotherapy with methotrexate, 5-fluorouracil, and chlorambucil during 17 months. The number of circulating T and non T lymphocytes, as defined by E, EAC, and ME rosette formation, were reduced during treatment. The Non-T lymphocytes, however, were reduced to the highest relative extent. Relative phytohemagglutinin and mixed lymphocyte culture responses of the cells decreased, whereas purified protein derivative responses were unchanged. Serum concentrations of IgM were reduced, but IgA and IgG concentrations were unchanged or slightly increased. Antibody titres to morbilli and herpes simplex were not changed, whereas the antibody activity against cytomegalovirus (CMV) increased in several seropositive patients. None of these patients, however, developed signs of a CMV infection.

Adult↗

Recent progress in the immunological monitoring of carcinomas using monoclonal antibodies.

In efforts to improve the specificity and sensitivity of tests to monitor patients with carcinoma, monoclonal antibody technology has been widely embraced by the scientific community. Results clearly indicate that novel antigen determinants have been identified and that significant improvements have been realized for the study of "classical" tumor antigens previously detected with polyclonal reagents. The concept of tumor specificity has also been amenable to an increased level of objectivity as based upon the probelike characteristic of monoclonal antibodies. It is apparent from this work that an antigen does not have to be tumor specific to be useful as a marker.

Alkaline Phosphatase↗

Immunological monitoring in patients with end-stage renal disease.

Parameters of cell-mediated immune function were determined in 76 patients with end-stage renal disease. Lymphocyte subpopulations (OKT3, OKT4, OKT8, OKIa1, OKM1, OKT9, OKT10), natural killer (NK)-cell activity (percentage 51Cr release from K562 targets), and delayed cutaneous hypersensitivity were measured and correlated with other variables. The results indicate that (1) uremic patients have a significant diminution in the OKT4-lymphocyte subpopulation and OKT4/OKT8 (helper/suppressor) ratio compared to normal controls; (2 blood transfusions do not induce significant alterations in the helper/suppressor-cell ratio; (3) uremic patients have a significant increase in OKM1 cells compared to normal controls; (4) the majority of uremic patients in this series developed delayed cutaneous hypersensitivity responses to recall antigens and could be de novo sensitized to 2,4-dinitrochlorobenzene (DNCB); (5) skin-test reactivity could not be correlated with total circulating T cells or levels of any lymphocyte subpopulations; and (6) NK-cell activity in uremic patients is not significantly different from that in normal controls. These results highlight the varying levels and function of different lymphocyte subsets in patients with end-stage renal disease when they are treated with chronic maintenance hemodialysis.

Adult↗

Immunological monitoring in workers occupationally exposed to asbestos.

Occupational exposure to asbestos is strongly associated with pulmonary diseases, cancer and immunotoxic effects. Both systemic and local immunity may play an important role in the pathogenesis of these events. Immune cells appear to be influenced by asbestos exposure, either through direct effects or as a result of the host's protective response to exposure. In this study several immune system parameters were assessed in workers (n = 61) with at least 5 years' exposure to asbestos at an industrial plant. Workers exposed to asbestos fibres had significantly increased levels of immunoglobulin E and concentrations of interleukin-6 and -8 in comparison with two sets of controls (in-plant and town control groups). The levels of soluble adhesion molecule ICAM-1 were higher in the exposed group compared to the town control group. Significantly increased levels of IgA were found in asbestos-exposed group in comparison to the town control. Evaluation of the expression of adhesion molecules on lymphocytes, monocytes and granulocytes by flow cytometry showed significant increases in the class of selectins CD62L on monocytes and granulocytes. Moreover, significantly increased expression of markers CD69 and CD66b on eosinophils was found among workers exposed to asbestos. In conclusion, exposure to asbestos fibres was found to have several effects on immune system. Alterations of these immune parameters may indicate hypersensitivity (increased levels of IgE, increased expression of activation markers CD66b and CD69 on eosinophils) and an elevated inflammatory status (increased levels of interleukins--IL-6, IL-8) in exposed workers.

Adult↗

Separation of flavivirus membrane and capsid proteins by multistep high-performance liquid chromatography optimized by immunological monitoring.

Complete separation of the three structural proteins, E, C and M, of an enveloped virus (tick-borne encephalitis virus) was achieved by means of a two-step high-performance liquid chromatography (HPLC) technique in less than 1 h. The hydrophobically associated membrane proteins E and M were successfully separated by high-performance gel permeation chromatography (TSK-3000 SW column) in the presence of sodium dodecyl sulphate (SDS), whereas the separation of M and C as well as desalting and removal of SDS was achieved by subsequent reversed-phase chromatography on a C3 column. With regard to further characterization by peptide mapping, analysis of the amino acid composition and aminoterminal sequencing, the second step was performed with volatile buffer systems. Quality control of the separation was achieved by a combination of HPLC with a highly sensitive dot immunoassay by the use of polyclonal as well as monoclonal antibodies. This method proved extremely sensitive and revealed strong tailing effects and cross-contaminations of peaks well-separated in reversed-phase chromatography, which were neither apparent in the absorbance curve at 214 nm nor in the analysis by SDS-polyacrylamide gel electrophoresis. By visualization of the peak-tailing effect, the chromatographic conditions could be modified in order to achieve an optimum separation of proteins.

Antibodies, Monoclonal↗