T-lymphocyte subpopulations in type I diabetes mellitus. A longitudinal study

Monoclonal antibodies were used to characterize peripheral T-lymphocyte subpopulations in 23 patients with type I diabetes mellitus. Initial measurements were made at diagnosis and in 10 of the patients further studies were carried out at 1, 3 and 6 months. T-cell subsets were also measured in 16 patients with type II diabetes, in 16 patients with various autoimmune diseases and in 17 healthy control subjects. At diagnosis, the type I diabetic patients showed a significant decrease in the percentage of cytotoxic/suppressor cells. Both total T-cells and helper/inducer cells were normal. However, when the helper/inducer population was analyzed in the context of islet cell antibodies (ICAs), it was found that those patients possessing ICAs had significantly higher proportions of helper/inducer cells than those lacking them. A significant inverse correlation was seen between the proportions of total T-cells and NK/K cells. At 1 month, the proportions of cytotoxic/suppressor cells returned to normal, whilst the helper/inducer cells showed a transient depression. By 6 months, the only change seen was a significant increase in the percentage total t-cells. No relationship was found between T-cell subset perturbation and metabolic control, as assessed by measurement of hemoglobin A1 (HbA1). The type II diabetic patients showed a significant increase in the percentage of total T cells. The autoimmune patients also showed a significant increase in the proportions of total T-cells; this appeared to reflect an increase in the helper/inducer subset. In the autoimmune patients these findings occurred in conjunction with significant decreases in the absolute numbers of each T-cell subset. It is surmised that, in some cases of type I diabetes, alterations in immune homeostasis may permit autoimmune processes, which lead to cell damage at the onset of diabetes.

Clonal analysis of cytotoxic T-lymphocyte response to autologous human metastatic melanoma

Peripheral blood lymphocytes (PBL) from a melanoma (Me) patient, previously shown to be unable to react against the autologous tumor (Me 28) after mixed lymphocyte-tumor culture (MLTC), were cultured in vitro with the autologous tumor in MLTC and/or with IL-2-containing supernatants. T-cell clones were then obtained by limiting dilution and by micromanipulation. Eleven clones, selected for autologous tumor (Auto-Tu) cytotoxicity, were tested for specificity on a panel of 17 cell cultures of normal and neoplastic origin, revealing a complex spectrum of lytic activities. Three groups of clones could be identified depending on the patterns of cytotoxicity. One clone (B11.12) lysed Me28 and expressed a borderline reactivity against one allogeneic Me. A second group of clones (A4, A4.18, H10, E12, C9) lysed the Auto-Tu and allogeneic Me. The last group of clones (A4.2, A4.3, A4.4, A7, B7) expressed a broader pattern of reactivity with significant cytotoxicity against targets of different histologic origin. Furthermore, the second and third groups of clones lysed K562 while B11.12 did not. The Auto-Tu-restricted reactivity of clone B11.12, confirmed by a further test on 13 allogeneic Me and on autologous IL-2 cultured lymphocytes, suggests the recognition of antigenic structures preferentially expressed on Me28. Blocking studies, performed with monoclonal antibodies (MAb), revealed that an anti-HLA class I MAb (w6/32), but not two anti-DR MAbs (L243, DI.12), could inhibit the cytotoxic activity of clones B11.12 on Me28. A significant blocking effect by w6/32 on Me28 was achieved also with clones A4.4 and H10 but not with clones A4.2, A4.3 and A7. The phenotype of all clones was T3+, T4-, T8+, HNK-I-, suggesting that the anti-tumor effectors were of the T-cell lineage. Taken together, these data indicate that it is possible to isolate anti-tumor CTL-clones after MLTC from a PBL population of a metastatic melanoma patient. Furthermore, we present evidence suggesting a role of class-I antigens in the interaction of some cloned effectors with the autologous tumor target.

Cytolytic activity of T lymphocytes isolated from ovarian carcinoma ascitic fluid. Analysis at the population and clonal level

T lymphocytes were isolated from ascitic fluid of three patients with ovarian carcinoma at III-IV stage. Surface markers analysis of such purified T cells revealed that T8+ cells were well represented among ascitic T lymphocytes (from 35 to 56%). Low percentages of activated T cells, as indicated by HLA-DR and TAC (interleukin-2 receptor) positivity, were also present. However, fresh ascitic T lymphocytes failed to lyse autologous tumor target cells in a 4-h 51Cr release assay. Furthermore, by applying a limiting dilution microculture system that allows optimal conditions for cloning of human T lymphocytes, we derived clones from these populations. From 41 to 63% of clones so obtained had cytolytic activity in a lectin-dependent assay allowing detection of cytolytic T cells of any specificity. More importantly, in all three patients several clones were found to lyse autologous tumor target cells as well. Some of these clones have been studied in more detail: 9 out of 10 expressed the T8+/T4- phenotype, whereas only one was T8-/T4+; 6 out of 9 clones had a definite NK-like activity, while none of them lysed autologous PHA-lymphoblasts.

Decreased level of suppressor/cytotoxic T cells (OKT8+) in polymyalgia rheumatica and temporal arteritis: relation to disease activity

Separated peripheral blood mononuclear cells were analyzed by fluorescent microscopy with monoclonal antisera for T cells (OKT3+), helper/inducer T cells (OKT4+) and suppressor/cytotoxic T cells (OKT8+). Thirty-seven patients with polymyalgia rheumatica (PMR), 13 of whom had positive biopsies for arteritis, were studied and compared with 25 age and sex matched normal subjects. The percentages of OKT3+ and OKT4+ T cells were similar in the PMR group and controls, but percentage of OKT8+ T cells was significantly reduced in patients (14.8 +/- 6.8) compared with controls (22.1 +/- 6.3). Values of OKT8+ T cells were extremely low in untreated patients with active, acute disease (7.8 +/- 4.4%) and significantly lower than in prednisone treated patients with inactive disease (17.3 +/- 5.9). These findings indicate that low values of circulating OKT8+ T cells is a feature of PMR and is related to disease activity.

Immune response to ultraviolet-induced tumors. I. Transplantation immunity developing in syngeneic mice in response to progressor ultraviolet-induced tumors

Ultraviolet-light-induced murine skin tumors were analyzed for the ability to induce transplantation immunity and cytotoxic lymphocytes in syngeneic mice. A correlation was found between tumor regression and the induction of cytotoxic T cells with specificity for a unique tumor-associated antigen. Processing tumors possessed tumor-associated transplantation antigens (TATA), which could be demonstrated by transplantation in hyperimmunized mice. Progression correlated with a lack of splenic cytotoxic T cell reactivity. High levels of in situ cytotoxic reactivity could be induced by presenting the tumor-specific antigen on nongrowing tumor cells. Tumor-bearer hosts were shown to be sensitized to TATA because cultured tumor-bearer T cells adoptively transferred protection against tumor outgrowth. Mechanisms of the in vivo suppression of antitumor immunity are discussed.

Demonstration in situ of subsets of T-lymphocytes in sarcoidosis

Five biopsy specimens of skin, four of lung, and one of a lymph node were taken from nine patients with sarcoidosis. Monoclonal antibodies were applied to frozen sections of the specimens by an immunoperoxidase technique to test for the presence and distribution of subsets of T-lymphocytes. T-cells expressing the suppressor/cytotoxic phenotype were found predominantly in lymphocytic mantles surrounding sarcoidal granulomas, whereas cells displaying the helper/inducer phenotype were distributed diffusely throughout granulomas. The ratio of helper to suppressor phenotypes in cutaneous sarcoidosis was 5.1 +/- 1.8. The microanatomic location of subpopulations of T-lymphocytes may be important in the pathogenesis of the granulomatous response of sarcoidosis.

Langerhans cells in various benign and malignant pigment-cell lesions of the skin

We used immunohistochemistry to study Langerhans cells (LCs) and the composition of the dermal inflammatory infiltrate both in normal skin and in biopsies from various benign and malignant pigment-cell lesions. In normal skin and most benign pigment-cell lesions, epidermal LCs are regularly distributed. OKT6-Positive cells outnumber the OKIa-positive cells. The inconspicuous dermal infiltrate studied in these biopsies was composed of helper and suppressor/cytotoxic T cells and some dermal LCs. More epidermal LCs with an abnormal cytologic presentation were found in a halo naevus and in the radial growth part of primary malignant melanomas. This finding was associated with a dermal infiltrate composed of suppressor/cytotoxic T cells, suggesting a defense mechanism of the host towards abnormal melanocytes. Epidermal LCs were rare in the central part of the biopsies which showed a primary malignant melanoma in its vertical growth. A dermal inflammatory infiltrate was absent in that area. These findings are interpreted as the morphologic expression of a damaged immune system.

Increased numbers of suppressor-cytotoxic cells in a patient with carbamazepine hypersensitivity

A patient is presented with a clinical syndrome of erythroderma, fever, liver function abnormalities, eosinophilia and atypical lymphocytosis due to carbamazepine hypersensitivity. Immunological analysis of peripheral blood mononuclear cells was performed using mouse monoclonal antibodies against T-cell and Ia antigens. A 12-fold increase in the absolute numbers of suppressor-cytotoxic T-cells was found, resulting in a reversed helper/suppressor ratio. Also the number of Ia-positive cells was greatly increased. Carbamazepine may induce a reversible proliferation and activation of the suppressor-cytotoxic subset of T-cells. Implications and pathogenetic possibilities are briefly discussed.

T-cell subpopulations in the blood and skin of patients with psoriasis

Monoclonal antibodies were used to determine, simultaneously, the proportions of T-cell populations in the peripheral blood and in the skin lesions of fifty-one patients with psoriasis. The results were analysed in relation to the extent, age and clinical type of the skin lesions. In the group of patients with extensive lesions, a significant reduction in the number of total T (TT) and T helper/inducer-cells, (TH), but not in T suppressor/cytotoxic cells (TS) was observed in the peripheral blood. Furthermore, the skin TH/TS ratio was greater in late guttate and in chronic plaque lesions than the corresponding ratio in the blood. These findings suggest that there is an active selective recruitment of TH cells into established psoriatic lesions. In contrast, the TH/TS ratio in early guttate lesions was the same as in the blood, and significantly lower than in the plaque lesions. An additional finding was a decrease of TS, and a corresponding increase of null cells in the blood of patients with chronic plaque psoriasis. These observations provide further evidence for the participation of T cells in the pathogenesis of psoriasis.

Intestinal lymphocyte subpopulations in inflammatory bowel disease: an analysis by immunohistological and cell isolation techniques

Lymphocyte subpopulations in the intestinal mucosa of patients with ulcerative colitis or Crohn's disease have been studied using a double marker immunofluorescence technique. Analysis of tissue sections revealed that the majority of intraepithelial lymphocytes (IEL) were T cells (Hle-1+ HuTLA+ UCHT1+). Of these, over 80% were of suppressor-cytotoxic phenotype (OKT8+:83 +/- 10.2%) with a small population of helper type IEL (OKT4+). Only one third of OKT8+ IEL reacted with the T cell antibody, anti-Leu-1. IEL were also Tac-, C3b-receptor- (C3RT05-), and Ig-. Within the lamina propria, OKT4+ T cells predominated (ulcerative colitis 64 +/- 6.0%; Crohn's disease 63 +/- 6.0%). Less than half of the smaller OKT8+ population in the lamina propria was Leu-1+. These finding did not differ from those seen in histologically normal tissues from controls, and are similar to those reported in the small intestine. Mononuclear cells were also isolated from the intestinal lamina propria using an enzymatic technique. The majority of lymphocytes obtained were T cells (OKT3+), with populations of OKT4+ and OKT8+ cells. Comparison of the ratio of OKT4+ to OKT8+ lymphocytes determined by immunohistological analysis with that obtained in mucosal isolates, however, suggested that the isolation procedure may deplete OKT8+ cells. These findings indicate that an imbalance of mucosal immunoregulatory T cells, as defined by monoclonal antibodies, does not occur in inflammatory bowel disease. They also emphasize that functional studies of isolated intestinal mucosal cells should be combined with morphological studies of cell populations in situ.

A case of pagetoid reticulosis bearing the T cytotoxic suppressor surface marker on the lymphoid infiltrate: further evidence that pagetoid reticulosis is not a variant of mycosis fungoides

We describe a patient with pagetoid reticulosis in whom the lymphocytic infiltrate bore the surface membrane marker of the cytotoxic/suppressor subset. This is further evidence that Pagetoid reticulosis is not a variant of mycosis fungoides.

[Effect of vitamin A deficiency in mice on the formation of specific cytolytic T-lymphocytes]

Content of retinol, retinyl acetate and retinyl palmitate was studied by means of high pressure liquid chromatography, in liver tissue of mice, kept on a vitamin A-free diet during various periods of time. Cell proliferative activity and formation of specific T-killers were distinctly inhibited in mixed culture of lymphocytes from spleen tissue of A-avitaminous animals. Proliferative and cytolytic activity of the stimulated lymphocytes might be corrected by means of retinoic acid and retinyl acetate in vitro and in vivo.

T-cell chronic lymphocytic leukemia with morphologic and immunologic characteristics of cytotoxic/suppressor phenotype

The human cytotoxic/suppressor T-cell subpopulation has characteristic cytoplasmic granules and unique surface antigens that are recognized by OKT8 monoclonal antibody. Using immunocytochemical techniques, we identified three patients with an indolent T-cell lymphoproliferative disorder having morphologic and immunocytochemical characteristics of a cytotoxic/suppressor T-cell phenotype. Review of the literature revealed 22 similar cases, which were frequently associated with neutropenia and anemia. These cases may represent a distinct clinicopathologic entity with an apparently indolent clinical course that differs from other T-cell lymphoproliferative disorders, which are generally considered to be more aggressive diseases.

T8 chronic lymphocytic leukemia. A distinctive disorder related to T8 lymphocytosis

A case of T chronic lymphocytic leukemia (CLL) was first suspected on histologic and cytochemical examination of a splenectomy specimen. Later the patient became frankly leukemic with an E+/T3+/T8+/T4- phenotype. From our case and other reported cases of T-CLL studied with monoclonal antisera, the authors conclude that there are significant clinical and morphologic differences between T4 CLL and T8 CLL. In contrast to T4 CLL, T8 CLL characteristically presents with relatively low lymphocyte counts, little organ involvement, and often only discreet bone marrow involvement, and has a long clinical course. The leukemic cells are often large and have abundant cytoplasm with azurophilic granules. Similar features in cases reported as T8 lymphocytosis with neutropenia lead us to consider both entities part of a spectrum of the same disorder.

In situ identification of mononuclear cells in lichen planus

In this study, the in situ immunological typing of cell populations in lichen planus was attempted. T lymphocytes and suppressor/cytotoxic subsets, B lymphocytes, macrophages, immunocytes and Langerhans' cells were studied by one or more technical parameters and semiquantitative assessment of T cell populations were carried out. A critical evaluation of assays for T cell characterization was also attempted. T cells were found predominant in lichen planus infiltrate but macrophages were also many. Langerhans' cells were increased in the epidermis compared to normal skin and contact dermatitis.