Hairy cell leukaemia: observations on natural killer activity in different clinical stages of the disease

Follow-up studies of natural killer (NK) cells, NK activity and antibody dependent cellular cytotoxicity (ADCC) in the course of hairy cell leukaemia (HCL) were carried out in a series of patients affected by the disease. NK activity against K562 targets was found to be high in all the patients with non-symptomatic stable disease. On the other hand, absent or extremely low NK activity was found only in patients with symptomatic progressive disease. NK activity determined in the transitional stages showed values between these two extremes. Antibody dependent cellular cytotoxicity (ADCC) was less closely correlated with the clinical stage than NK activity. Our findings suggest that investigation of in vitro NK cell cytotoxicity might serve as a useful adjunct in determining clinical stage in HCL.

Patients with CLL and hypocomplementaemia have an impaired serum bactericidal activity against the Salmonella minnesota Re mutant

The bactericidal effect of 25 serum samples from 23 patients with chronic lymphocytic leukaemia (CLL) against the Salmonella minnesota S form and Re mutant has been studied. No killing of the S form was observed in any of the sera tested, whereas a normal bactericidal effect was found against the Re mutant (group 1) in 17/25 sera of CLL patients. By contrast, in 8 serum samples from 6 CLL patients no killing or a markedly delayed killing of the Re strain was observed (group 2). Significant differences in the complement levels were found between the sera of group 1 and group 2. In group 1 mostly normal or elevated complement levels were observed, while in group 2 levels of C4 and C2 were found to be strongly decreased. A significant correlation was found between the bactericidal effect on the one hand and the C4 and C2 levels on the other.

Plasma lactoferrin levels in leukaemias

A solid-phase, one-step radioimmunoassay was developed for the determination of plasma lactoferrin concentration. The detection limit of the assay is 150 micrograms/l. Leakage of cellular lactoferrin was minimal when EDTA was used as anticoagulant, while results obtained from serum and from heparinized plasma were not reproducible. The plasma lactoferrin concentration of 35 female and 44 male healthy adults was measured in order to determine normal values. The geometric mean of lactoferrin levels in men is about 10% higher than in women: 483 (200-1500) micrograms/l in men and 446 (200-870) micrograms/l in women. Patients with acute and chronic leukaemias were also studied. In 38 patients with chronic myeloid leukaemia plasma lactoferrin levels were increased by three times while the neutrophil count was ten times higher than normal. Normal lactoferrin concentrations were measured in plasma samples from 15 patients with chronic lymphocytic leukaemia in incomplete remission while no detectable lactoferrin was found in samples from those in relapse (10 patients). In the untreated patients or those in relapse (19 cases) of both acute lymphocytic and myeloid leukaemias, plasma lactoferrin concentrations were undetectable while they seemed to return to normal during remission (3 cases). The data obtained indicate that the determination of plasma lactoferrin concentration might play an important role in facilitating the assessment of total blood granulocyte pool (TBGP).

Antibodies to the second Epstein-Barr virus nuclear antigen in non-Hodgkin lymphomas

Human antibodies against the first and second Epstein-Barr virus encoded nuclear antigens (EBNA-1 and EBNA-2) were analysed by modified ELISA reaction on immunoblots: 5 out of 20 EBNA-1 positive, healthy donor sera reacted with the EBNA-2. Healthy EBV seronegatives contained no antibodies against EBNA-2. The antibodies against this EBNA-2 developed several months after acute EBV infections. Four out of 8 infectious mononucleosis sera failed to react EBNA-2 in the late stage. In the group of EBV seropositive patients with non-Hodgkin lymphoma, 14 out of 18 sera contained EBNA-2 antibodies.

C1 and C4 abnormalities in chronic lymphocytic leukaemia and their significance

Clinical and laboratory correlations of low C1 and C4 levels previously found to be a characteristic feature of chronic lymphocytic leukaemia (CLL) were analysed. Abnormalities of C4 were restricted to stage 1, 2 and 3 of CLL, whereas in the more advanced disease (stage 4) only low C1 levels were found. It was demonstrated that the observed disorders were associated with an increased susceptibility of the patients for infections and impair the immune complex precipitation inhibiting capacity of the patients' sera as well.

A study of lymphocyte subsets in patients with angioimmunoblastic lymphadenopathy

Immunological marker studies of peripheral blood lymphocytes in 22 patients with typical angioimmunoblastic lymphadenopathy were carried out. There was a decrease of the absolute lymphocyte number, of T-helper cells and the T4/T8 ratio in the active stage of the disease. The active T-cells and total T-cells were reduced both in the active and in the inactive state. The number of B-cells was in both states increased. Implications and possible mechanism of these observations are discussed. The histological findings and the clinical picture of angioimmunoblastic lymphadenopathy (AILD) or immunoblastic lymphadenopathy (IBL) were described by Frizzera et al (1974) and Lukes & Tindle (1975). The aetiology and pathogenesis of AILD are unknown. Hyperimmune phenomena, hypersensitivity (Lukes & Tindle, 1975), and chronic antigenic stimulation (Neiman et al, 1978) were suggested as possible factors. A defect in T-cell regulatory function with secondary B-cell system proliferation was also postulated due to the decreased T-suppressor cells (Lukes & Tindle, 1975; Frizzera et al, 1974). In almost all of the reported cases of AILD there has been a decrease in T-cells and an increase in B-cells (Pruzanski, 1980). In this report we describe the results of immunological studies of peripheral blood lymphocytes in 22 patients with typical AILD. We have found that the active state of the disease is characterized by T-lymphopenia due to the decrease of OKT4 positive cells.

Large granular lymphocytes, Leu 7 reactivity and natural killer cell function in peripheral blood of patients with Hodgkin's disease

The percentage and absolute number of lymphocytes and Leu 7+ cells were significantly lower in HD even in active stages. There was no significant difference in the percentage of LGL between the three groups (control, active HD, inactive HD), however, because of differences in counts of lymphocytes the absolute number of LGL was significantly lower in HD even in the active group than that in healthy controls. The absolute count of LGL and Leu 7+ cells in patients in remission was significantly higher than that in active HD. Natural cytotoxicity against K-562 cells was also significantly lower in active patients in comparison with controls, while the percentage of cytotoxicity was slightly but not significantly higher in patients in remission than that in the active group. A positive correlation was observed between all the three examined parameters both in controls and in patients with active and inactive HD.

Immunological investigations in acute and chronic human pancreatitis

Follow-up immunological studies in 27 patients with acute pancreatitis of known etiology showed a significant elevation in the level of circulating immune complexes (IC), a significant inhibition in migration of leukocytes (with direct LMT) of patients and a significant decrease in the percentage of T-active, T-total peripheral lymphocytes and in the absolute count of peripheral T cells. Elevated circulating IC levels could been detected 3-4 weeks after the onset of acute pancreatitis. These immunological changes have still been demonstrated in a number of patients 7-14 months after recovery. We have found similar immunological alterations in patients with chronic pancreatitis as well. The possible causes and role of these long-term existing immunologic abnormalities are discussed.

Antibody dependent cellular cytotoxicity of lymphocytes in patients with renal diseases of immunopathological origin

Antibody dependent cytotoxicity (ADCC) of lymphocytes from twenty-two patients with histologically proven chronic glomerulonephritis and eight patients with SLE nephropathy was studied in a xenogeneic assay on chicken red blood cells and in an allogeneic test system using Rh(+) human erythrocyte targets. ADCC activity of the lymphocytes of patients with chronic glomerulonephritis did not differ from that of normals, while all patients with SLE nephropathy showed significantly lower cytotoxicity than healthy controls. The possible role ADCC in the pathogenesis of renal diseases of immunopathological origin is discussed.