Modulation of human concanavalin A-induced lymphocyte proliferative response by physiological concentrations of beta-endorphin

The effects of physiological concentrations of beta-endorphin on the proliferative response to concanavalin A of human peripheral blood mononuclear cells from a large series of healthy donors are reported. These effects are also compared with those obtained employing beta-endorphin and phytohemagglutinin under the same experimental conditions. The donors (32), aged between 20 and 48 years, chosen among military personnel of the Italian Air Force, underwent clinical and laboratory investigations to exclude any detectable disturbance in their psychophysical fitness. Our results show that beta-endorphin is not mitogenic per se and is unable to modify the response of mononuclear cells to phytohemagglutinin irrespective of the concentration of opioid or mitogen used. beta-Endorphin is also unable to alter the PBMC response to low concentrations of concanavalin A, but significantly increases such a response when higher concentrations of concanavalin A and concentrations of beta-endorphin similar to those found in human plasma under physiological conditions are used. The effect is not reverted by naloxone, the specific opiate antagonist. When the activity of beta-endorphin on the mononuclear cell response to concanavalin A is examined at the single donor level, it is noted that some of the donors fail to show the opioid-dependent increase. The baseline levels of the response to concanavalin A of such subjects, compared to those of the donors whose response is augmented by the opioid, are significantly higher, thus demonstrating that beta-endorphin can selectively modulate concanavalin A-induced mitogenesis with a behavior depending on the individual characteristics of the donor's response. The process involves non-opioid cell receptors.

Direct and cell-mediated effects of interferon-alpha and -gamma on cells chronically infected with HTLV-III

The replication of the human T lymphotropic retrovirus HTLV-III in persistently infected cells is relatively insensitive to the direct antiviral action of human interferon-alpha or -gamma (IFN-alpha or -gamma), showing only a two- to threefold reduction of HTLV-III, even though the host cells are very sensitive to IFN, as shown by vesicular stomatitis virus (VSV)-yield reduction assay (4-5 log reduction of VSV). However, IFN anticellular activity is strongly enhanced in the presence of normal peripheral blood mononuclear cells, suggesting a cell-mediated effect of IFNs.

Immunoglobulin deficiencies and meningococcal disease

Five male military recruits were studied for evidence of immunologic deficiencies. Four had recovered recently from a first-episode meningococcal meningitis and one presented with recurrent meningococcemia. A selective decrease in IgG and IgA was found in one of the first-episode patients and a selective IgG2 subclass deficiency in the recurrent case. No complement abnormalities were detected, however, in any of the five cases. These results present further proof of the crucial role of immunoglobulins in the defense against N. meningitidis and they stress the necessity of a through examination of humoral immunity before military career enlistment.

Raised serum levels of IgM-rheumatoid factor and anti-F(ab')2 autoantibodies in patients with active inflammatory bowel disease

The serum levels of IgM-Rheumatoid Factor and of anti-F(ab')2 autoantibodies were investigated in patients with inflammatory Bowel Disease (IBD) by sensitive radioimmunoassays. Serum levels of the 2 autoantibodies were significantly increased in active IBD. In patients with Crohn's Disease raised titers of the 2 antibodies appeared to be also related to colonic involvement. There was, in Crohn's Disease, a significant association between concordantly positive results with the 2 assays and the occurrence of systemic complications. Immunocomplexes detected by the C1q-SP method were higher in sera of Crohn's Disease patients with raised IgM-RF than in the others. Data from the present investigation indicate that in active IBD and particularly in Crohn's Disease autoantibodies directed against different parts of the immunoglobulin molecule may be produced. These findings add support to the concept that an in vivo polyclonal B-cell activation may occur in these patients.

Humoral inhibition of neutrophil chemotaxis in Crohn's disease

In patients with Crohn's disease (CD) we investigated the C3 conversion of zymosan-activated serum (ZAS) and looked for the occurrence of chemotactic factor inactivation (CFI). We also studied the cell-directed inhibitory effect (CDI) of the CD patients' plasma and, in the same group, complement activation and complement-mediated deactivation. The mean value of ZAS C3 conversion in CD was no different from that of healthy controls, but in steroid-treated patients it was lower than in untreated CD. CFI occurred in 1 of the 23 CD sera tested, and CDI was observed in 6 out of the 22 patients tested. EDTA C3 conversion was present in 12 patients, and complement-mediated deactivation was associated with high values of EDTA C3 conversion. Our findings indicate that complement dysfunction and inhibitory factors of neutrophil chemotaxis are present in CD. These findings could explain the defective neutrophil migration into skin windows. Whether they are relevant to the pathogenesis of tissue injury or of infectious complications and are specific for CD, however, remains to be established.

Isotypic analysis of antibody response to a food antigen in inflammatory bowel disease

We studied the class-specific antibody response to the cow's milk antigen beta-lactoglobulin (beta-LG) in sera from patients with ulcerative colitis and Crohn's disease. IgG and IgM to beta-LG were significantly higher in patients when compared to healthy non-atopic controls, whereas IgA values were similar, and specific IgE absent in all groups. No correlation between IgG- or IgM-containing immune complexes was found with the corresponding isotype of antibody to beta-LG; however, IgM complexes correlated with serum total IgM in ulcerative colitis. In these patients, IgG antibodies were higher in active cases, whereas IgM increased in patients without signs of disease activity. Antibody titers did not correlate with disease duration or administration of antiinflammatory drugs. This pattern of anti-beta-LG reactivity suggests that the presence of intestinal lesions may be revealed by the selective increase of some antibody isotypes to orally administered antigens. Enhanced mucosal permeability may be studied by this type of serological analysis.

Serum IgG, IgA, IgM, IgE, salivary IgA levels and lung function in a healthy male population from the Italian Air Force: a preliminary study

The reliability of total IgE quantitation in predicting atopic states was evaluated in a highly homogeneous group of 315 male subjects between 19 and 22 years of age, in apparent good health. A parallel evaluation of the other major Ig classes (serum IgG, IgA, IgM and salivary IgA) and a series of lung function tests were also performed. Forty-eight subjects (15%) referred history of allergy (41 respiratory and seven cutaneous). Twenty-one percent of these had IgE greater than 440 IU/ml, a value reported as abnormally high. No significant association was found between atopy and any of the lung function tests performed. Clinical history or IgE levels were not related to other Ig classes. Conversely, serum but not salivary IgA levels were significantly reduced in tonsillectomized subjects. From the present data it appears that neither IgE determinations nor performing lung function tests can be considered reliable substitutes for an accurate history and evaluation of clinical parameters.

Comparison of pathologic and normal sera by immune complex determination: five disease groups within 190 samples are discriminated by computer-selected combinations of 13 methods. Report of the Italian committee for the study of immune complexes (WIC)

Pathological (190) and normal (33) sera were tested for their content of circulating immune complexes (CIC) by a battery of 13 assays performed in 11 laboratories. Statistical processing was done both by pooling all pathological samples and by extracting those falling into well-defined disease groups, i.e., rheumatoid arthritis, diabetes, lupus, melanoma, and glomerulonephritis. Highly significant correlations between methods--taken two at a time--for each disease differed in proportion (ranging from 6 to 30%) and in the pattern displayed on a checkerboard. Disease-linked patterns were also found when a function maximizing discrimination between pathological and normal samples was derived by combining the information from all methods. Here the order and the weight attributed by the computer to the methods differed for each of the disease groups. Taken together these results are interpreted as an indication that all assays may not determine the same classes of CIC, and thus vary in sensitivity depending on the prevailing properties of the complexes present in the serum, which in turn may depend on the etiology, pathogenesis, and stage of the disease.

Chronic granulomatous disease in two sisters

Two sisters with chronic granulomatous disease (CGD) have been studied. The diagnosis was suggested by the histopathological findings from the spleen and lymph nodes of the proband and confirmed by the low values obtained in the following tests performed on polymorphonuclear leukocytes (PMN): chemiluminescence, nitroblue tetrazolium (NBT) reduction, killing of Staphylococcus aureus, and O2- production. NADPH oxidase activity was not detected in the homogenates of the patients' PMN but cytochrome b was normally present. In addition, PMN depolarization induced by phorbol-myristate acetate was absent, thus suggesting a defect of the activation mechanism of the respiratory enzyme. The normal depolarization induced by ouabain indicated that the membrane polarity regulated by the Na/K pump in the patients' cells was not affected. The low, but not completely absent, respiratory activity of the patients' PMN could suggest an X-linked mode of inheritance with incomplete Lyonization. From a clinical point of view, one sister had mild symptoms whereas the other was almost symptomless, thus confirming once more the heterogeneity of CGD syndrome.

Detection and partial characterization of circulating immune complexes in hydatid disease

Thirty sera from eight patients with disseminated or localized hydatid disease have been examined for the presence of circulating immune complexes (CICs) by the conglutinin-binding assay and for immunoglobulin levels. The highest levels of CICs were of the immunoglobulin A (IgA) class, with lower values of IgG-CIC and IgM-CIC; these results did not correlate, except for IgG, with the free immunoglobulin levels. Efforts to identify parasitic antigen(s) involved in the CIC formation with different methods have been unsuccessful. In the follow-up of each patient, CIC appeared to be better correlated to clinical conditions than to hemagglutination titers. We have concluded that the presence of CIC in hydatid disease is probably an expression of B-cell polyclonal activation and that these complexes are valuable in the clinical monitoring of the disease.

In vitro and in vivo effect of sisomicin and gentamycin on polymorphonuclear chemotaxis and phagocytosis

Ten patients with acute bacterial infections were studied to demonstrate the influence of two aminoglycosides, sisomicin and gentamycin on polymorphonuclear (PMN) chemotactic and phagocytic functions. Five of these subjects were treated with gentamycin and five with sisomicin both at a dosage of 2.5 mg kg-1 day-1. The assays were performed before and after 5 days of therapy. Before beginning treatment, the in vitro action of the aminoglycoside antibiotics (20 micrograms ml-1) was also tested. Granulocytes from 8 healthy people were used as controls. After therapy, no significant difference in basic values was found in either the gentamycin treated or in the sisomicin treated group. Similar results were obtained in incubation tests on both patients and healthy subjects. In conclusion, we conclude that the use of these mentioned aminoglycoside antibiotics, at the therapeutical doses employed, does not interfere with the PMN functions.

Circulating Immune Complexes in Human Malignant Melanoma

The sera from 34 patients with malignant melanoma at various clinical stages of the disease were examined for the presence of circulating immune complexes (CIC) by the C1q solid-phase assay. Their urine and serum samples had been previously examined for the presence of an urinary melanoma-specific protein (MSP) and the corresponding serum antibody. Low levels of CIC (only in the third stage of the disease) and no positive correlation with the presence of MSP were found. The discordance between our and other author's data stresses again the fact that the different laboratory methods for CIC evaluation reveal in a different way the various CIC populations occurring in several diseases.

Serum and salivary IgA levels in normal subjects: comparison between tonsillectomized and non-tonsillectomized subjects

Serum IgA and secretory IgA (SIgA) were determined in 1,000 apparently healthy subjects; 274 were tonsillectomized. Four groups were identified in this study: (1) 0.3% of subjects had no serum IgA and SIgA; (2) 1.6% of subjects showed partial serum and SIgA deficiency; (3) 27.4% of individuals were tonsillectomized and had partial serum IgA deficiency but normal SIgA, and (4) 71.4% were normal, both with respect to serum IgA and SIgA. There results stress the relatively high incidence of IgA deficiency in the normal population and confirm the role of the tonsils in maintaining serum IgA levels.

Antigen-specific detection of soluble immune complexes in conglutinin-binding assays

A modification of the conglutinin-binding assay has been used for antigen identification in circulating immune complexes (IC). The complexed antigen was identified, in conglutinin-bound complexes, by antibodies or antibody fragments, specifically directed against the antigen. These antibody preparations were either radiolabelled or detected with 125I-protein A. This system was found efficient using in vitro-formed bovine serum albumin--anti-bovine serum albumin and tetanus toxoid--anti-tetanus toxoid soluble immune complexes at equivalence or at slight antigen or antibody excess. In addition, with 125I-IgG--anti-HBs and with 125I-F(ab')2--anti-HBs, we examined 44 sera from 41 patients with viral type B hepatitis and the presence of HBs was observed in 18 (40.9%) IC containing tested samples. Therefore, this method appears applicable to clinical investigation.

In vitro studies on cellular and humoral chemotaxis in Crohn's disease using the under agarose gel technique

The locomotor function of polymorphonuclear cells (cellular chemotaxis) and serum chemotactic activity (humoral chemotaxis) were studied in 51 patients with Crohn's disease using a method of migration under agarose gel. To study cellular chemotaxis patient's polymorphonuclear cells were challenged against normal Zymosan activated serum and humoral chemotaxis was evaluated testing the patient's Zymosan activated serum against normal polymorphonuclear cells. Cellular chemotaxis in the Crohn's disease group was normal (although 30% of the 51 patients had migration values out of the normal range), while humoral chemotaxis was significantly lower in Crohn's disease patients than in the control group. However, the value of humoral chemotaxis in the group of Crohn's disease patients treated with steroids was lower than that of patients not treated, thus accounting for the low mean value observed inthe Crohn's disease-group as a whole. The present results suggest that a defective chemotactic response may occur in some Crohn's disease patients, particularly during steroid treatment. These findings might be related either to a defective generation of complement derived chemotactic factors or to the presence of circulating inhibitors.

Circulating immune complexes detected by C1q solid phase assay in leprosy

Sixty-three sera of patients with leprosy were tested for the presence of circulating immune complexes (CIC) by C1q solid phase assay (C1qSPA). The mean values in CIC levels in leprosy patients were very high in comparison to native and European controls. No difference was found in the tuberculoid and lepromatous forms, but there was a good correlation between the presence of CIC and autoantibodies.

Zinc-dependent chemotactic defect in an infant with acrodermatitis

A 5-month-old infant developed acrodermatitis enteropathica when weaned from breast milk to cows' milk. Plasma zinc concentration was low. T- and B-lymphocyte functions were normal, but there was a severe defect of neutrophil chemotaxis. Oral treatment with zinc sulphate (40 mg daily) induced an immediate clinical improvement, with restoration of normal plasma zinc level and complete correction of neutrophil chemotaxis.

Neutrophil chemotaxis defect in IgA deficiency evaluated by migration agarose method

The chemotactic and random mobility functions of twelve selectively IgA-deficient patients were evaluated by a method using agarose gel. A severe polymorphonuclear cellular chemotactic defect was found in ten out of twelve patients, but only five of them also showed a marked associated impairment of random locomotory function. Furthermore, in one subject, levamisole therapy resulted in a dramatic improvement of both chemotactic and random mobility functions. These results are discussed in the paper with respect to the possible pathogenetic implications.

IgA deficiency and circulating immune complexes in Neapolitan children with fatal acute respiratory infections

Immunoglobulins, C3 and C4 levels and circulating immune complexes have been measured on admission sera from 34 children admitted to a Naples hospital during the winter of 1978/79 with severe, usually fatal, acute respiratory infections and in age-matched controls from Rome. The Naples sera were characterised by low IgA, C3, and C4 levels, increased IgM and IgG concentrations, and high titres of circulating immune complexes. These immunological abnormalities could explain the high concentration of fatal cases.

Immune complexes in the sera and amniotic fluids of human pregnancy

The polyethylene-glicol (P.E.G.) precipitation assay was used to examine the sera of 91 pregnant women, 30 with normal pregnancies, 16 with EPH-Gestosis, 20 with pregnancy complicated by diabetes and 25 with case histories of recurrent abortions, in order to find evidence of eventual circulating immune complexes (C.I.C.). We also examined 30 amniotic fluids from normal pregnant women and 6 from pregnant women with diabetes. Several sera and all amniotic fluids were also examined by rheumatoid factor (RF) - inhibition test. C.I.C. were not discovered in the normal pregnant women neither in their sera nor in their amniotic fluids, while they were found in the following cases: in 8 patients with EPH-Gestosis (50%), in 8 with diabetes (40%) and in 3 with anamnesis positive for recurrent abortions (12%). The 6 amniotic fluid samples from women with diabetes were all negative. We were only able to examine 11 of the 19 positive cases from 4 days to 5 months after delivery and C.I.C. were absent in the sera of all the patients.

[Circulating immunocomplexes in patients with various morbid conditions]

The polyethylenglycol (PEG) precipitation technique has been employed for the measurement of immune complexes in the circulation of 100 normal subjects and in 14 patients suffering from a variety of diseases (systemic lupus erythematodes, nephrosic syndrome, cryoglobulinaemia, Buckley's syndrome). Values higher than 0.80 UA on the absorption scale were considered pathological, namely 2 standard deviations above the mean (0.32 UA) in the subjects examined; in the patients, values between a minimum of 0.98 UA and a maximum of 2.38 UA were observed. Longitudinal study of these cases also pointed to the disappearance of immune complexes during therapy. The results suggest that the PEG precipitation technique can play an important part as a screening test in situations in which circulating IC pathology is suspected; it is also a sensitive means of monitoring treatment.

Study of chemotaxis by a modified method of migration under agarose gel

In this paper the standardization of a method for studying chemotaxis of polymorphonuclear cells under agarose gel in vitro on 20 adult normal subjects is reported. An original method of reading is emphasized in which the maximum migration distance and the number of migrated cells are held in consideration.

[Transverse myelopathy caused by systemic lupus erythematosus (LES)]

The authors have described a case of transverse myelopathy as a complication of L.E.S.; serological studies are reported. This case was considered very important because the damage of the spinal cord was the first symptom of mesenchymopathy.

Immunologic and clinical investigation on a bovine thymic extract. Therapeutic applications in primary immunoedificiencies

Thirteen patients with primary immunodeficiencies (eight with T-cell deficiency, one with Wiskott-Aldrich (W-A) syndrome, two with common variable agammaglobulinemia (CVA), and two with severe combined immunodeficiency (SCID) were treated with a calf thymus extract, called thymostimulin (TS). It has been shown that this extract causes in vitro differentiation of T-cell precursors in patients with T-cell defect. Five of eight patients with pure T-cell defect showed immunologic recovery and clinical remission lasting for several months after interruption of the therapy; one had only transient reconstitution, one had slight increase in T-cells (clinical conditions not yet estimated), and two patients soon died from severe infections after showing a slight increase of T-cells. Immune recovery was assess by an increase of the absolute number of E-rosettes forming cells, of human T-lymphocyte antigen positive cells and of PHA responsiveness in the peripheral blood, and by a positive delayed hypersensitivity reaction to antigens. In five patients, there was also B-cell increase after TS treatment. Clinical remission consisted of disappearance of infections, weight gain, and in improvement in general conditions. No effect was observed in one patient with W-A syndrome, in two with CVA, and in two with SCID. Several hypotheses on the mechanisms involved in immune reconstitution are discussed. It seems likely that TS acts on prethymic cells or on the epithelial cells of hypoplastic thymuses. TS was not effective, either in vitro or in vivo, in patients with SCID probably because of a defect in stem cells.

Circulating immune complexes in normal pregnant women and in some conditions complicating pregnancy

The polyethylene-glycol (PEG) precipitation assay was used to examine the sera of sixty-nine pregnant women, thirty with normal pregnancies, ten with toxaemia of pregnancy, eleven with pregnancy complicated by diabetes and eighteen with case histories of recurrent abortions in order to find evidence of eventual circulating immune complexes (CIC). CIC were not seen in normal pregnancies, but were found in two of the toxaemic group, in two of those with recurrent abortions and in two of those with diabetes. After delivery, these six positive cases were all negative. The presence of CIC may have a determining role in the pathogenesis of some of the cases of the above conditions.

Rosette formation with mouse erythrocytes by lymphocytes from normal donors and patients with various diseases

Rosette formation of human lymphoid cells with mouse erythrocytes has recently been proposed as a marker for a subpopulation of B lymphocytes. In this work we studied the percentage of mouse rosette forming cells (MRFC) in normal and pathological conditions and compared them to the percentage of sheep rosette forming cells (SRFC) a marker for T lymphocytes. Peripheral blood lymphocytes (PBL) from normal donors contained 6.2 +/- 1.1% (mean +/- 1 S.D.) MRFC. High percentages of MRFC were found in CLL patients, and a slight increase was observed in patients with systemic lupus erythematosus. MRFC were absent in Bruton's type agammaglobulinaemia, but were normally present in patients with T cell defects. Cryopreservation of lymphocytes in 10% DMSO did not significantly affect the mean percentages of SRFC and MRFC, though a slight increase of the former and a small reduction of the latter was observed. Double binding experiments on peripheral blood lymphocytes showed a predominant association of MRFC with cells staining for surface IgM and/or IgD. In all samples tested, we also observed a small population of MRFC negative for sIgM or sIgD and a few sIgM or sIgD positive cells that did not rosette with mouse erythrocytes.

T and B lymphocytes in the liver and peripheral blood of subjects with acute and chronic hepatitis

E and EAC rosette-forming cells in the peripheral blood and in the liver of subjects with acute and chronic hepatitis were studied. We found a highly significant reduction (P less than 0.01) of E rosette percentage in the lymphocytes isolated from the liver patients with chronic persistent, and chronic active, hepatitis. EAC rosette-forming cells were significantly increased in the liver of patients with chronic active hepatis (P less than 0.01). In this condition lymphocytes with Fc receptor were also found.

[Personal experiences of immunotherapy using the transfer factor]

Six subjects, four suffering from chronic mucocutaneous candidosis, one from ataxiatelangiectasia and one from partial combined immunological deficiency with ongoing pulmonary tuberculosis, were treated with transfer factor. The deficient immunological situation normalized in all subjects after treatment. Clinically, all showed improvement excepting one candidosis case.

Histological and Immunological Study of Patients with Lung and Digestive Tract Tumors. Analysis of T and B Lymphocytes from the Peripheral Blood and from the Lymph Nodes Draining the Tumor

The nature of the immune response to the tumor cell is complex and has yet to be clearly defined. Although past research has focused on the cytotoxic effect of T lymphocytes versus tumor cells, it has been shown in animal studies that B lymphocytes may also be implicated. Lymphocytes from patients with respiratory and digestive tract tumors were studied. B and T lymphocytes of peripheral blood and of draining lymph node tumors were studied using the following techniques: E rosettes (marker for T cells); membrane Ig, EAC rosettes, aggregated-Ig (marker for B lymphocytes); PHA and PKW in vitro response of lymphocytes using tritiated thymidine incorporation. It was observed that both groups of patients had normal or depressed B and T populations. PHA response was depressed in the majority of the cases with lung tumor. No difference was observed between lymphocytes from peripheral blood and from lymph node suspensions. As in normal lymph nodes the EAC rosettes were constantly observed in the cortical area of lymph node draining tumors. The immune defect observed in part of these cases is discussed in relation to the local and general immunological factors probably responsible for this defect.

Lymphoid cells in infectious mononucleosis classified according to T and B cell markers

It has been demonstrated that peripheral blood lymphocytes, particularly the "atypical" ones, are predominantly of the T type in infectious mononucleosis (IM). This is based on membrane marker studies (E rosettes, receptor for complement, receptor for Fc fragment of immunoglobulins (Ig), and membrane Ig) and by anti-T lymphocyte serum. On the other hand, lymphoblastoid cell lines derived from IM patients show the characteristics of B lymphocytes. This permits the suppostion that EBV infects B lymphocytes and stimulates them to proliferate. The cell proliferation is unlimited in vitro and is probably controlled in vivo by T cells. The reduction of cellular immunity in vivo, which contrasts with the high number of T cells in peripheral blood, could be explained by the fact that T cells are engaged in the regulation of B cell proliferation.