Immunopathology of BCG infection in genetically resistant and susceptible mouse strains

Natural resistance to Mycobacterium bovis (BCG) is under the control of a single gene, designated Bcg. Resistant (Bcgr) mice prevent multiplication of an i.v. injected inoculum of congruent to 10(4) dispersed BCG cells, whereas progressive multiplication of this pathogen occurs in the first 3 wk of infection in spleens and livers of susceptible (Bcgs) mice. Striking differences in the development of cellular immunity, as measured by granuloma formation in the liver and spleen, delayed-typed hypersensitivity, and a resistance to the challenge with homologous (BCG) and heterologous (Listeria monocytogenes) pathogens, were detected between Bcgr (C3H/HeN and A/J) and Bcgs (C57BL/6J and B10.A) strains. Cellular immune reactions progressively developed in the Bcgs mice, as a response to the increasing bacterial load, whereas greatly inferior levels of acquired immunity were observed in Bcgr strains. These findings support the concept that mice genetically resistant to BCG infection are able to prevent bacterial multiplication without the need for a cellular immune response, whereas genetically susceptible mice will eventually control bacterial multiplication with the acquisition of cellular immunity.

Immunopathology of BCG infection in genetically resistant and susceptible mouse strains

Natural resistance to Mycobacterium bovis (BCG) is under the control of a single gene, designated Bcg. Resistant (Bcgr) mice prevent multiplication of an i.v. injected inoculum of congruent to 10(4) dispersed BCG cells, whereas progressive multiplication of this pathogen occurs in the first 3 wk of infection in spleens and livers of susceptible (Bcgs) mice. Striking differences in the development of cellular immunity, as measured by granuloma formation in the liver and spleen, delayed-typed hypersensitivity, and a resistance to the challenge with homologous (BCG) and heterologous (Listeria monocytogenes) pathogens, were detected between Bcgr (C3H/HeN and A/J) and Bcgs (C57BL/6J and B10.A) strains. Cellular immune reactions progressively developed in the Bcgs mice, as a response to the increasing bacterial load, whereas greatly inferior levels of acquired immunity were observed in Bcgr strains. These findings support the concept that mice genetically resistant to BCG infection are able to prevent bacterial multiplication without the need for a cellular immune response, whereas genetically susceptible mice will eventually control bacterial multiplication with the acquisition of cellular immunity.

[New technic for detecting anti-double-stranded DNA antibodies. Value in disseminated lupus erythematosus in children]

Two assays for antibodies to double stranded (ds) DNA were compared in children with systemic lupus erythematosus (SLE). An indirect immunofluorescent test using Crithidia luciliae (IF-CL) was more specific but slightly less sensitive than the DNA binding assay (RIA). Detection of antibodies to ds-DNA (anti-ds-DNA) by IF on 3 different trypanosoma (T. brusei, T. equiperdum, and T. musculi) was as specific and as sensitive as IF-CL, but more difficult to read microscopically. No correlation was found between immunoglobulin (Ig) class of circulating anti-ds-DNA and severity of renal disease in SLE. A comparison of serologic and immunohistopathologic (kidney and skin) data in 12 children with SLE showed that immune-complex glomerulonephritis was more frequently encountered when anti-ds-DNA was detected in serum, and that Ig deposits were found only in the skin when anti-ds-DNA could not be detected in serum.

Primary nephrosis in childhood associated with focal glomerular sclerosis: is long-term prognosis that severe?

In our study, 32 nephrotic children with focal glomerular sclerosis were observed for an average period of 8 years (ranging 1-19 years of age). Of the 32, 25 children showed histological lesions of focal segmental sclerosis (FSG) and 7 of focal global glomerulosclerosis (FGG). All patients were reevaluated in 1979, creating the most recent status as follows: for children with FSG, 6 (24%) are in remission, 10 (40%) have a relatively normal renal function but exhibit either a persisting proteinuria (PP) or a recurrent nephrotic syndrome (NS), 1 (4%) is in chronic renal failure, 5 (20%) required dialysis and transplantation, and 3 (12%) died from non-renal causes. For children with FGG, 4 (57%) are in remission, 2 (29%) have a good renal function but display either PP or NS, and 1 patient (14%) is in chronic renal failure. The long-term observation of our study shows a more favorable prognosis than the one reported in researched literature. We believe that such results reflect a difference in the type of population encountered in our institution. Our population of patients represents less a highly referred population than the one of the centers who reported similar long-term studies, and we believe therefore that our study may represent a wider spectrum of the natural history of the disease. Moreover, the group of patients with PP or NS does not show a progressive decrease of glomerular filtration rate with time, which suggests that the disease may progress in a stepladder fashion.

Acute non-specific inflammatory reactions and protection against experimental Candida albicans infection

A non-specific acute inflammation induced in mice by an intrapleural injection of calcium pyrophosphate or dextran increased the resistance against a Candida albicans infection, and the transfer of this protection to normal mice was obtained by the injection of sera from animals developing an acute non-specific inflammation.

Limitations of the direct immunofluorescence test for antibody-coated bacteria in determining the site of urinary tract infections in children

The results of the direct immunofluorescence test for antibody-coated bacteria to determine the site of a urinary tract infection do not always correlate with the clinical data. When this test was performed on urine specimens from 282 children with significant bacteriuria, false-negative and false-positive results were observed in 20% (19/94) and 52% (19/188) of the specimens. Contamination of the specimen during collection and the presence of Fc receptors (receptors for the crystallizable fragment of the immunoglobulin molecule) on the surface of some strains of Staphylococcus aureus yielded false-positive results, and stools and vaginal secretions were shown to be potential sources of antibody-coated bacteria. It is suggested that for children this test be run on urine collected by bladder puncture. The use of conjugated anti-IgG antiserum containing only F(ab')2 (the antigen-binding fragments of the IgG molecule) is also recommended to eliminate false-positive results due to the presence of Fc receptors on the bacterial surface.

Effects of sera and exudate from carrageenan-treated rats on two models of acute inflammation

The air bleb has been studied as a cavity suitable for the production of a chronic inflammatory response. The ability of carrageenan and CPPD crystals to produce a chronic response in this cavity has been studied and the nature of the reaction described quantitatively and qualitatively. Carrageenan produced a fluid exudation predominated by mononuclear cells and histologically chronic in nature. However, CPPD failed to produce an inflammatory response apart from the formation of a few foreign body giant cells. Using the model described, experiments were undertaken to examine the ability of exudates and sera taken from animals undergoing either an acute or chronic reaction to modify two models of acute inflammation. Firstly the carrageenan complement dependent pleurisy and secondly the CPPD complement independent pleurisy. Volume of chronic and acute total cell numbers were reduced by chronic and acute exudates and sera on the carrageenan pleural model. No significant effect was on the CPPD pleural model.

[Demonstration of the presence during acute inflammatory reactions of a serum factor mitogenic macrophages (author's transl)]

1. The authors have searched for the existence of mitogenic factor for macrophages in the serums of rats having undergone diverse immune and non-immune inflammatory reactions. 2. The evolution of the mitogenic activity of the inflammatory serums have been studied over a 48 hour period. This study underlined that the appearance of the mitogenic factor is very rapid since it can be found as early as 30 minutes after the injection of the irritant. 3. In most cases the evolution of the mitogenic activity of serums reveals a biphasic aspect: a strong activity is observed 1 to 2 hours after the injection of the irritant followed by a decrease of this activity which becomes weak or even null towards the sixth hour. It then increases to attain, after about 24 hours, values almost equal to those seen for the first peak.

Kidney transplantation in uremic children with cystinosis

10 children underwent cadaveric renal transplantation between the ages of 8.0 and 12.5 years for uremia secondary to infantile cystinosis. 6 children are doing well 6-62 months after-transplantation. 3 of the 4 other recipients required a second graft and eventually died of uremia or fulminant viral encephalitis, the other lost her first graft due to accelerated acute rejection and is now on maintenance hemodialysis. No further systemic complications of cystinosis have been observed in the patients with functioning grafts. Our experience confirms that kidney transplantation is the treatment of choice for uremic children with infantile cystinosis.

Induction of macrophage DNA synthesis in vitro, by non-immunological inflammatory sera: effect of irradiation and thymus or bone marrow cell reconstitution

The mitogenic activity on macrophages of acute inflammatory serum is increased when this serum is obtained from irradiated rats. Transfer to irradiated rats of normal syngeneic thymic or bone marrow cells enhances the mitogenic activity of inflammatory serum. The enhancement of mitogenic activity is more pronounced after transfer of cells harvested from rats with an acute inflammatory reaction. It is postulated that the mitogenic activity of inflammatory serum could be related to both thymic and bone marrow cells and that this cellular activity is enhanced when inflammation is present.

[Effect of an acute inflammatory process on anti-infectious resistance in mice]

Acute Inflammatory reaction induced by intrapleural injection of calcium pyrophosphate increases the resistance of mice to Klebsiella pneumoniae infection. Transfer to mice of protection against Klebsiella pneumoniae is effected by injection of inflammation sera.

[Stimulation of proliferation of rat spleen cells, in vitro, by a nonspecific acute inflammatory exudate. Modulation of cell response to phytohemagglutinin (PHA)]

The effect of an acute non-specific inflammatory exudate with mitogenic activity on macrophages in culture has been tested on the spontaneous and PHA-induced DNA synthesis of spleen cells in vitro. Stimulatory effect of this exudate was observed on spontaneous DNA synthesis which was detectable over a range of 1 : 4 to 1 : 4,000 concentrations. After optimal PHA stimulation, an inhibition of mitogen-induced DNA synthesis was observed when the cells were exposed to the highest concentrations (up to 1 : 128) of the exudate. Thereafter, the phenomenon could be reversed and the stimulation was maximal at a concentration of 1 : 2,000. When a sub-optimal dose of PHA was used, the simulatory effect was more pronounced and detected from 1 : 8 up to 1 : 4,000 concentrations.

Possible C1q bypass loop activation in the haemolytic uraemic syndrome

Ultrastructural and immunofluorescent microscopic studies were performed on renal tissue obtained from nine patients during the acute and convalescent phase of the haemolytic uraemic syndrome (HUS). All had glomerular deposits of IgM in the absence of circulating immune complexes. This was associated with deposition of C1q during the acute phase, and properdin and C3 during the convalescent phase. C4 was consistently absent. Since such a pattern of complement deposition does not fulfil criteria either for alternate or classical pathway activation, the possibility of C1q bypass loop activation by IgM is suggested.

In vitro effect of an acute nonspecific inflammatory exudate on tritiated-thymidine incorporation by unstimulated and PHA-stimulated spleen cells

The effect of an acute nonspecific inflammatory exudate with mitogenic activity for macrophages in culture has been tested on the spontaneous and PHA-induced DNA synthesis by spleen cells in vitro. Stimulatory effect of this exudate was observed on the spontaneous DNA synthesis which was detectable over a range of 1:4 to 1:4096 concentrations. After optimal PHA stimulation, an inhibition of mitogen-induced DNA synthesis was observed when the cells were exposed to the highest concentrations (up to 1:128) of the exudate. Thereafter, the phenomenon could be reversed and the stimulation was maximal at the concentration of 1:2048. When a suboptimal dose of PHA was used, the stimulatory effect was more pronounced and detected from 1:8 up to 1:4096 concentrations.

Induction of macrophage DNA synthesis in vitro by non-immunological inflammatory exudates: effect of irradiation and thymus or bone marrow cell reconstitution

An acute inflammatory exudate possesses mitogenic activity in that it is able to induce both DNA synthesis and proliferation of macrophages in vitro. This activity is reduced however if the inflammatory exudate is obtained from irradiated rats (900 r). Transfer of bone marrow syngeneic cells into irradiated rats does not reverse this reduction. On the contrary the decrease of mitogenic activity is more pronounced. On the other hand transfer of thymic syngeneic cells not only restores the mitogenic activity of inflammatory exudate from irradiated rats but increases it. Transfer of both types of cell together fully restores the mitogenic activity of inflammatory exudate. It is postulated that the mitogenic activity of inflammatory exudate could be related to thymic cells and that T lymphocytes may be involved in non-specific inflammatory reactions.

[Origin of a mitogrenic factor for cultivated macrophages (IMF: Inflammatory Mitogenic Factor) found in exudates of non-specific acute inflammation]

The mitogenic activity of inflammatory exudate obtained from irradiated Rats is reduced. After transfer of bone marrow syngeneic cells into irradiated Rats this mitogenic activity is further decreased, while after transfer of thymic cells it is increased. It is postulated that the mitogenic activity of inflammatory exudate could be related to thymic cells and that T lymphocytes may be involved in non specific-inflammatory reactions.

Induction of DNA synthesis in rat peritoneal macrophages in culture by a pleural inflammatory exudate

Peritoneal macrophages in culture are blocked in the G0 phase of the cell cycle, but retain many of their functional characteristics such as phagocytic ability. Peritoneal macrophages have been thought to be a terminal cell type. It has been investigated whether such properties could be modified by a substance released in acute inflammatory exudates. For this purpose a pleural exudate obtained from rats injected with dextran (40,000) 4 hours before, was centrifuged to eliminate cells, sterilized by filtration on Millipore filter 0.22 mum and diluted 50% with 199 medium culture. This medium was used to treat normal and activated peritoneal macrophages in culture. The effects were observed 24, 48, 72, 96 hours after the beginning of treatment. An enhancement of spreading and capacity of phagocytosis was observed 24 hours after the beginning of treatment. After 48 hours, the number of cells incorporating tritiated thymidine increased and became highest 4 days later. These phenomena were also obtained with pleural exudate of inbred rats (Lewis, Wag) treating macrophages of the same strain and with rat pleural exudate treating mouse macrophages. No effects were observed with dextran alone. The chemical nature of the stimulatory factor remains to be elucidated.

[The effect of prostaglandins E1 and A2 on the proliferation and phagocytosis of mouse peritoneal macrophages in culture]

The action of prostaglandins E1 and A2 was studied on the proliferation and the phagocytosis of mouse peritoneal macrophages in culture. The proliferation was not stimulated by prostaglandins E1 and A2, but the phagocytosis was increased by prostaglandin A2 and decreased by prostaglandin E1. These actions could be correlated with the regulatory role of prostaglandins.

Characteristic immunohistochemical and ultrastructural glomerular lesions in Nude mice

Kidney glomerular lesions were studied by light microscopy and immunofluorescence in 17 congenitally athymic Nude mice and 25 of their phenotypically normal littermates. The 3-month-old mice had glomerular deposits of total IgG, IgG2, IgM, and C3, but IgG1 was consistently absent and IgA was present in only 30 per cent of cases. Conversely, the 6-month-old littermates showed no deposits. However, the 9- and 12-month-old littermates had glomerular deposits of all of the immunoglobulins and C3. Kidney tissue from five Nude mice was studied by electron microscopy. In three of these five mice the mesangial and subendothelial deposits contained characteristic double layered lamellar structures approximately 130 A wide. Antinuclear antibodies were found in the serum of 3 or 10 Nude mice and 1 of 12 littermates. Different hypotheses on the origin of the characteristic lamellar structures are proposed. The significance of the early development of autoimmunity and glomerular lesions in Nude mice is discussed.

Clinical application of a rapid technique for urinary electrophoresis in multiple myeloma

Proteinuria in three cases of multiple myeloma was studied without prior concentration of the urine, using a simple technique of urinary protein electrophoresis. In each case a free light chain spike was observed in association with a glomerular, tubular or normal urine protein electrophoresis pattem. The suggestion is made that this simple procedure may become a screening test for investigation of renal diseases.