The role of mucous glycoproteins in the rheologic properties of cystic fibrosis sputum

Cystic fibrosis (CF) is characterized by excessive amounts of thick and tenacious mucous secretions that obstruct organ ducts and passages. In the respiratory tract this is associated with chronic infection resulting in the hypersecretion of purulent sputum, which the patient finds difficult to clear. We have studied the rheologic properties of purulent sputum from six patients with CF and five patients with chronic bronchitis to assess whether CF is associated with increased sputum viscoelasticity. In addition, we have isolated the major rheologic determinants, mucous glycoproteins, from CF and chronic bronchitis sputa and, using a magnetic microrheometer, investigated the possibility that the altered properties of mucus in CF are associated with abnormalities in these glycoproteins. Creep compliance analysis indicated that the CF sputa possessed raised levels of both elasticity (p less than 0.01) and viscosity (p less than 0.01). These increases in both rheologic parameters were found to be associated with increases in the DNA content (p less than 0.01) and dry weight (p less than 0.05). Mucous glycoproteins were isolated from CF and chronic bronchitis sputum samples by gel filtration on Sepharose CL4B, followed by concentration to form 8% wt/wt gels. In the absence of other sputum components, no abnormality in the rheologic properties of CF mucin gels could be detected. However, when DNA was added, the CF gels responded with increases in both elasticity and viscosity of as much as 30% (p less than 0.05), an effect not observed in the chronic bronchitis gels. These results suggest that a subtle abnormality may exist in CF mucous glycoproteins and that this could have a role in the altered physical properties of mucous secretions in CF.

Activation of human monocyte-derived macrophages to kill schistosomula of Schistosoma mansoni in vitro

Human peripheral blood monocytes from normal donors were isolated by elutriation and differentiated by culture in the presence or absence of various immunomodulators. Cells were harvested between 0 and 24 days and tested for their ability to kill schistosomula of Schistosoma mansoni in vitro as a measure of activation. Freshly isolated monocytes showed no significant cytotoxic activity in the presence or absence of IFN-gamma or LPS. As the cells matured in vitro, there was a slight increase in their inherent toxicity against the parasite, which was greatly enhanced by pretreatment with either IFN-gamma or CSF-1. Optimal antibody-independent larvicidal activity occurred after stimulation with both IFN-gamma and CSF-1, using cells that had matured for at least 7 days in vitro. Under these conditions, killing of up to 70% of the larvae was observed. Although enhanced larvicidal activity was not found to strictly correlate with production of any of several proposed effector molecules examined, activated monocyte-derived macrophages were capable of producing significant amounts of H2O2 and TNF-alpha. These observations indicate that cytokine-activated human monocyte-derived macrophages are able to kill schistosome larvae by an antibody-independent mechanism, as has been observed using murine peritoneal macrophages. Stimulation with multiple differentiation and activation signals, as would occur in vivo, may be required for development of optimal larvicidal activity.

Activation of human monocyte-derived macrophages to kill schistosomula of Schistosoma mansoni in vitro

Human peripheral blood monocytes from normal donors were isolated by elutriation and differentiated by culture in the presence or absence of various immunomodulators. Cells were harvested between 0 and 24 days and tested for their ability to kill schistosomula of Schistosoma mansoni in vitro as a measure of activation. Freshly isolated monocytes showed no significant cytotoxic activity in the presence or absence of IFN-gamma or LPS. As the cells matured in vitro, there was a slight increase in their inherent toxicity against the parasite, which was greatly enhanced by pretreatment with either IFN-gamma or CSF-1. Optimal antibody-independent larvicidal activity occurred after stimulation with both IFN-gamma and CSF-1, using cells that had matured for at least 7 days in vitro. Under these conditions, killing of up to 70% of the larvae was observed. Although enhanced larvicidal activity was not found to strictly correlate with production of any of several proposed effector molecules examined, activated monocyte-derived macrophages were capable of producing significant amounts of H2O2 and TNF-alpha. These observations indicate that cytokine-activated human monocyte-derived macrophages are able to kill schistosome larvae by an antibody-independent mechanism, as has been observed using murine peritoneal macrophages. Stimulation with multiple differentiation and activation signals, as would occur in vivo, may be required for development of optimal larvicidal activity.

The role of nitrogen oxides as effector molecules of parasite killing

The many years of effort in the attempt to identify the effector molecules of lymphokineactivated macrophages have recently come to fruition with the discovery of immuneactive nitrogen oxide. Here, Stephanie James and John Hibbs discuss the novel mammalian biochemical pathways for the synthesis of inorganic nitrogen oxides that mediate antibody-independent killing of infectious agents as well as of tumor cells. Interaction with nitrogen oxides causes iron loss from critical target enzymes in invading organisms, resulting in metabolic failure of extracellular and even of intracellular parasites of the macrophages themselves.

Aluminum concentrations in infant formulae

The aluminum concentrations in breast milk and in 25 commercially available infant formulae were measured. The mean concentration in breast milk was 49 micrograms/L while concentrations in most of the humanized formulae were less than 500 micrograms/L. Higher concentrations were found in Nan, Prem Enfamil and the three soya formulae. We suggest that all formulae have the potential to be contaminated with aluminium, and to varying degrees in different batches. Until it is known whether aluminium toxicity occurs in normal infants fed these formulae, it seems reasonable to expect manufacturers to routinely measure aluminium and keep aluminium contamination to a minimum. This may be especially important for formula fed to infants with compromised gastrointestinal and renal systems.

The origin of DNA associated with mucus glycoproteins in cystic fibrosis sputum

The relative importance of host and bacteria-derived deoxyribonucleic acid (DNA) in the increased viscoelasticity of purulent sputum in cystic fibrosis (CF) and other airway diseases is unclear. We report the identification of the DNA associated with mucus glycoproteins purified from the purulent sputum of 9 patients with CF. Mucus glycoproteins were purified from CF sputum by gel exclusion chromatography and the co-purifying DNA isolated by phenol extraction. Electrophoresis indicated that the DNA preparations had a size of approximately 300 to greater than 50,000 bases. The origin of the DNA was determined by slot blotting and subsequent hybridization with 32P-labelled DNA probes specific for human DNA sequences and those from bacterial species commonly isolated from CF sputum. The results indicated that in all cases the DNA was almost entirely human in origin. This implies that it is the patient's own DNA which may contribute to the rheological abnormalities of CF sputum.

The origin of DNA associated with mucus glycoproteins in cystic fibrosis sputum

The relative importance of host and bacteria-derived deoxyribonucleic acid (DNA) in the increased viscoelasticity of purulent sputum in cystic fibrosis (CF) and other airway diseases is unclear. We report the identification of the DNA associated with mucus glycoproteins purified from the purulent sputum of 9 patients with CF. Mucus glycoproteins were purified from CF sputum by gel exclusion chromatography and the co-purifying DNA isolated by phenol extraction. Electrophoresis indicated that the DNA preparations had a size of approximately 300 to greater than 50,000 bases. The origin of the DNA was determined by slot blotting and subsequent hybridization with 32P-labelled DNA probes specific for human DNA sequences and those from bacterial species commonly isolated from CF sputum. The results indicated that in all cases the DNA was almost entirely human in origin. This implies that it is the patient's own DNA which may contribute to the rheological abnormalities of CF sputum.

Tumour necrosis factor (TNF) as a mediator of macrophage helminthotoxic activity

Lymphokine-activated macrophages are cytotoxic for larvae of the helminth parasite Schistosoma mansoni. That soluble secreted factors may mediate this cytotoxicity was suggested by the observation that culture supernatant fluids from stimulated macrophages also exhibited larvacidal activity. These fluids contain the monokine tumour necrosis factor (TNF). Several observations indicated that TNF is directly toxic to schistosome larvae. Cytotoxic sera taken from BCG- or S. mansoni-immunized mice after endotoxin challenge killed schistosomula in vitro, and upon gel filtration the larvacidal factor(s) in the sera co-eluted with the tumoricidal activity defined as TNF. Recombinant-derived TNF exhibited direct toxicity to schistosomula at high concentrations, or at lower concentrations in the presence of IFN gamma. The larvacidal activity of macrophage supernatant fluids was abrogated by addition of either anti-TNF antisera or Zn+2, which has been shown to inhibit TNF-induced damage of tumour cells. Anti-TNF and Zn+2 likewise suppressed schistosomulum killing by lymphokine-activated peritoneal macrophages or the IC-21 macrophage line, indicating that TNF also plays a role in the effector mechanism of larval killing by whole cells.

Macrophage cytotoxicity against schistosomula of Schistosoma mansoni involves arginine-dependent production of reactive nitrogen intermediates

Lymphokine (LK)-activated macrophages are cytotoxic for multicellular larvae of the helminth parasite Schistosoma mansoni. Macrophage-mediated larval killing was found to be arginine dependent, as indicated by inhibition in the presence of exogenous arginase or the competitive inhibitor NG-monomethyl-L-arginine. Culture supernatant fluids from the larvicidal LK-activated macrophages contained nitrite, a product of activated macrophages derived by oxidation of arginine and implicated in the antitumor and antimicrobial effector function of these cells. Nitrite was not detectable in supernatant fluids obtained from nonactivated macrophages or from macrophages stimulated with LK in the presence of arginase or NG-monomethyl-L-arginine. Addition of excess iron or the reductant sodium dithionite to LK-activated macrophage cultures also inhibited larval killing in vitro, under conditions that have been shown by others to stabilize the activity of iron-containing enzymes involved in respiration. Nitrite production was not decreased under these conditions. These observations are consistent with the hypothesis that macrophage-mediated schistosomulum killing is caused, at least in part, by a mechanism proposed for tumor cytotoxicity, whereby production of reactive nitrogen intermediates triggers iron loss from critical target cell enzymes leading to lethal metabolic inhibition. In accordance, schistosomula were shown to be killed by inhibitors of mitochondrial respiration.

Macrophage cytotoxicity against schistosomula of Schistosoma mansoni involves arginine-dependent production of reactive nitrogen intermediates

Lymphokine (LK)-activated macrophages are cytotoxic for multicellular larvae of the helminth parasite Schistosoma mansoni. Macrophage-mediated larval killing was found to be arginine dependent, as indicated by inhibition in the presence of exogenous arginase or the competitive inhibitor NG-monomethyl-L-arginine. Culture supernatant fluids from the larvicidal LK-activated macrophages contained nitrite, a product of activated macrophages derived by oxidation of arginine and implicated in the antitumor and antimicrobial effector function of these cells. Nitrite was not detectable in supernatant fluids obtained from nonactivated macrophages or from macrophages stimulated with LK in the presence of arginase or NG-monomethyl-L-arginine. Addition of excess iron or the reductant sodium dithionite to LK-activated macrophage cultures also inhibited larval killing in vitro, under conditions that have been shown by others to stabilize the activity of iron-containing enzymes involved in respiration. Nitrite production was not decreased under these conditions. These observations are consistent with the hypothesis that macrophage-mediated schistosomulum killing is caused, at least in part, by a mechanism proposed for tumor cytotoxicity, whereby production of reactive nitrogen intermediates triggers iron loss from critical target cell enzymes leading to lethal metabolic inhibition. In accordance, schistosomula were shown to be killed by inhibitors of mitochondrial respiration.

Acute regulation of the predominant organic solutes of the rabbit renal inner medulla

High concentrations of organic solutes are present in the medulla of the antidiuretic kidney. However, their role in and response to acute changes in the diuretic state are unknown. In this study the organic solute content of the renal medulla was determined from extracts with the use of high-performance liquid chromatography following the acute dilution of the medullary interstitium during various forms of diuresis. After acute infusion of saline and furosemide, inner medullary urea, sodium, inositol, sorbitol, and betaine decrease significantly with no change in glycerophosphorylcholine (GPC) content. After diuresis, inner medullary urea and sodium contents eventually returned to control levels, although inositol, sorbitol, and betaine contents still remained low. Addition of antidiuretic hormone to the saline/furosemide infusion gave similar results. In contrast, induction of diuresis from mannitol infusion caused an acute decrease in all 4 organic solutes, whereas glucose infusion caused an acute decrease in all organic solutes except sorbitol. These data demonstrate that a decrease in all four organic solutes can accompany medullary dilution. However, GPC and sorbitol do not decrease when diuresis is induced by furosemide or glucose, respectively. In addition, the recovery of these compounds in a normally functioning kidney after diuresis is much slower than the regeneration of the sodium chloride and urea gradients.

The cost of intensive and special care of the newborn

The cost of providing intensive (level-3) and special (level-2) care for newborn infants in a tertiary perinatal service was determined prospectively and was expressed in 1984 Australian dollars. Direct costs that were expressed per occupied bed-day were $690 for level-3, high-dependency care; $421 for level-3, low-dependency care; $544 for over-all level-3 care; $242 for level-2, high-dependency care; $170 for level-2, low-dependency care; and $201 for over-all level-2 care. Each level of care generated additional costs of $42 per occupied bed-day. Taking these additional costs into account, the over-all occupied bed-day cost of level-3 and level-2 neonatal care was $339. The major components of this over-all cost were: nursing staff members, 50%; medical staff members, 11%; consumable and recyclable items, 12%; and diagnostic services, 8%.

Calcified cerebral sinus thrombosis in infancy--CT appearances with pathological correlation

A case of calcified cerebral venous sinus thrombosis in an infant is described, with autopsy correlation. Calcification of sinus thrombosis is rare. A triangular calcific density was demonstrated in the superior sagittal sinus, with extension of linear calcification laterally into the transverse sinuses. Following intravenous contrast administration there was intense enhancement of the superior sagittal and transverse sinuses around the calcified thrombus. The cerebral hemispheres showed generalised atrophy. Autopsy confirmed a calcified venous sinus thrombus. Triangular calcium density within the sagittal sinus or linear calcification within the transverse sinuses would appear to be characteristic of calcified cerebral sinus thrombus.

Schistosome vaccines: current progress and future prospects

Vaccination against human schistosomes in laboratory hosts is now a reality. A number of different parasite molecules have been shown to confer partial protective immunity against challenge infection with Schistosoma mansoni or Schistosoma japonicum in rodent or primate hosts. These antigens are unusually diverse in their structure and stage specificity. Interestingly, although all of the vaccine molecules characterized are situated in the tegument, their exposure on the parasite surface, in most instances, is transient and/or non-essential. The properties of four of these immunogens, glutathione-S-transferase (P26,28), paramyosin (Sm97), GP38, and GP18 are discussed. Despite the identification and recombinant synthesis of several promising protective antigens, vaccination of humans against schistosomiasis remains in the realm of fantasy. At the technical level, a major problem is the failure of any of the current vaccine immunogens and immunization protocols to induce levels of resistance sufficient for significant reduction of human infection or disease. Once this important hurdle is passed, human immunization trials should be attempted as the potential beneficial impact of a vaccine against schistosomiasis remains enormous.

Long-term evaluation of knee stability and function following surgical reconstruction for anterior cruciate ligament insufficiency

Currently used measures of knee stability and function for ACL reconstructed knees have not gained universal acceptance. Clinical test results often are given more value than the patient's subjective evaluation of the surgical outcome. This study was designed to identify specific knee stability and function variables that were most predictive of the patient's rating of knee function following one of two types of combined (intraarticular and extraarticular) ACL reconstruction procedures. Individual measures of knee stability and function were also evaluated for differences between contralateral operated and nonoperated limbs. Postoperative and healthy contralateral knees of 51 male and female patients aged 18 to 49 years (mean, 23.7 years) were evaluated on a battery of tests at an average of 48.0 months after surgery (range, 24 to 101 months). All subjects possessed a normal contralateral knee for comparative purposes. The results of this retrospective study indicated that the variables selected were not highly correlated with, nor could they effectively predict, the patients' perceptions of postoperative knee status as measured by the Knee Function Rating Form (KFR). Statistically significant differences (P less than 0.001) between operated and nonoperated knees were found for 9 of 11 variables analyzed. The data suggest that patients' perceptions of postoperative knee status were independent of the results of static and dynamic clinical tests commonly used to assess knee stability and function. Postoperative deficits of up to 30% between the surgically reconstructed and normal contralateral knees on specific measures of knee stability and function did not greatly influence the patients' perceptions of knee function. Development of new, more specific dynamic tests may be necessary before stronger relationships between clinical test results and patients' perceptions of knee status in the ACL reconstructed knee can be realized.

Proximal tibial osteotomy in patients who are fifty years old or less. A long-term follow-up study

Proximal tibial valgus osteotomy was performed for unicompartmental osteoarthritis in forty-five patients (fifty-one knees). The average age of the patients was forty-one years (range, twenty-three to fifty years), and the average length of follow-up was ten years. At follow-up, 70 per cent (thirty-six knees) were rated as good or excellent and 30 per cent (fifteen knees) were rated as fair or poor. There was no clear correlation between the quality of the result and the radiographic evidence of the severity of the arthritis preoperatively, the age of the patient at osteotomy, or the length of follow-up. There was a correlation between an improved result and an increased angle of correction after osteotomy, but the values were not statistically significant. The most important factor influencing the quality of results was the over-all level of disease in the knee as reflected in the preoperative knee score. Deficiency of the anterior cruciate ligament at the time of the osteotomy did not prevent a good result. We believe that proximal tibial osteotomy for unicompartmental arthritis of the knee is a good and effective procedure for patients who are less than fifty years old and who have an active life-style, and that lasting results can be achieved if the procedure is done early in the course of the disease.

Induction of protective immunity against Schistosoma mansoni by vaccination with schistosome paramyosin (Sm97), a nonsurface parasite antigen

Paramyosin (Sm97), a 97-kDa myofibrillar protein identified by the unusually monospecific antibody response induced by intradermal vaccination of mice with a complex soluble worm antigen preparation (SWAP) of adult Schistosoma mansoni administered with bacillus Calmette-Guérin (BCG), was purified and tested for its capacity to protect mice against challenge infection. When administered intradermally with BCG at total doses of only 4-40 micrograms per mouse, both the native molecule and a recombinant expression product containing approximately 50% of the whole protein were found to confer significant resistance (26-33%) against challenge infection, while 2 mg of unfractionated SWAP was required to induce similar levels of protection. In addition, paramyosin was shown to stimulate T lymphocytes from vaccinated mice to produce lymphokines [e.g., gamma interferon (IFN-gamma)] that activate macrophages to kill schistosomula. Neither schistosome myosin nor a heterologous paramyosin from a different invertebrate genus were protective, indicating a requirement for specific epitopes in the immunization. That the protection induced by paramyosin involves a T-cell-mediated mechanism was supported by the failure of anti-paramyosin antibodies to passively transfer significant resistance to infection to recipient mice. Lymphocytes from mice vaccinated with paramyosin were found to produce IFN-gamma in response to living schistosomula, suggesting that during challenge infection of vaccinated hosts, paramyosin (a nonsurface antigen) may elicit a protective T-cell response as a consequence of its release from migrating parasite larvae. Paramyosin-depleted SWAP was also found to be protective as well as stimulatory for T lymphocytes from SWAP-vaccinated mice, indicating that other antigens in this preparation may have immunoprophylactic potential. In summary, these results (i) suggest that the induction of T-cell-dependent cell-mediated immunity against soluble nonsurface antigens may be an effective strategy for immunization against multicellular parasites and (ii) in the case of schistosomes, identify paramyosin as a candidate vaccine immunogen in this category.

The influence of adjuvant on induction of protective immunity by a non-living vaccine against schistosomiasis

Mice were protected against subsequent infection with Schistosoma mansoni by intradermal or s.c. vaccination with killed schistosomula or soluble parasite extracts and bacillus Calmette-Guérin (BCG). Treatment with i.p. immunization was somewhat less effective, whereas i.m. vaccination failed to elicit protective immunity. The level of resistance induced by intradermal immunization was influenced by the strain of BCG used, and isolated BCG cell walls did not reliably substitute for whole BCG organisms as adjuvant. Bordetella pertussis vaccine and saponin were also able to function as adjuvants for protective immunity in this model, whereas other immunopotentiators including Corynebacterium parvum and aluminum hydroxide were ineffective. No correlation between resistance to challenge infection and antibody levels was detected. Animals immunized intradermally using either protective or non-protective adjuvants all showed minimal humoral reactivity against schistosomulum surface Ag but strong IgG response to soluble parasite components including paramyosin, which is the major serologically recognized Ag in mice vaccinated intradermally with schistosome Ag plus BCG and is protective in this model. In contrast, a strong correlation was observed between resistance and Ag-specific cell-mediated reactivity, including IFN production by T lymphocytes in vitro and macrophage activation in vivo. These results further substantiate the hypothesis that protection in this model is based on cell-mediated immune effector mechanisms. Moreover, they may be of general relevance in the design of vaccination protocols using other Ag or against other infectious agents.

The influence of adjuvant on induction of protective immunity by a non-living vaccine against schistosomiasis

Mice were protected against subsequent infection with Schistosoma mansoni by intradermal or s.c. vaccination with killed schistosomula or soluble parasite extracts and bacillus Calmette-Guérin (BCG). Treatment with i.p. immunization was somewhat less effective, whereas i.m. vaccination failed to elicit protective immunity. The level of resistance induced by intradermal immunization was influenced by the strain of BCG used, and isolated BCG cell walls did not reliably substitute for whole BCG organisms as adjuvant. Bordetella pertussis vaccine and saponin were also able to function as adjuvants for protective immunity in this model, whereas other immunopotentiators including Corynebacterium parvum and aluminum hydroxide were ineffective. No correlation between resistance to challenge infection and antibody levels was detected. Animals immunized intradermally using either protective or non-protective adjuvants all showed minimal humoral reactivity against schistosomulum surface Ag but strong IgG response to soluble parasite components including paramyosin, which is the major serologically recognized Ag in mice vaccinated intradermally with schistosome Ag plus BCG and is protective in this model. In contrast, a strong correlation was observed between resistance and Ag-specific cell-mediated reactivity, including IFN production by T lymphocytes in vitro and macrophage activation in vivo. These results further substantiate the hypothesis that protection in this model is based on cell-mediated immune effector mechanisms. Moreover, they may be of general relevance in the design of vaccination protocols using other Ag or against other infectious agents.

Genetic complementation of defects in vaccine-induced immunity against Schistosoma mansoni in P- and A-strain inbred mice

Inbred P- and A-strain mice are deficient in their capacity to develop resistance to challenge infection in response to vaccination with irradiated cercariae of Schistosoma mansoni and are also defective in their cell-mediated response as assessed by the activity of antigen-elicited macrophages in killing schistosome larvae in vitro. In contrast, vaccinated (P x A)F1 mice displayed high levels of both immunity to challenge and macrophage larvicidal activity, indicating that the P- and A-strain defects in the vaccine-induced response are controlled by distinct genetic loci.

Induction of protective immunity against Schistosoma mansoni by a non-living vaccine. VI. Antigen recognition by non-responder mouse strains

Previous studies have shown that many strains of mice develop partial resistance to Schistosoma mansoni as a result of intradermal vaccination with soluble schistosome antigens plus BCG. However, P and BALB/c mice are non-responsive to this intradermal vaccination protocol. In this study, humoral and cellular responses to schistosome antigens in vaccinated P and BALB/c mice were compared to those in protected C57BL/6 mice to identify an immune correlate to resistance in this model. Levels of circulating IgG and IgM antibodies to soluble adult worm antigens, as measured by ELISA, were comparable between strains. Moreover, Western blot analysis revealed no qualitative differences in antibody reactivity, with sera from vaccinated animals of all three strains recognizing the antigen previously identified as Sm-97 (paramyosin). However, vaccinated P and BALB/c mice showed specific defects in cell-mediated immunity to schistosome antigens, including decreased production of macrophage-activating lymphokines and an inability to produce activated macrophage effector cells in vivo at the site of antigen challenge. These observations strengthen our hypothesis that the intradermal vaccine acts through induction of T-cell-mediated immune resistance mechanisms.

Effects of inhibitors of tumoricidal activity upon schistosomulum killing by activated macrophages

Larvae of the helminth parasite Schistosoma mansoni are efficiently killed in vitro by lymphokine-activated macrophages, leading to the hypothesis that these cells may participate in the effector mechanism of protective immunity against schistosomiasis. Larvacidal activity has also been demonstrated in the IC-21 macrophage cell line in the absence of a demonstrable respiratory burst, indicating that macrophages possess nonoxidative mechanisms of schistosomulum killing. In this study, we demonstrated that IC-21 larval killing was most effective when contact was allowed between cells and target. Nonoxidative larvacidal activity was prevented by protein synthesis inhibitors, by the inhibition of microtubule polymerization, and by tosyllysylchloromethylketone but not by other inhibitors or substrates of tryptic or chymotryptic protease activity. The addition of excess iron to the culture also prevented IC-21-mediated larval killing, suggesting that the production of an iron-binding molecule may be involved. In contrast, the addition of excess thymidine or arginine did not reverse macrophage larvacidal activity, nor did lysosomotropic agents that depress the activity of acid hydrolases. Under appropriate conditions of activation and surface membrane stimulation, IC-21 cells could be induced to release soluble cytotoxic factors retaining larvacidal activity. These observations provide insight into the mechanism of macrophage-mediated schistosome killing, in comparison to the cytotoxic mechanisms described in the better-studied tumoricidal models, and supply a basis for further biochemical investigation of macrophage function against a multicellular target.

Induction of protective immunity against Schistosoma mansoni by a non-living vaccine. V. Effects of varying the immunization and infection schedule and site

Intradermal (i.d.) injection with non-living schistosome antigens plus bacterial adjuvant protects mice against subsequent infection with Schistosoma mansoni. This protection became apparent within 2 weeks after a single inoculation and persisted for at least 8 weeks. Administration of one or more booster immunizations enhanced the level of protection but never produced complete resistance to cercarial challenge under the conditions tested. All immunized mice recognized the Sm 97 antigen in adult worms, as measured by antibody reactivity in ELISA, although the level of reactivity did not correlate with the level of resistance. Significant protection was observed when mice were immunized in the skin of the chest, the footpad or at the base of the tail if challenge infection was administered percutaneously either on the abdomen or back. However, when mice were infected by cercarial exposure of the tail skin, the level of resistance was consistently lower regardless of the immunization site. Vaccinated mice were not resistant to infection with lung stage parasites. These results demonstrate that the i.d. vaccine induces significant and persistent resistance in mice, the level of which is strengthened by booster immunization. The resistance is unrelated to inflammation at the site of immunization. However, immune response at the challenge site may play a critical role in the effector mechanism of resistance in this model.

Genetic association of defects in macrophage larvicidal activity and vaccine-induced resistance to Schistosoma mansoni in P strain mice

In contrast to most inbred strains, P mice fail to develop significant resistance to Schistosoma mansoni infection as a result of vaccination with irradiated cercariae. Vaccinated P mice also exhibit a defect in macrophage activation for killing of larval schistosomes upon specific-antigen challenge in vivo. To examine the genetic basis of these defects in vaccine-induced immunity, inheritance of the two traits was examined in (C57BL/6 X P)F1, F2, and reciprocal backcross generations. The defect in macrophage function which characterizes the P strain parent was found to be inherited in a fully recessive manner and to be controlled by only one or two major genetic loci. Moreover, a highly significant correlation (P less than 0.0025) was observed between the level of macrophage larvicidal activity and the level of resistance to challenge infection in segregating generations. Such an association is consistent with a cause-and-effect relationship, providing strong in vivo evidence implicating activated macrophages as immune effector cells of resistance to S. mansoni in the mouse-irradiated-vaccine model.