CD3-negative lymphoproliferative disease of granular lymphocytes containing Epstein-Barr viral DNA

Lymphoproliferative disease of granular lymphocytes (LDGL) is a heterogeneous disorder and the pathogenesis is likely to be complex. Some patients with chronic active EBV (CAEBV) infection also have LDGL. To investigate the relationship between EBV infection and the pathogenesis of LDGL, we conducted a survey for EBV DNA sequences by Southern blot analysis of DNA obtained from the peripheral blood of seven patients with LDGL, including one with CAEBV infection. Interestingly, EBV DNA was detected in the sample from the patient with CAEBV infection, and in the samples from four other patients with CD3-LDGL. Moreover, a single band for the joined termini of the EBV genome was demonstrated in two samples, suggesting a clonal disorder of those LDGL. These findings strongly suggest that EBV may play a pathogenic role in some cases of LDGL.

Induction of inflammatory mediators (histamine and leukotrienes) from rat peritoneal mast cells and human granulocytes by Pseudomonas aeruginosa strains from burn patients

Clinical isolates of Pseudomonas aeruginosa from severely burned patients were analyzed with regard to their capacity to induce inflammatory-mediator release from rat mast cells or human granulocytes. The bacterial strains were characterized according to their cell-associated hemolysin activity as well as their secreted hemolysin and phospholipase C activities. P. aeruginosa expressing heat-labile hemolysin and phospholipase C induced histamine release from rat mast cells and leukotriene formation from human granulocytes, while bacterial strains expressing heat-stable hemolysin were potent releasers of histamine but did not lead to leukotriene formation. The mediator-inducing capacity was dependent on the growth characteristics of the bacterial strains. The purified glycolipid (heat-stable hemolysin) of P. aeruginosa was a potent inducer of histamine release but did not initiate leukotriene formation. Exotoxin A did not affect inflammatory-mediator release. P. aeruginosa with leukotriene-inducing capacity also enhanced omega oxidation of endogenous leukotriene B4, suggesting an additional inactivation of the chemotactic potential. Our data suggest that both hemolysins of P. aeruginosa contribute to the pathogenicity of P. aeruginosa by inducing and modulating inflammatory-mediator release from various cells.

Replication of herpes simplex virus type 1 in differentiated human promyelocytic HL-60 cells

The capability of herpes simplex virus type 1 (HSV-1), strain Angelotti (ANG), to replicate in human promyelocytic HL-60 cells treated with 1,2-tetradecanoyl-phorbol-13-acetate (TPA) and dimethyl sulfoxide (DMSO) was examined. Virus titrations and infectious center assays revealed that HSV-1 ANG replicated in nontreated HL-60 cells and in HL-60 cells treated with TPA. An abortive infection was observed in DMSO-stimulated HL-60 cells. Viral DNA synthesis was detected in nontreated and TPA-treated cells, but not in DMSO-treated cells. Analysis of HSV-1 transcripts revealed that albeit the differences in pretreatment, HL-60 cells synthesized viral immediate-early (ICP4) and early (tk and pol) RNAs, whereas a late viral transcript (gC) was almost exclusively detected in nontreated and TPA-treated HL-60 cells. In line with these observations were the results obtained from studies on viral protein synthesis. The immediate-early protein ICP4 was found in all three cell types. Early (pol), delayed-early (gB), as well as late proteins (VP 5, gC) were identified in nontreated and TPA-treated cells, but only in reduced amounts in DMSO-treated cells. These data suggest a translational block of HSV replication in DMSO-treated HL-60 cells at the level of early gene expression.

AIDS: a syndrome of immune dysregulation, dysfunction, and deficiency

Acquired immune deficiency syndrome (AIDS) is a disease caused by the human immunodeficiency virus (HIV) in which cellular immune functions are severely impaired. Acute infection and subsequent destruction of helper T cells, although occurring readily in cell cultures, do not appear to be the only mechanisms mediating helper T cell loss. Other mechanisms that may account for the loss of helper T cells include: T cell syncytia formation, decreased T cell production, and autoimmune-related destruction of helper T cells. Immune abnormalities seen early in the course of HIV infection include immune hyperactivation and autoimmune phenomena suggestive of immune dysregulation rather than immune deficiency. Many changes in immune function are, in fact, seen in HIV-seropositive patients who possess a normal number of helper T cells. Mechanisms (other than the loss of helper T cells) that may contribute to the immune abnormalities seen in these patients include noninfectious effects of HIV and HIV proteins, effects of HIV on non-T cells, autoimmune-related manifestations of HIV infection, and HIV-induced activation of normal immunosuppressive circuits.

Histologic, immunofluorescence, and electron microscopic study of infectious process in mouse lung after intranasal challenge with Coxiella burnetii

A histologic, immunofluorescence, and electron microscopic study of the intracellular parasitism of Coxiella burnetii (the Q fever agent) in mouse lungs after intranasal challenge was undertaken. It was shown that this microorganism invades type I and, rarely, type II pneumocytes as well as pulmonary fibroblasts and histiocytes. The infectious process can be described as a focal intra-alveolar inflammation with the macrophages prevailing in the exudate. It is self-limited, with a complete resolution. The inflammation is associated with atelectases and with increased secretory activity by type II pneumocytes. Alveolar macrophages and granulocytes degrade C. burnetii. This degradation is followed by damage to and eventual disintegration of some macrophages and by damage to some bacterium-free pneumocytes and vascular endothelial cells in the vicinity of macrophages degrading organisms. The cell damage might be caused by lipopolysaccharide released from degraded organisms. The infectious process is also associated with the influx of T cells in the pneumonic foci, T-cell attachment to the macrophages degrading organisms, and fusion of some macrophages. These are considered a morphologic expression of cell-mediated immunity involved in the infectious process.

The microscopic double immunofluorescence technique, a method for quantitative differentiation between extra- and intracellularly located bacteria in isolated polymorphonuclear granulocytes

A simple microscopic double immunofluorescence staining technique for the study of phagocytosis of living bacteria by human polymorphonuclear granulocytes (PMN) is presented. This technique enables the differentiation between cell-attached and ingested bacteria and allows the kinetics of phagocytosis to be monitored. The practicability and accuracy of this method is demonstrated by using two genetically defined Yersinia enterocolitica strains of different virulence, and isolated PMN resuspended in serum-free and serum-containing medium, respectively. The advantages of this method over other techniques are discussed.

Modification of glycosylation by tunicamycin treatment inhibits lectin-mediated adhesion of Streptococcus pneumoniae to various tissues

Oligosaccharide moieties of cell surface glycoconjugates are thought to be involved in recognition events associated with infectious diseases. Treatment of Streptococcus pneumoniae (which exhibits well defined surface lectins) with subinhibitory concentrations of the antibiotic tunicamycin was found to block the protein glycosylation of the bacterial surfaces. Since bacterial lectins (adhesins) are in most cases glycoproteins and play an important role in the organ specificity of infectious diseases, adhesion of Streptococcus pneumoniae to frozen sections of lung, meninges and kidney (from Balb/c-mice) was almost totally lacking after inhibition of the biosynthesis of N-linked carbohydrate chains which are important for an adequate lectin function. Chemiluminescence measurements of human granulocyte stimulation yielded results suggesting a great importance of lectin-carbohydrate interactions in this process, too. These experimental data indicate that the presence of specific cell surface carbohydrates is required for a successful completion of the adhesion phase of pathogenic bacteria in infectious diseases and for the induction of granulocyte stimulation.

In vitro cytotoxic effect of alpha-hemolytic and nonhemolytic Escherichia coli on human blood granulocytes and monocytes

The in vitro cytotoxic effect of Escherichia coli on human phagocytic blood cells in the presence of fresh autologous plasma was assessed using (i) a technique by which cell damage was quantified by measuring the release of chromium 51 from labelled granulocytes and (ii) a technique based on the degree of morphological cell damage induced in monocytes. All of 109 alpha-hemolytic strains were cytotoxic, the cytotoxic effect ranging from very weak to strong. Log-phase cultures had the strongest cytotoxic effect, the individual microorganisms being most cytotoxic in the early log-phase. Plateau-phase cultures progressively lost their cytotoxic ability and 24 h old cultures were almost noncytotoxic. Strongly cytotoxic strains induced high degrees of cell injury, caused an abrupt damage during the first 20 min of incubation and were able to induce injury with few bacteria present. Weakly cytotoxic strains induced only low degrees of cell injury, caused a more gradually developing damage, and were able to induce injury with only high numbers of bacteria present. All of 75 nonhemolytic and 3 beta-hemolytic strains were noncytotoxic.

Poliovirus infection of established human blood cell lines: relationship between the differentiation stage and susceptibility of cell killing

The replication of type 1 poliovirus in 13 established human blood cell lines differing in the differentiation stage and cell lineage was investigated. Three T (CCRF-CEM, CCRF-HSB-2, and Molt-3) and three B (Raji, CCRF-SB, and RPMI 8226) cell lines showed no cytopathic effects (CPE) or virus production. CPE associated with virus production were detected in the other seven cell lines: HL-60, ML-1, and KG-1 (granulocytic lineage), U-937 and THP-1 (monocytic lineage), K-562 (erythroid lineage), and Molt-4 (T cell lineage). These susceptible cell lines greatly differed in the speed at which the CPE progressed. The progression of CPE was faster in relatively well-differentiated cell lines such as HL-60 and U-937, independently of the multiplicity of infection, than in less differentiated cell lines such as K-562, KG-1, and THP-1. Thus, for the same lineage, the speed at which CPE progressed became proportionally higher with subsequent differentiation stages. In the K-562 cell culture, CPE were not observed until at least 5 days postinfection (p.i.), while more than 80% of HL-60 cells were killed within 3 days p.i. There were no significant differences between infected HL-60 and K-562 cells in the efficiency of infection determined at 8 hr p.i. by the indirect immunofluorescent technique, the rate of virus growth, or the amount of viral capsid protein synthesized. This indicated that there were similar viral replication cycles in the two cell lines. These observations suggest that the killing function of the virus is expressed more slowly in K-562 cells than in HL-60 cells.

Optimal conditions for the opsonophagocytosis test with Streptococcus pneumoniae serotypes 3, 6A, 7F and 19F and human granulocytes

There are great variations in test systems used to measure pneumococcal opsonophagocytosis; therefore, in the present study, a detailed analysis of the human granulocyte opsonophagocytosis test with pneumococci was made. Variables affecting the test were evaluated. These were the amount of bacteria, the amount of antipneumococcal antibody and complement in the test. Correlation between phagocytosis percentage (percentage of cells taking part in the phagocytosis) and phagocytosis index (mean amount of bacteria phagocytosed per cell) was shown. The conclusion is that, after precise test-adjustment, weak phagocytosis is better detected by phagocytosis percentage and high phagocytosis activity is best shown by phagocytosis index.

Morphological study of the in vitro cytotoxic effect of alpha-hemolytic E. coli bacteria and culture supernatants on human blood granulocytes and monocytes

The morphological changes of human blood granulocytes and monocytes caused in vitro by alpha-hemolytic strains of E. coli and bacteria-free culture supernatants of these bacteria were studied by light- and transmission electron microscopy. The following sequence of cellular alterations were observed: Cessation of intracellular cytoplasmic streaming and cellular movements succeeded by extension of cytoplasmic pseudopodia, degranulation and development of cytoplasmic and nuclear edema. Within two hours the leukocytes appeared as empty sacks. Finally, long straight filaments were formed between the cells. The changes induced by alpha-hemolytic bacteria and culture supernatants containing free alpha-hemolysin appeared to be identical. The cytotoxic effect became more pronounced as the numbers of bacteria, the hemolytic activity of growth supernatants or the period of incubation were increased. A beta-hemolytic and a nonhemolytic E. coli strain were not cytotoxic.

Differences in initial rate of intracellular killing of Salmonella typhimurium by granulocytes of Salmonella-susceptible C57BL/10 mice and Salmonella-resistant CBA mice

The contribution of granulocytes to differences in the innate susceptibility of mouse strains to infection by Salmonella typhimurium was assessed on the basis of the size and composition of the inflammatory exudate after i.p. injection of bacteria and the intracellular killing of the bacteria by exudate peritoneal cells and blood granulocytes of resistant CBA and susceptible C57BL/10 mice. The increase in the numbers of both peritoneal granulocytes and macrophages 24 hr after i.p. injection of various numbers of live S. typhimurium was two to four times higher in C57BL/10 mice (p less than 0.05) than in CBA mice. However, despite the larger number of phagocytes in the inflammatory exudate, the numbers of viable S. typhimurium in the peritoneal cavity 24 hr after injection was higher (p less than 0.01) in C57BL/10 mice than in CBA mice. Because the proportion of noningested bacteria was similar in the two mouse strains (less than 30%), these findings indicate a difference in the rate of intracellular killing of the bacteria by exudate peritoneal cells (greater than 75% granulocytes) of the two mouse strains. Subsequent determination of the initial rate of intracellular killing (Kk) of S. typhimurium revealed that after phagocytosis of the bacteria in vivo, exudate peritoneal granulocytes (harvested 24 hr after i.p. injection of 10(3) live S. typhimurium) of CBA mice killed S. typhimurium twice as efficiently (Kk = 0.014 min-1; p less than 0.01) as exudate granulocytes of C57BL/10 mice (Kk = 0.008 min-1) did. Similarly, the initial rate of intracellular killing of the ingested S. typhimurium by blood granulocytes of CBA mice (Kk = 0.017 min-1) was two times higher (p less than 0.01) than that of C57BL/10 mice (Kk = 0.007 min-1). These findings may be specific for S. typhimurium, because L. monocytogenes were killed with equal efficiency by exudate granulocytes and blood granulocytes of these mouse strains (p greater than 0.20). The results of the present study are relevant with respect to the innate resistance of mice to S. typhimurium, particularly during the initial phase of infection when the inflammatory exudate contains predominantly granulocytes.

Chlamydia trachomatis (L2 serovar) binds to distinct subpopulations of human peripheral blood leukocytes

We have previously shown that infants with pneumonitis caused by Chlamydia trachomatis, an obligate intracellular bacterium, possess increased percentages of B lymphocytes but not T lymphocytes in their peripheral blood. It was then demonstrated that chlamydiae induce proliferation in vitro of human peripheral blood B lymphocytes and, in the presence of T cells, differentiation of B cells to immunoglobulin-secreting cells. In this study, we show that C. trachomatis (L2 serovar) binds preferentially to 50% of human B lymphocytes from peripheral blood but only to a small percentage, if any, of T cells. Both monocytes and granulocytes bind and ingest chlamydiae. Despite chlamydial binding to B cells and ingestion by monocytes, no uptake by B cells and limited growth (fewer than 0.5% inclusion-containing cells) in monocytes occur. There is a dramatic decrease in the percentage of cells associated with the bacteria after culture. These results are the first demonstration of binding of C. trachomatis (L2 serovar) to lymphocytes and represent a direct step toward correlating physical interactions between bacteria and lymphocytes with specific immunostimulatory activities in vitro.

Isolation of haemorrhagic fever with renal syndrome virus from leukocytes of rats and virus replication in cultures of rat and human macrophages

Newborn rats were inoculated intraperitoneally with haemorrhagic fever with renal syndrome (HFRS)-related virus (B-1 strain), and virus isolation from their various organs was attempted between 1 and 25 weeks after inoculation. Virus could be isolated repeatedly from lung, brain, spleen and kidney and also from peripheral blood. When virus isolation was carried out on fractionated peripheral blood cells, virus was associated mainly with the macrophage fraction and to a lesser extent with granulocytes. Virus replicated well in peritoneal exudate cells of normal rats and it grew in the adherent mononuclear cells from normal human peripheral blood. These data suggest that macrophages, permissive for HFRS-related virus replication, might contribute to the spread of viral infection in vivo.

The isolation of enteroviruses from blood: a comparison of four processing methods

Blood from 28 children hospitalized with symptomatic enterovirus infections was processed by four different methods in an effort to define optimum conditions for detecting viremia. Enteroviremia was demonstrated in 11/28 children. Virus was isolated by method 1 (serum) in 7/11 children and by method 2 (mononuclear leukocytes) in 9/11, but in only 3/10 and 3/11 children by methods 3 and 4 (granulocytes and plasma-mixed leukocytes, respectively). In four children, the only blood isolate was from mononuclear leukocytes, and in two, serum was the only positive blood preparation. This suggests that viremia can be often detected in hospitalized children with enterovirus disease and shows that the methods used for processing blood may significantly influence the isolation rate.

Target cells for malignant catarrhal fever virus in rabbits

Lymphocytes from lymph nodes and spleens of malignant catarrhal fever virus (MCFV) infected rabbits were tested for MCFV infectivity in secondary calf thyroid cell monolayers. Most infectivity was demonstrated in the lymphocytes. Some infectivity was also detected in macrophages/monocytes. It was thus concluded that lymphocytes form the major target cell for the herpesvirus of malignant catarrhal fever in rabbits.

Participation of immunoglobulins and complement components in the intracellular killing of Staphylococcus aureus and Escherichia coli by human granulocytes

Immunoglobulins and complement components are required for optimal ingestion and optimal killing of microorganisms by granulocytes. The degree of opsonization of microorganisms necessary for their ingestion was lower than that required for the killing of these bacteria during the ingestion phase. Killing during this phase was found to depend mainly on the presence of heat-labile opsonins, probably C3b, present on the microorganisms. Extracellular immunoglobulin G (IgG) and C3b were indispensable for optimal intracellular killing after ingestion was complete. This was established with an assay permitting assessment of the course of the number of viable intracellular bacteria independent of the ingestion of new live bacteria. Maximal intracellular killing by human granulocytes of ingested catalase-positive (Staphylococcus aureus and Escherichia coli) or catalase-negative (Streptococcus pyogenes and S. pneumoniae) microorganisms was found only when fresh serum was present extracellularly. Killing was suboptimal in the absence of serum. With heat-inactivated serum, the killing index lay between the indices obtained in the presence and absence of fresh serum. The stimulatory activity of heat-inactivated serum was most probably due to the interaction of IgG with the Fc receptor on the granulocyte membrane, since IgG subclasses IgG1 and IgG3 as well as pFc fragments of IgG stimulated the intracellular killing to the same degree as heat-inactivated serum did. In addition, (Fab1)2 fragments of IgG did not stimulate killing, and reduced killing was observed in the presence of heat-inactivated serum after reduction of the number of Fc receptors. The extra stimulation of the killing process in the presence of fresh serum compared with heat-inactivated serum was due to the interaction between membrane receptors and complement--most probably C3b generated by both the classical and the alternative pathways of complement activation. This conclusion is based on results obtained with sera in which one or both complement pathways were blocked, on the restoration of the killing-stimulatory activity of C3-deficient serum after addition of fresh C3, and on the reduced killing observed in the presence of fresh serum after reduction of the number of C3 receptors by the use of pronase or antigranulocyte serum.

[Cellular immune status and microphage function in Behçet's disease]

Besides routine clinical and laboratory investigations, several lymphocyte and polymorphonuclear leukocyte function tests were performed in 10 patients with Behçet's disease (1 of Turkish and 9 of German descent, 5 of them male and 5 female). No true abnormality could be detected in both number of T- and B-cells as well as in T-cell response to PHA-stimulation. In contrast, there was a significant enhancement of microphage migration and chemotaxis in all of our patients compared with a large control group of healthy individuals. The very same investigations carried out in 10 patients suffering from benign recurrent aphthosis (most of them of Mikulicz's type) showed no difference to our controls. And above all, there was no increase of chemotactic microphage function. Therefore, assessment of microphage chemotaxis has become an important investigative procedure for in-vitro testing of atypical or low-grade manifestations of Behçet's disease. Abnormal polymorphonuclear leukocyte chemotaxis indeed give some explanation of non-specific cutaneous pathergy as a phenomenon and, no doubt, should be superior in diagnostic reliability as abnormal chemotaxis can even be detected in patients suffering from faint relapses of Behçet's disease.

[Light and electron microscopy studies of actinomycosis of the lacrimal duct]

For the first time we present electron-microscopic results of an actinomycosis of the lacrimal canaliculus. The interior of the actinomycotic conglomerate showed no evidence of a cellular defence reaction but in the loosly woven outer network of hyphae we observed a massive granulocytic reaction. Also, after phagocytosis the structure of the actinomycotic micro-organisms within the granulocytes is not significantly damaged. Within the tissue of the lacrimal canaliculus adjacent to the actinomycotic conglomerate we observed an increased number of plasmacells but no pathogenic organisms.

Value of examining buffy coats for intragranulocytic micro-organisms in patients with fever

To determine the significance of the presence of intragranulocytic micro-organisms in the blood buffy coat in patients with suspected infection, buffy coat examination and blood cultures were simultaneously performed in 455 consecutive patients with fever. There was no general correlation between the finding of intragranulocytic micro-organisms in the buffy coat and positive blood cultures. Patients with persistent bacteraemia and sterile blood cultures were, however, shown to have persistently positive buffy coat findings on repeated examination. These patients, who had culture-negative endocarditis or catheter-associated infections, had sterile blood cultures because of antibiotic treatment. Repeated positive findings in the buffy coat may therefore be valuable in detecting patients with persistent bacteraemia, but sporadic findings of micro-organisms in the buffy coats of acutely ill patients seem to have little diagnostic value.