Antibacterial activity of human natural killer cells

Immunomagnetic isolation of NK and LAK cells

The present study describes the immunomagnetic isolation of human natural killer (NK) and lymphokine activated killer (LAK) cells. Antibodies against CD56 and sheep anti-mouse IgG-coated magnetic monodisperse particles (Dynabeads M-450) were used for the positive isolation of CD56+ cells from unstimulated mononuclear cells (PBMC). A highly enriched population of CD56+ cells (less than or equal to 3% contaminating cells) was obtained with this method. The cellular yield of CD56+ cells was high (5.3% of the unseparated PBMC). The CD56+ cells remained unactivated after separation and preserved their functional characteristics, as measured by cytotoxic activity against the NK sensitive K562 cells. Incubating the CD56+ cells with IL-2 resulted in high LAK activity, as measured by cytotoxic activity against Daudi cells. Large numbers of functionally active CD56+ cells were obtained from IL-2 stimulated lymphocytes using anti-CD56 coated Dynabeads 450. A further enrichment of effector cells with LAK activity was accomplished by depleting the CD56+ cells for T-cells by anti-CD3 coated Dynabeads M450. The immunomagnetic isolation technique described was easy to perform, did not require expensive equipment and yielded NK and LAK cells of satisfactory purity.

Activated murine natural killer cells control growth of Mycobacterium lepraemurium in mouse macrophages; in vitro and in vivo evidence

The role of natural killer cells (NK) in murine leprosy was investigated in vivo and in vitro. In a first set of experiments, it was found that IL-2 (interleukin-2) activated NK cells reduced Mycobacterium lepraemurium (MLM) growth in mouse C57BL/J peritoneal macrophages which had phagocytosed low numbers (MOI of 10 : 1) of MLM (P less than 0.0001 at day 20). There was no cytotoxicity exerted by the NK cells against the infected cells in these conditions. Conversely, macrophages heavily infected with MLM (multiplicity of infection of 1000 : 1) were found to be susceptible to lysis by activated NK cells in vitro. In vivo, progressing murine leprosy was associated with a sharp increase in splenic NK cell activity, which was abrogated by treatment with a monoclonal antibody against NK cells. Administration of this monoclonal antibody against NK cells enhanced C57BL6/J mouse susceptibility to mouse leprosy, as seen by a decrease in survival time of mice infected with 10(7) MLM i.v. (81 days vs 110 days, P less than 0.0005). Overall, these findings suggest that NK cells may play an important role in resistance to leprosy, either by reducing MLM growth in macrophages or by lysing heavily infected macrophages.

Effects of beta-adrenergic receptor activation, cholera toxin and forskolin on human natural killer cell function

Membranes from highly purified natural killer (NK) cells were ADP-ribosylated by treatment with cholera toxin (CTX). CTX resulted in a single band of specific 32P incorporation at Mr 43,600. CTX treatment of intact NK cells caused a 9-fold increase in cyclic AMP (cAMP) concentrations. Pretreatment of NK cells with CTX diminished their ability to lyse K562 tumour cells by up to 79%. Forskolin treatment elevated NK cell cAMP levels 8-fold and decreased lysis of K562 cells by up to 45%. Adrenaline and isoprenaline (isoproterenol) both inhibited lysis of K562 cells by approx. 35% and elevated cAMP by at least 2.5-fold, and their inhibition of lysis was reversed by propranolol. These data suggest that the stimulatory guanine-nucleotide-binding protein GS coupled to beta-adrenergic receptors is involved in transducing signals which inhibit NK cell lysis of tumour cells. CTX and forskolin also diminish the ability of NK cells to bind K562 cells (binding is necessary for lysis). This suggests that the NK-cell receptor(s) for the tumour cell may be altered as a consequence of cAMP-mediated events or by activation of GS.

Suppression of target cell proliferation by natural killer cells

The cytolytic effects of natural killer (NK) cells have been extensively studied in recent years. In the present study we have investigated the cytostatic effects of NK cells. Human peripheral blood lymphocytes from healthy volunteers were used as a source of effector cells, and the cell lines K562, U937, U1285, and Molt-4 were used as target cells. Effector cells were enriched for NK cells using Percoll gradients and depleted of NK cells on Percoll gradients or by using Leu-19 antibodies and magnetic beads. By monitoring cell numbers during co-culture of effector cells and K562, it was found that after an initial phase of cell killing for 3 h target cell numbers remained stable during the following 24-48 h. In a microcytotoxicity assay measuring inhibition of uptake of [3H]thymidine, the four target cell types were shown to have different NK sensitivity; inhibition of greater than or equal to 80% was obtained for K562 and U937 at an effector to target cell (E/T) ratio of 30:1, 50% for U1285, and 30% for Molt-4. This inhibition was shown to be partly a direct effect on DNA synthesis for all cell lines, as incorporation of [3H]thymidine was decreased in cocultured target cells compared with an equal number of target cells alone. Inhibition of DNA synthesis was thus not directly related to cell death and was also observed for the Molt-4 cell line that was not killed. A cell division assay, with target cells in agarose and effector cells in a liquid upper layer, showed a decline in the rate of target cell divisions. Effects on the cell cycle were studied on latent-phase cells. It was shown that effector cells delayed the onset of DNA synthesis. This anti-proliferative effect was observed for several days, but cell growth then gradually resumed. The effector cells were identified as CD56-positive large granular lymphocytes (LGL). Double-layer cultures and experiments using effector cell supernatants demonstrated that the growth-inhibitory effect could be mediated by soluble factors, and the production of such factors was stimulated by exposure to a small proportion of target cells (50:1). Studies with specific antibodies indicated that growth inhibition was not mediated by alpha interferon (IFN-alpha) but it was partly mediated by tumour necrosis factor alpha (TNF-alpha). It is concluded that NK cells have a growth-inhibitory effect that is distinct from the cytolytic effect and this activity is probably mediated by several soluble factors including TNF-alpha.

Natural killer cell activity during measles

Natural killer cells are postulated to play an important role in host anti-viral defences. We measured natural killer cell activity in 30 individuals with acute measles (73 +/- 21 lytic units (LU)/10(7) cells) and 16 individuals with other infectious diseases (149 +/- 95 LU) and found it reduced compared with values for adults (375 +/- 70 LU; P less than 0.001) or children (300 +/- 73 LU, P less than 0.01) without infection. Reduced natural killer cell activity was found in measles patients with (84 +/- 30 LU) and without (55 +/- 18 LU) complications and was present for at least 3 weeks after the onset of the rash. Activity was increased by in vitro exposure of cells to interleukin-2. Depressed natural killer cell activity parallels in time the suppression of other parameters of cell-mediated immunity that occurs during measles.

Anesthesia inhibits poly I:C induced stimulation of natural killer cell cytotoxicity in mice

The effects of general anesthesia on the levels of baseline and inducible splenic natural killer (NK) activity of mice were examined. General anesthesia significantly inhibited the induction of NK activity by Poly I:C, while having no effect on baseline NK. Since this effect was reproduced using three different anesthetics (Avertin, ether, and Ketamine/Xylazan), the inhibition of inducible NK activity is probably due to the state of general anesthesia, rather than to the pharmacological properties of the anesthetics. Inhibition of the Poly I:C mediated induction of NK was observed for at least 4 days after anesthesia. In contrast to anesthesia alone, anesthesia with surgery significantly decreased baseline NK activity. However, the addition of surgery to anesthesia did not significantly alter the level of inhibition of NK stimulation by Poly I:C compared to anesthesia treatment alone. Experiments assessing the NK modulatory effects of surgery alone were not performed. Interestingly, neither anesthesia alone nor anesthesia with surgery were able to significantly decrease splenic NK activity that had been induced with Poly I:C prior to anesthesia. In view of the important role of NK cells in the innate immune defenses, the possible clinical applications of these results are discussed.

The evolution of acquired immunity to parasites

Evolutionary pressures exerted by parasites on the immune system, and vice versa, are surveyed from a speculative viewpoint. New information is presented about the possible channelling of suppression by MHC Class II genes in the mouse, where a novel pattern of dominant unresponsiveness mediated by H-2Ab is described. In addition, the hypothesis is advanced that phosphatidyl-inositol anchorage on the surface of parasites may represent a novel evasion mechanism, in which the spread of the immune response by epitope linkage is inhibited by host phospholipase.

Preservation of cytotoxic function during multi-cycle immunomagnetic cell separations of human NK cells using a new type of magnetic bead

The isolation from human peripheral blood lymphocytes of natural killer (NK) cell populations by a novel magnetic cell sorting (MACS) procedure yielded large amounts of viable cells with active cytotoxic function. Non-adherent B cell-depleted lymphocytes were sequentially labelled with specific monoclonal antibodies, biotin-conjugated second antibody, FITC-conjugated streptavidin and biotin-conjugated magnetic particles (diameter 50-150 nm). In the magnetic field of a permanent magnet, positively labelled cells were retained on columns with a ferromagnetic matrix. When OKT3 was used for the depletion, 96-99% of the T cells were removed. The resulting non-labelled NK cell population contained 78-89% Leu11b+ and 87-96% Leu19+ cells. Magnetic retention of NK cells mediated by anti-Leu19 yielded about 81% and retention mediated by anti-Leu11b about 80% of total cells as determined by positive fluorescence. The resulting labelled and unlabelled cell subpopulations maintained their full NK activity as determined in 4 h cytotoxicity assays against human K562 tumor cells. The viability of non-labelled cells was fully preserved, whereas that of labelled cells slowly decreased with increasing numbers of preparative cycles. Furthermore, the ability of the isolated NK cells to show enhancement of their NK cytotoxicity after preincubation with IL-2 was maintained. The cytotoxic function of NK cells was also preserved when two or more MACS cycles using the same or different antibodies were carried out. The saving of time and the physiological condition of the isolated cells offer valuable advantages over FACS procedures.

Natural killer (NK) cell response after vaccination of volunteers with killed influenza vaccine

Many experiments have shown convincingly that natural killer (NK) cell activity against viral infections is an important early defence mechanism in mice. Since the NK response occurs soon after infection, often long before clinical signs of disease become manifest, it has been difficult to design studies to monitor accurately NK cell kinetics following infection, without actually administering pathogens to volunteers. There is therefore little data pertaining to the role of NK cells in humans. Nevertheless, a number of studies have shown elevated NK activity in response to herpes simplex and influenza virus infections in humans. Our study was designed to show that NK activity could be provoked in humans by exposure to viral particles without actual live viral infection. The development of NK cell response in the peripheral blood of volunteers shortly after vaccination with killed influenza trivalent vaccine was studied. The results demonstrate that killed virus vaccine induces and augments NK cell activity for relatively long periods. Such data may prove valuable for designing possible modes of augmenting NK activity as a therapeutic tool.

In vivo administration of interleukin 2 plus T cell-depleted syngeneic marrow prevents graft-versus-host disease mortality and permits alloengraftment

Previous work from this laboratory has demonstrated that T cell-depleted (TCD) syngeneic marrow can delay, but not prevent, the mortality from acute graft-vs.-host disease (GVHD) caused by MHC-mismatched lymphoid cells administered to lethally irradiated mice. We demonstrate here that a protective effect against GVHD is also observed after in vivo treatment with IL-2. Administration of 10,000-50,000 U of IL-2 twice daily for the first 5 d after bone marrow transplantation markedly reduced the mortality from both acute and chronic GVHD induced across complete MHC barriers in lethally irradiated mice, and frequently led to long-term survival. Complete allogeneic reconstitution was demonstrated in all long-term survivors of this treatment regimen. While either IL-2 or TCD syngeneic marrow administered alone was protective in some experiments, the maximal protective effect was observed after administration of both IL-2 and TCD syngeneic marrow, especially when the effects of IL-2 were suboptimal. The timing of IL-2 administration was critical to this beneficial effect, since a delay of 7 d in commencing IL-2 treatment was associated with accelerated GVHD mortality. This new approach to the prevention of GVHD permits the administration of allogeneic T cells, and may therefore avoid the increased incidence of graft failure and loss of antileukemic effects associated with the T cell depletion of allogeneic marrow, which is otherwise required for the prevention of GVHD.

A patient with simultaneous absence of "classical" natural killer cells (CD3-, CD16+, and NKH1+) and expansion of CD3+, CD4-, CD8-, NKH1+ subset

The clinical manifestations of putative natural killer (NK) cell deficiency are not well-known but theoretically should include recurrent tumors and systemic viral infections. In this article, we discuss a patient with recurrent condylomata, vulvar and cervical carcinoma in situ, pulmonary infiltrates of unknown significance, and a hypercoagulable state. This patient has a dramatic persistent deficiency in her circulating "classic" NK cells (CD3-, CD16+, NKH1+) and a simultaneous persistent expansion of a normally minor lymphocyte cell subset (CD3+, CD4-, CD8-, NKH1+) that does not express the alpha beta heterodimer of the T cell receptor. T-lymphocyte function, as measured by mitogen and alloantigen responsiveness in vitro, was normal. The coexistence of this particular clinical complex with this unusual set of laboratory abnormalities tends to emphasize our meager understanding of the biologic role of NK cells. At the very least, these findings suggest that the clinical manifestations of NK cell deficiency need not be dominated by disseminated systemic viral infections and that perhaps there should be a higher index of suspicion for the scrutinization of NK cell function.

Clinical course and prognosis of the lymphoproliferative disease of granular lymphocytes. A multicenter study

Lymphoproliferative disease of granular lymphocytes (LDGL) is a recently recognized, relatively rare atypical lymphocytosis characterized by the presence of over 2000 lymphocytes with cytoplasmic azurophilic granules/mm3 in the peripheral blood. The clinical course is heterogeneous, varying from spontaneous regression to progressive, malignant disease. As a consequence, clinical intervention is not standardized. In a worldwide multicenter study, the authors observed 151 patients with LDGL for a mean follow-up time of 29 months. Forty-three patients were asymptomatic at the time of diagnosis. In the remaining cases, clinical symptoms included fever (41 cases), infections (58), neutropenia (47), anemia (17), and thrombocytopenia (12). In 69 cases, LDGL coexisted with an associated disease. Most patients had a nonprogressive clinical course despite the presence of severe symptoms. In 19 patients, death related to LDGL occurred within 48 months. The authors investigated which features at diagnosis were significantly associated with increased mortality. In the univariate analysis, lymph node and liver enlargement, fever at presentation, skin infiltration, a low (less than or equal to 5000/mm3) or high (greater than 20,000/mm3) peripheral leukocyte count, relatively low (less than or equal to 3000) or high (greater than 7000/mm3) absolute peripheral granular lymphocyte (GL) count, and a low (less than or equal to 15%) percentage of HNK-1-positive cells were found to be predictors of increased mortality. In the multivariate analysis, significant independent predictors were fever at diagnosis, a low (less than or equal to 15%) percentage of HNK-1-positive peripheral blood mononuclear cells (PBMC) and a relatively low (less than or equal to 3000) GL count. These results showed that about 25% of the patients with LDGL were diagnosed after a routine blood count and had no clinical symptoms. The remaining patients were symptomatic, with some experiencing a fatal clinical course. The author's analysis of the significant prognostic features of LDGL may help in understanding the heterogeneous nature of this syndrome.

Quantitation of effector-target affinity in the human NK cell and K562 tumor cell system

A quantitative procedure to characterize the affinity of human natural killer (NK) cells for K562 tumor is described. Using highly purified (greater than or equal to 98%) NK cells, measurements of the conjugate frequencies permit the determination of the apparent Michaelis constants (KappM) for the conjugation process. Because no intermediate steps for the lytic process are involved the interpretation of the values of KappM is the simplest one that can be achieved. Thus, we found that a plot of KappM against the number of effector cells allows us to determine the dissociation constant, KS, that characterizes the effector-target affinity. KS is independent of the donor cell source and this value was (1.0 +/- 0.1) x 10(5) cell/tube. In contrast, the KappM values vary among donors, and this could be used to compare the relative activity of different donors in relation to their binding capacity.

The mechanisms involved in the activation of human natural killer cells by staphylococcal enterotoxin B

The induction of enhanced natural cytotoxicity from human peripheral mononuclear cells by staphylococcal enterotoxin B (SEB) was examined. The activated killer cytotoxicity (AKC) was maximum at 16 hr with 1 mg/ml SEB. The precursor and effector cells of AKC were determined to be primarily CD5 negative, CD8 negative, CD16 positive cells. Monocytes and interleukin-1 played no role in the generation of AKC. However, a major role for interleukin-2 (IL-2) in AKC was shown by the inhibition of AKC when anti-IL-2 antibody or cyclosporin was added to the induction cultures. SEB rapidly induced the production of IL-2 from glass nonadherent cells by 6 hr and reached peak levels by 24 hr (162 U/ml). IL-2 induced by SEB in these induction cultures was preferentially produced by CD16 positive cells. Even though interferon-gamma (IFN-gamma) production was induced in these cultures, no role for IFN could be shown in SEB-induced AKC.

Prostaglandins from human T suppressor/cytotoxic cells modulate natural killer antibacterial activity

We have recently described potent antibacterial activity of purified human NK cells. Here we show that this function is regulated by T cytotoxic/suppressor CD8+ cells. Thus, coculture of NK and CD8+ cells for 3 h or longer times abrogated the expression of the NK antibacterial activity, and of two activation markers IL-2R and transferrin receptor (Tf-R). The suppressive activity was mediated by PGE2 as demonstrated by direct PGE2 determination in CD8+ cell free supernatants, and by inhibition of CD8+ cell suppression with indomethacin or piroxicam in vitro. We also found that resting T cytotoxic/suppressor cells purified by negative selection produce higher amounts of PGE2 than adherent cells like monocytes and macrophages, and that these concentration levels are in the range of concentrations known to suppress a significant number of in vitro immunologic functions.

Selective proliferation of natural killer cells among monocyte-depleted peripheral blood mononuclear cells as a result of stimulation with staphylococcal enterotoxin B

In vitro stimulation of monocyte-depleted peripheral blood mononuclear cells with staphylococcal enterotoxin B (SEB) resulted in selective proliferation of cells which express the phenotypic and functional characteristics of natural killer (NK) cells. This culture system provides an easy method for obtaining highly purified NK cells, by sequential incubation of monocyte-depleted cells with SEB and then with interleukin-2 (IL-2). After culture for 4 to 5 days in the presence of SEB, 98 to 100% of the cells expressed the CD16 (Leu11) and HNK-1 (Leu19) antigens. This purification occurred through the death of lymphocytes lacking NK cell markers and marked proliferation of NK cells themselves, which leads to an enrichment of the NK cell population. Activation of NK cells was detected by the appearance of the gamma interferon receptor and IL-2 receptor antigens. This homogeneous population showed the morphology of large granular lymphocytes, were potent effectors of cell-mediated cytotoxicity against K562 and Daudi tumor cell lines, and were able to kill gram-positive and gram-negative bacteria. IL-2 was necessary to maintain the activation and proliferation after SEB stimulation for 4 days. Moreover, the maximum frequency of binding to K562 cells (60.6%) was similar to that recently found (58 +/- 3%) (P. Garcia-Peñarrubia, F. T. Koster, and A. D. Bankhurst, J. Immunol. Methods 118:199-208, 1989) with fresh and highly purified NK cells. This method can be used as a source of highly purified NK cells to study their functional properties and applications to the treatment of cancer.

The maximum conjugate frequency (alpha max) characterizes killer cell populations

A quantitative procedure to characterize NK cell populations based on the dependence of the frequency of conjugation (alpha) on the effector-to-target ratio (R) is shown. To this end, a detailed study of the influence exerted by: (a) the value of R; (b) the number of effector and target cells (N, T); and (c) the source (donor) and enrichment of the effector cell population on the frequency of conjugation between NK effector and K562 target cells has been performed. This has demonstrated that for a given value of R large differences in the values of alpha can be obtained for different donors and/or N values. Hence, the usual practice of reporting the frequency of conjugation at a given value of R cannot be used as a valid criterion for comparison, and this could explain the differences in the alpha values reported in the literature for the same effector-target system. Moreover, the frequency of conjugation depends on the enrichment of the effector cell populations, although it has been shown that in all cases a plot of 1/alpha vs. R for N = constant is always linear with intercept 1/alpha max.alpha max represents the maximum frequency of conjugation for an effector-target system and remains constant for all values of R and N, and is also independent on the donor of the cell source. These characteristics make that the values of alpha max can be used as an easy criterion to determine with accuracy conjugate frequencies in an effector-target system, and could also be applied to characterize the activation or inhibition of effector cell populations by monoclonal antibodies or other agents. This criterion was applied to characterize the enrichment of NK cell populations and so, a value of alpha max = 58 +/- 3% has been obtained when highly purified (greater than or equal to 99%) NK effector cells obtained by panning with the monoclonal antibodies Leu-2, Leu-3 and Leu-4 are used. However, the corresponding value for MDC (14% NK cells) was lowered to 26 +/- 1%.

Biology of natural killer cells

Studies of cytotoxicity by human lymphocytes revealed not only that both allogeneic and syngeneic tumor cells were lysed in a non-MHC-restricted fashion, but also that lymphocytes from normal donors were often cytotoxic. Lymphocytes from any healthy donor, as well as peripheral blood and spleen lymphocytes from several experimental animals, in the absence of known or deliberate sensitization, were found to be spontaneously cytotoxic in vitro for some normal fresh cells, most cultured cell lines, immature hematopoietic cells, and tumor cells. This type of nonadaptive, non-MHC-restricted cellmediated cytotoxicity was defined as “natural” cytotoxicity, and the effector cells mediating natural cytotoxicity were functionally defined as natural killer (NK) cells. The existence of NK cells has prompted a reinterpretation of both the studies of specific cytotoxicity against spontaneous human tumors and the theory of immune surveillance, at least in its most restrictive interpretation. Unlike cytotoxic T cells, NK cells cannot be demonstrated to have clonally distributed specificity, restriction for MHC products at the target cell surface, or immunological memory. NK cells cannot yet be formally assigned to a single lineage based on the definitive identification of a stem cell, a distinct anatomical location of maturation, or unique genotypic rearrangements.