Agammaglobulinaemia with B lymphocytes. Specific defect of plasma-cell differentiation

Identification and characterization of subpopulations of lymphocytes in human peripheral blood after fractionation on discontinuous gradients of albumin. The cellular defect in X-linked agammaglobulinemia

Normal human peripheral blood lymphocytes were separated on discontinuous gradients of 17-35% bovine serum albumin (BSA) into nine fractions. Three subpopulations of lymphocytes were obtained. One occupies the top third of the gradient (fractions 1-3, 17-23% BSA) and is rich in cells characterized by a high spontaneous rate of DNA synthesis and by the ability to give rise to colony-forming units. The middle portion of the gradient (fractions 4 and 5, 23-27% BSA) is rich in thymus-derived (T) lymphocytes identified by their vigorous response to mitogens and by their ability to form rosettes with sheep erythrocytes (E). The third subpopulation at the bottom of the gradient (fractions 6-9, 27-35% BSA) is rich in bone marrow-derived (B) lymphocytes capable of staining with fluorescent antiimmunoglobulin antisera and of forming rosettes with EAC1423. The peripheral blood lymphocytes of five boys with proved X-linked agammaglobulinemia and two with probable X-linked agammaglobulinemia were found to be totally deficient in B lymphocytes (fractions 6-9) and lacked the subpopulation identified by immunofluorescent staining or rosette formation with EAC1423. One boy with proved X-linked agammaglobulinemia and two with probable X-linked agammaglobulinemia possessed a normal amount of circulating B lymphocytes.

Surface markers on lymphocytes of patients with infectious diseases

PERIPHERAL BLOOD LYMPHOCYTES FROM NORMAL SUBJECTS AND PATIENTS WITH VIRAL AND BACTERIAL INFECTIOUS DISEASES WERE EXAMINED FOR THE PRESENCE OF THREE SURFACE MARKERS: (i) surface immunoglobulins, (ii) receptor for C3 complement component (EAC test), and (iii) spontaneous binding of sheep red blood cells (E rosette formation). The first two markers are used to detect bone marrow-derived lymphocytes (B cells); the E rosette formation is dependent on thymus-derived lymphocytes (T cells). We demonstrated these assumptions, as defined by others, by the fractionation of lymphocytes on bead columns coated with immunoglobulin plus anti-immunoglobulin. The peripheral blood lymphocytes of normal individuals consisted of 52% T cells, 23% B cells with EAC receptor, and 21% B cells with membrane immunoglobulin. There was no significant difference in these values from those obtained in viral or bacterial diseases. Only a few cases of infectious mononucleosis had an increase in T cells. These results give us a partial picture of the T- and B-cell frequency in normal subjects and in patients with infectious diseases.

B and T lymphocytes in primary immunodeficiency disease in man

B- and T-cell populations in 32 patients with different forms of primary immunodeficiency disease were studied. The B-cells in peripheral blood were investigated with respect to surface immunoglobulins by means of immunofluorescence. The T-cell function was studied utilizing quantitation of proliferative response to phytochemagglutinin (PHA)(1) and delayed allergy to various antigens. In 10 patients lymph node lymphocytes were also evaluated 11 male children with infantile x-linked agammaglobulinemia were divided into two subgroups. One did not show immunoglobulin spots on peripheral blood lymphocytes at all, the other contained a very low percentage of IgM- and occasionally IgA bearing lymphocytes. Eight patients with common variable immunodeficiency had moderately decreased percentages of peripheral blood and lymph node lymphocytes with surface immunoglobulins, but these patients lacked immunoglobulin secreting cells. Four cases of isolated IgA deficiency had normal or high percentages, and two cases of ataxia-telangiectasia had high percentages of lymphocytes with IgA in so called receptor distribution in both peripheral blood and lymph nodes. In three patients with infantile combined immunodeficiency that had been corrected by marrow transplantation, the percentages of Ig-bearing lymphocytes increased to normal or high levels together with establishment of functional T-cell population and ultimate secretion of serum immunoglobulins. One case of Di George syndrome reconstituted by fetal thymus transplant showed gradual decrease of B lymphocytes in circulation parallel to restoration of T-cell population.

Deletion of b5 immunoglobulin-bearing lymphocytes in allotype-suppressed rabbits

The proportion of peripheral blood lymphocytes with cell surface b5 immunoglobulin (Ig) was compared with serum b5 Ig levels in allotype-suppressed and recovering b5 homozygous rabbits in order to establish the cellular defect in suppression and to determine the relation between lymphocyte membrane Ig and secreted Ig of the same allotype. In rabbits fully suppressed for b5, the absence of circulating b5 Ig is reflected in a complete deletion of b5-bearing lymphocytes. During spontaneous escape from suppression, the appearance of b5-bearing lymphocytes precedes the appearance of detectable serum b5. During recovery from suppression b5-bearing lymphocytes recover rapidly toward normal levels, but circulating b5 levels remain chronically and disproportionately depressed.