Cell-mediated immune reactions to human tumors

Epidemiological and diagnostic aspects of oral squamous cell carcinoma

Available data in United States on morbidity, mortality and survival is reviewed and trends discussed. Oral squamous cell carcinoma is a small problem in numerical terms, but is a highly lethal disease. The diagnosis is not difficult for the competent pathologist but problems arise in the diagnosis and prognosis of potentially malignant conditions. Our understanding of the behavior of dysplastic lesions is limited and any attempts to determine individuals "at risk" should be encouraged.

Peripheral K-lymphocyte population in head and neck cancer

Peripheral K-lymphocytes in head and neck cancer were measured by assay of plaque forming-cells. In the cancer patients, the percentage (4.37 +/- 0.87%, mean +/- SD, N = 42, P less than 0.01) and absolute counts (68 +/- 28/mm3, P less than 0.01) of K-lymphocytes were significantly lower than those in normal controls (8.04 +/- 1.41%; 175 +/- 53/mm3, N = 29). The untreated group showed decreased K-lymphocyte counts (63 +/- 22/mm3, N = 13) as compared with the treated, disease-free group (83 +/- 27/mm3, N = 13, P less than 0.05). There were significant correlations between absolute counts of K-lymphocytes and T-cells or B-cells within the untreated group (r = 0.79 in T-cells, P less than 0.01; r = 0.64 in B cells, P less than 0.01). Moreover, absolute counts and percentage of K-lymphocytes in the patients having regional lymph node metastasis (58 +/- 25/mm3; 4.14 +/- 0.77%, N = 22) were significantly lower than those in the negative node group (80 +/- 26/mm3, P less than 0.01; 4.63 +/- 0.91%, P less than 0.05; N = 20). In a total of 25 patients with squamous cell carcinoma who were grouped into grade I, II, and III according to classification of the histologic differentiation of the World Health Organization, the absolute counts and percentage of K-lymphocytes in the grade I group (93 +/- 33/mm3; 5.14 +/- 1.08%, N = 7) showed significant increases in comparison to those in the grade II group (62 +/- 19/mm3, P less than 0.02; 4.06 +/- 0.62%, P less than 0.02, N = 14). Moreover, the change of the K-lymphocyte population in the treated, disease-free eight patients revealed a gradual increase of K-lymphocytes. These results led us to suggest that the measurement of peripheral K-lymphocytes is a useful method of characterizing host defense in head and neck cancer.

Human autologous mixed lymphocyte reactions (a review)

The literature concerning the autologous mixed lymphocyte reactions has been reviewed. This analysis supports the following conclusions: human subjects have self-responsive cells which are capable of proliferating when co-cultured with irradiated autologous non-T or Ia+ T cells. Since monoclonal antibodies recognizing distinct determinants of Ia antigen have different effects on AMLR with non-T cells and on Ia+ type AMLR, there is the possibility that different Ia molecule determinants have different functional role in the process of cell-to-cell interaction. The presence of AMLR abnormalities in disease strongly suggests that reactivity among different cell subsets plays a role in immunological homeostasis.

A study of the immune response to the organ-specific neoantigen of human bladder cancer

The antitumor immune response of monocytes armed with cytophilic antitumor antibody to an organ-specific neoantigen of human bladder cancer was measured by the tube leukocyte adherence inhibition assay. Of 29 patients with Stage A bladder cancer, 27 had positive tests, whereas of 11 patients with Stage B, C and D bladder cancer, 2 had positive tests. If the leukocytes from advanced bladder cancer patients were preincubated briefly with prostaglandin E2, the negative response was converted to positive. Of 189 patients with diseases of other organs, 2 had positive tests. Patients with acute or chronic cystitis had negative tests. The sensitivity of the assay was 88 per cent; specificity was 95 per cent. The bladder cancer extracts prepared from metastatic tissue or the tissue-cultured cell line, T24, had similar activity in the assay. Normal bladder tissue did not share the bladder cancer organ-specific neoantigen nor did cancers of other organs. Bladder epithelial cells expressed the OSN before they acquired invasive properties since patients with dysplastic bladder epithelium or in-situ cancer had positive tests. Antitumor immunity was often detectable before a recurrence became obvious by cystoscopy or cytology of urine and became undetectable quickly after removal of the bladder cancer. Of 100 patients with prior bladder cancer without evidence of exophytic tumor, 18 had positive tests; the possibility must be considered seriously that some had precancerous changes which formed no visible gross abnormalities. The results suggested that antitumor immunity to bladder cancer was a sensitive indicator of precancerous or cancerous changes existing in epithelial cells.

Depressed mononuclear cell function in advanced neoplastic disease

The ascites fluids from 9 patients with invasive gynecologic neoplasms were examined to determine the immunocompetence of the mononuclear ascites cells and the immunoregulatory properties of the cell-free ascitic fluid. Blood mononuclear cells (from 5 patients) were also tested. The mononuclear cells from the cancer patients responded poorly to stimulation with polyclonal mitogens; only the blood mononuclear cell response to pokeweed mitogen was not significantly less than that of normal subjects. The addition of autologous serum or cell-free ascitic fluid to the cell cultures enhanced the response of the cells to phytohemagglutinin and pokeweed mitogen, had little effect on the response to concanavalin-A, and greatly depressed the response to succinyl-concanavalin-A. We found no evidence for the presence of suppressor cells in the ascites cell populations. The data are consistent with the thesis that the depressed immune responses are the result of malnutrition associated with advanced malignant disease.

Effect of immunomodulating factors present in ascitic fluids and sera from cancer patients on the responses of cultured mononuclear cells from normal subjects

Ascitic fluids and sera from patients with malignant tumors were tested for their ability to modulate the mitogen-induced blastogenic responses of normal subjects' peripheral blood mononuclear cells in vitro. The addition of either ascitic fluid or serum to cultures of normal blood cells greatly enhanced the blastogenic response of cells to phytohemagglutinin P, and markedly depressed the responses to concanavalin A and succinyl-concanavalin A. The blastogenic response of the cells to pokeweed mitogen was unaffected by the addition of serum and depressed by the addition of ascitic fluid. Autologous normal serum also enhanced the response to phytohemagglutinin P but had no effect on the response to the other mitogens. These activities were concentration-dependent and heat-stable (56 degrees C, 60 min) and could be detected even if the ascitic fluid or serum was added as late as the second day of culture. Cells that had been preincubated with serum or ascitic fluid and washed well before culturing with the mitogens responded in the same manner as cells cultured in the presence of serum or ascitic fluid. The mitogen-induced blastogenic responses of mononuclear cells were not affected by the addition of autologous cells that had been preincubated with either serum or ascitic fluid, washed, and treated with mitomycin C. Indomethacin (2 X 10(-7)M) did not prevent the ascitic fluid-mediated depression of blastogenic responses of normal cells. The ascitic fluid and serum of these cancer patients appeared to contain a specific immunoinhibiting substance which exerted its effects by a direct action on the responding mononuclear cells and not by the induction of suppressor cells.

Antibody-dependent cell-mediated cytotoxicity in human cancer: characterization of patient leukocyte activity and treatment effects

Antibody-dependent cell-mediated cytotoxicity (ADCC), medicated by peripheral blood Hypaque-Ficoll separated mononuclear cells, was studied in humans using chicken erythrocytes (CRBC) incubated in a 1:1200 dilution of rabbit anti-CRBC and human B erythrocytes (HRBC) incubation in a 1:20 dilution of isoantibody. At the optimal target effector ratio of 3:1, ADCC to both CRBC and HRBC was significantly higher than normal in 27 lung cancer, 18 malignant melanoma, and seven colon cancer patients, but not in 20 breast cancer patients. Chemotherapy (single-agent or combination) in 12 patients did not effect ADCC in vitro but significantly suppressed ADCC to both targets after only four or five days of therapy in vivo (ADCC to CRBC, 47.4 to 24.1% lysis: ADCC to HRBC, 48.1 to 16.3% lysis). Immunotherapy with intravenous (IV) corynebacterium parvum or IV methanol extraction residue of BCG (MER) boosted ADCC to both targets within four to seven days of the first dose. It was found that ADCC to HRBC but not to CRBC was completely absent in three cases of active hairy cell leukemia but was present in two cases in remission. The ADCC to HRBC showed an age-dependent increase in both the 51 normal subject and the cancer patients. This was not observed for ADCC to CRBC. The ADCC to CRBC was mediated mainly by an Fc-receptor-positive, nonadherent, small lymphocyte, and ADCC to HRBC was mediated entirely by an adherent monocyte. The ADCC did not correlate significantly with the H3 thymidine incorporation of peripheral blood mononuclear cells, cultured without stimulation for either one or seven days. It also did not correlate with the number of residual granulocytes in the mononuclear cell suspensions. Measurement of ADCC is a useful method of characterizing host defense in malignant disease and its modification by therapy.

Cellular and humoral in vitro cytotoxicity against autologous bladder tumor cells in humans. Differences in autologous cytotoxicity against non-invasive and invasive transitional-cell tumors of the urinary bladder

Lymphocyte-mediated cytotoxicity (LMC), antibody-dependent cell-mediated cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC) were measured in a 51Cr assay against autologous tumor cells from 7 patients with non-invasive and 9 patients with invasive transitional-cell tumors of the urinary bladder (TCC). Cytotoxicity against the invasive tumor cells were demonstrated in CDC. Heat-inactivation of sera lead to complete loss of cytotoxicity while addition of allogenic serum restored cytotoxicity. The cytotoxicity of allogenic sera from controls against invasive tumor targets showed no differences when compared with autologous sera. No or very weak cytotoxicity was found against non-invasive tumor targets in autologous or allogenic assays. LMC and ADCC showed weak or no reactivities. Intensive wash or trypsinization of effector cells did not affect the cytotoxicity in LMC. The results indicate the occurrence of complement-dependent antibodies directed against target cells from invasive tumors of the urinary bladder while no cytotoxic responses were detectable when the target cells originated from non-invasive tumors.

Lymphocyte cytotoxicity against autologous bladder tumor cells in humans, investigated by use of a chromium-51 release assay

A technique for isolation of a single cell suspension of viable tumor cells from bladder tumor biopsies is described. By application of the tumor cells as targets in a 51chromium release assay, the cytotoxicity of autologous lymphocytes was measured in 38 patients with transitional-cell tumors of the urinary bladder. The lymphocyte-medicated cytotoxicity was evaluated in relation to the histological grade and clinical stage of the bladder tumors. No significant correlations were found between the autologous cytotoxicity and the grade or stage of the bladder tumors.

Immunoglobulins associated with human tumours in vivo: IgG concentrations in eluates of colonic carcinomas

The concentrations of IgG in acidic and 3MKCl eluates of resected colonic carcinomas and adjacent normal tissue were determined by radioimmunoassay. The mean concentration of IgG was significantly higher in both acidic and KCl eluates of primary Dukes Stage C tumours than Dukes Stage A tumours. These results provide direct evidence for increased fixation of IgG in vivo by human colonic cancers which had metastasized. Our results also raise the possibility that IgG is more tightly bound to the Stage C tumours. It is likely that this tumour-associated Ig represents antibody to tumour antigens or antigen-antibody complexes, bound to Fc receptors in the tumour.

Interferon and cell-mediated immunity

The thesis is introduced that the phenomena of cell-mediated immunity proceed with the necessary involvement of interferon. In view of this thesis various examples of cell-mediated cytotoxicity both antibody-dependent, and antibody-independent are analyzed. The role of interferon in transplantation, allergic diseases and the treatment of cancer is also discussed. Based on this analysis it is concluded that interferon provides for the cytotoxicity of immune and non-immune leukocytes. It is suggested that interferon is responsible for the cytotoxic effect in itself, since it facilitates lethal hybridization. Recognition of the important role of interferon in the mechanism of cell-mediated immunity leads to some practical conclusions: a) The selective inhibition of the activity of type II interferon may be a sufficient measure in cases where now total immunosuppression is applied. b) Periodic treatment of healthy population by lymphokine stimulants may be a method of prevention of cancer. c) Transplantation, allergic diseases, immunotherapy of cancer should be considered in terms of the role of interferon in these processes.