In vitro analysis of cell populations involved in Hodgkin's disease lesions and in the characteristic T cell immunodeficiency

Analysis of antigen receptor genes in Hodgkin's disease

AIM

To analyse the configuration of the antigen receptor genes in Hodgkin's disease.

METHODS

DNA extracted from 45 samples of Hodgkin's disease was analysed using Southern blotting and DNA hybridisation, using probes to the joining region of the immunoglobulin heavy chain gene, the constant region of kappa immunoglobulin light chain gene, and the constant region of the beta chain of the T cell receptor gene.

RESULTS

A single case of nodular sclerosing disease showed clonal rearrangement of the immunoglobulin heavy and light chain genes, all other samples having germline immunoglobulin genes. The nature of the clonal population in the diseased tissue is uncertain, because the intensity of the rearranged bands did not correlate with the percentage of Reed-Sternberg cells present. The T cell receptor genes were in germline configuration in all the samples.

CONCLUSIONS

Antigen receptor gene rearrangement is a rare finding in unselected cases of Hodgkin's disease.

Recent results on the biology of Hodgkin and Reed-Sternberg cells. I. Biopsy material

The most recent sophisticated investigations have provided new and revealing, but also contradictory and controversial information on the biological nature and the cellular origin of Hodgkin and Reed-Sternberg cells (H-RS). Immunophenotypic analyses have shown variable phenotypic antigen expression; but, on balance the data suggest a lymphoid cell expressing T- and/or B-cell-associated markers and certain activation antigens while lacking immunological features of monocytes-macrophages or other lineages. Molecular genetic studies have demonstrated heterogenous findings with respect to rearrangements of T-cell receptor and immunoglobulin genes. Only a small percentage of the cases has rearrangements; this might be due to the threshold of sensitivity of the method combined with the scarcity of the malignant cells. Epstein-Barr virus (EBV) genomes are clonally integrated in the H-RS cells of about half the cases. The significance of these findings--whether EBV is a causative agent or an epiphenomenon--remains to be elucidated. H-RS cells express mRNA and proteins of various cytokines and cytokine receptors implying a predominant role for cytokines in the pathophysiology of HD. The mononuclear and polynuclear H-RS cells are capable of DNA synthesis and nuclear division; the lack of cellular division leads to multinuclearity through the process of endomitosis. Mutations and expression of only a limited number of oncogenes have been tested thus far. Whether the bcl-2 oncogene is involved in HD remains a matter of debate. Aneuploidy and non-random chromosomal abnormalities are the results of cytogenetic analyses of H-RS cells. However, no chromosomal marker specific for HD has yet been found. Thus, while studies of EBV involvement, growth factor production, oncogene expression and chromosomal abnormalities contributed a fair amount of new data on the nature of H-RS cells, only immunophenotyping and genotyping provided some indication of the cellular derivation: an activated lymphoid cell that possibly expresses oncogenes, that probably is infected with EBV, that most likely produces cytokines, that certainly has multiple karyotypic abnormalities.

Cell adhesion molecules in Hodgkin's disease

The fact that Hodgkin's cells are capable of binding lymphocytes has been observed both in vivo and in vitro. It is not unexpected, therefore, that cultured Hodgkin's cells have been found to express a high number of adhesive sites, including representative molecules from various adhesion molecule families.

Analysis of regulation of T-cell responses by soluble inhibitory factors from the sera of patients with Hodgkin's disease

Soluble inhibitory factors (SIF) have been demonstrated in the sera of cancer patients, which interfere with the T-cell activation process. We have shown that the major contributory factor to the inhibitory effect of sera from patients with Hodgkin's disease (HD) could be the soluble form of Interleukin-2 receptors (sIL-2R). The parameters studied to show the presence of SIF include (i) inhibiton of mitogen-induced proliferation; (ii) status of high- and low-affinity IL-2R; and (iii) internalization of IL-2-IL-2R complex, by lymphocytes from healthy donors activated with mitogen in presence of HD sera. Parameters studied to show the inhibitory role of sIL2R include (i) quantitation of sIL-2R in HD sera; (ii) effect of high-sIL-2R-containing sera on mitogen-induced proliferation and detection of IL-2 in activated lymphocyte culture supernatants; (iii) effect of exogenous IL-2 supplementation; and (iv) abrogation of inhibitory activity of sIL-2R-containing sera after passing them through IL-2 affinity columns. Our results show that 6/23 HD sera tested had high inhibitory activity (greater than 50% inhibition of mitogen-induced proliferation). The SIF did not affect expression of high- and low-affinity IL-2 receptors, or internalization of the complex by activated lymphocytes. Ten of the 15 sera tested showed significantly high levels of sIL-2R. Pooled sera with high sIL-2R content inhibited mitogen-induced proliferation of normal lymphocytes with a concomitant reduction in IL-2 activity in the lymphocyte culture supernatants. When supplemented with exogenous IL-2, there was a partial recovery of the inhibitory effect. When sIL-2R containing serum pool was passed on IL-2 affinity columns, the inhibitory effect was reduced. The eluted "sIL-2R" adsorbed on the IL-2 column showed anti-proliferative effect.

An epidemiologist's view of the new molecular biology findings in Hodgkin's disease

Recent advances in molecular biology provide new strategies to address the pathogenesis of Hodgkin's disease (HD). Immunophenotyping studies of Reed-Sternberg cells suggest lymphoid cells, 'frozen in a state of activation.' Clonal rearrangement studies find heavy and light chain immunoglobulin and beta and gamma T-cell receptor gene changes. Chromosomal studies find a complex but nonrandom mixture of structural rearrangements including many seen in other hematologic disorders. These findings are consistent with a pathogenesis involving chronic antigenic stimulation. This interpretation is supported by the epidemiologic features of HD which suggest that HD may develop as a rare consequence of infection with a common latent virus where risk is increased if infection is delayed until adolescence or young adulthood. Such 'late' infections are generally more clinically severe and may result in more chronicity of virus replication. Serologic and genome probe studies of the Epstein-Barr virus--a candidate agent--in HD specimens support this hypothesis. In summary, the new molecular biology findings in HD converge with the previous epidemiologic, immunologic, and clinical data to support a unifying hypothesis of pathogenesis in which genetic abnormalities occur secondarily to a sustained host response to chronic tissue-based antigenic stimulation.