Nucleinsäure- und Proteinstoffwechsel in Lymphocytenkulturen von Gesunden und Patienten mit Erkrankungen des lymphatischen Systems

[Investigations for pathogenesis of depression of lymphocyte transformation in chronic uremia (author's transl)]

In order to investigate the depressive effect of the hypothetical low molecular weight "uremic toxins" methylguanidine and phenol on lymphocyte transformation these substances were added to lymphocyte cultures with increasing concentrations. 3H-thymidine uptake and LDH-activity in the supernatant culture medium as a parameter of continuous cell destruction were analyzed after incubation for 5 days. Both substances induced in spontaneous as well as in PHA-stimulated cultures dose-dependent depression of 3H-thymidine uptake and simultaneous increase in LDH-activity. Thus the effect of both toxins may be cytotoxic depression of lymphocyte viability. Furthermore in the same arrangement-way higher molecular weight metabolites from urine of healthy and chronic uremic persons were added in increasing concentrations to lymphocyte cultures. The same result: dose-dependent depression of transformation and increase of LDH-activity was slightly diminished by urine metabolites from uremic patients as compared to healthy persons. This may be due to a shift toward non-toxic compounds. But as these metabolites are excreted in 20-30 fold larger quantities in chronic renal insufficiency, an accumulation in the serum and classification as "uremic toxins" can be excluded.

[Transfer factor (TF) treatment of patients with HBs-Ag-positive chronic active hepatitis. A prospective, controlled study (author's transl)]

It is a clinically and experimentally well supported working hypothesis that infection with hepatitis B virus may result in chronic active hepatitis in patients with suspected immune deficiencies. On this basis, a pilot study was performed in order to evaluate the effect of "specific" transfer factor (TF) in the treatment of HBS-Ag-positive chronic active hepatitis. From the leukocytes of 500 ml venous blood each of 40 volunteers that had completely recovered from acute virus hepatitis B within the last 6 months, a unique TF pool (40 units of TF) was prepared according to the method of Lawrence. Preexaminations indicated that this preparation was able to enhance cellular immune reactions in vitro. Thirteen patients with HBS-antigenemia and chronic active hepatitis (i.e., two liver biopsies within the last 6 or more months with the histological criteria of chronic aggressive hepatitis according to de Groote, elevated serum levels of bilirubin, alkaline phosphatase, transaminase activities, and/or gamma-globulines) were randomized: Seven received s.c. injections of two units of TF each on days 1 and 15, the other six saline. Conversion of skin reactions to some ubiquitous antigens occurred in the TF group, but no significant and constant drop of HBS-Ag serum titers was observed. Although some of the biochemical parameters seemed to ameliorate in the TF group, the differences versus the control group did not prove to be significant within the limited number of patients under observation. The in vitro reactivity of patients' lymphocytes to HBS-Ag, tested by means of the 3H-thymidine uptake, was never found enhanced after TF application. In the used doses, "specific" TF was not effective in the treatment of HBS-Ag-positive chronic active hepatitis; unfavorable side-effects were not observed.

Lymphocyte proliferation to phytohemagglutinin (PHA) in hepatitis B antigen-positive and -negative hepatitis

Lymphocytes from patients with HBs-Ag-positive and -negative acute, chronic-persistent, and chronic-active hepatitis, from healthy controls and from patients with alcoholic liver cirrhosis were tested under standardized conditions. These included use of a single charge of Phytohemagglutinin (PHA-P) dissolved and diluted in one operation, of a single pool of homologous serum of the major blood group AB found free of HBs-Ag and cytotixic factor, and elaboration of PHA dose response curves in the presence of autologous and homologous serum in each case examined. During the early phase of acute virus hepatitis B and non-B, and in HBs-Ag-positive chronic persistent and active hepatitis, hyperresponsiveness of lymphocytes to PHA was observed independently of the source of the serum present in the culture. Lymphocyte responsiveness returned to normal in the later phase of acute hepatitis and depressed in alcoholic liver cirrhosis and in cases of HBs-Ag-positive chronic active hepatitis in which cirrhosis had developed. Although the cause of these alterations in lymphocyte responsiveness is not completely understood, the central role of a primary change of the lymphocytes themselves affecting their ability to react to PHA seems probable.

Biochemical findings in multiple sclerosis. V. Transformation of lymphocytes from patients with multiple sclerosis by human basic protein

Lymphocyte stimulation tests with human basic protein of myelin were performed on patients with multiple sclerosis, with other neurological diseases and on normal subjects. In both MS and OND group, a hypersensitization to basic protein was seen in about one third of the cases. All normal subjects, except one, had negative responses. In the MS group, a positive correlation could be found with some features of the disease: significantly more positive responses were found in independent patients with a short duration of illness and in those with an oligoclonal distribution in the CSF. The authors compare their results with those of the literature. The possible role of BP in pathogeny of MS and OND is discussed.

[Spontaneous lymphocyte transformation in chronic renal insufficiency (author's transl)]

3H-thymidine uptake of lymphocytes cultured from patients with regular dialysis treatment was determined at the time of maximal transformation, which was ascertained in previous investigations to be 5 days after the beginning of incubation. Spontaneous DNS synthesis was found to be significantly depressed: 1137 plus or minus 1122 c.p.m./culture; controls: 9783 plus or minus 7499 c.p.m./culture, whereas LDH activity in the supernatant culture medium measured as a parameter of continuous cell destruction showed no alteration. After stimulation with 400 mug PHA DNS synthesis in 7 patients was also decreased, but elevated in 5 patients with previous infections. After incubation with added serum from 11 chronic uremic patients, spontaneous lymphocyte transformation in cultures sampled from 2 healthy subjects was also found to be depressed with positive correlation to the hemoglobin and hematocrit levels in the corresponding blood. The significantly increased LDH activity values in the medium as the consequence of impaired cll viability showed also positive correlation with 3-H-thymidine uptake levels; therefore depressed DNS synthesis cannot be due alone to accelerated cell destruction. In analogy to the erythrocytes, two stimultaneous effects of uremic toxins in serum are assumed to be exerted on the lymphocytes: metabolic inhibition of DNS synthesis and impaired cell viability.