Detection of human T cells using anti-monkey thymocyte antisera. Tissue distribution and evidence for antigenic heterogeneity

Characterization of a subset of human natural killer cells that express OKM1 but lack HNK-1 (Leu-7) antigens

The HNK-1(Leu-7) monoclonal antibody selectively identifies a population of human granular lymphocytes with natural killer (NK) cell activity. We previously reported that the HNK-1+ cell fraction purified from blood mononuclear cells accounted for virtually all NK activity in six individuals. In this study we analysed additional normal individuals and found that in eight out of 14 donors HNK-1+ cells, purified with a fluorescence-activated cell sorter (FACS), exhibited greatly enriched NK cell activity, whereas HNK-1- cells did not have significant activity. In four donors the HNK-1+ cells were enriched in NK activity compared with HNK-1- cells; however, the HNK-1- cells also had moderate levels of activity. In the two remaining donors, NK activity was not enriched in the HNK-1+ fraction in comparison with the HNK-1- fraction. To determine the cell type responsible for NK activity in the HNK-1- subset, these cells were further sorted with the FACS onto OKM1+ and OMK1- fractions and analysed for morphology and function. HNK-1- OKM1- cells were found to be small- to medium-sized lymphocytes devoid of NK activity in all donors tested, whereas most HNK-1- OKM1+ cells were granular lymphocytes and in some donors demonstrated NK function at a level comparable to HNK-1+ cells. Thus some individuals have an important subset of granular lymphocytes with NK-cell activity and the HNK-1- OKM1+ phenotype. It is important to account for these cells in studies involving granular lymphocytes and NK cell function.

Depressed levels of granular lymphocytes with natural killer (NK) cell function in 247 cancer patients

The HNK-1 (Leu-7) monoclonal antibody was used to enumerate and characterize the level of blood granular lymphocytes in 247 cancer patients. The results were compared to 146 control individuals. A fluorescence-activated cell sorter was used to purify blood HNK-1+ cells from cancer patients. The monoclonal antibody identified a homogeneous population of granular lymphocytes with greater than 95% purity. Conversely, virtually 100% of HNK-1- cells from cancer patients were agranular lymphocytes. These results were the same as previously observed in normal individuals, where the HNK-1+ cell fraction contained all the lymphocytes with spontaneous cytotoxicity in natural killer (NK) and killer (K) cell assays. The level of HNK-1+ cells in cancer patients correlated significantly with the patient's age and sex, with older individuals having higher levels and male patients containing a higher proportion than female patients. The levels in the cancer patients were significantly lower than normal controls (p = 0.04). When the results were subdivided by the histologic type of cancer, additional differences were noted. Compared to age and sex-matched controls, significantly depressed levels of HNK-1+ granular lymphocytes were observed in 49 patients with colon cancer (9.7% vs. 15.8%, p = 0.0001), 18 patients with lung carcinoma (11.7% vs. 27.0%, p = 0.0001), 24 patients with breast carcinoma (12.0% vs. 15.5%, p = 0.04) and 64 patients with head and neck carcinoma (15.9% vs. 19.1%, p = 0.05). However, there were no significant differences overall in the average HNK-1+ cell level of 66 patients with melanoma (13.0% vs. 13.5%, p = 0.75) and nine patients with sarcomas (15.8% vs. 14.3%, p = 0.71). Thus, this important subpopulation of granular lymphocytes with NK and K cell function was significantly depressed in most cancer patients. Accounting for the patient's age and sex and the histologic type of cancer was critical to interpreting the results.

Differentiation stages of human natural killer cells in lymphoid tissues from fetal to adult life

Virtually all human granular lymphocytes expressed the HNK-1 differentiation antigen when examined in lymphoid compartments from adults, neonates, and fetuses. The HNK-1+ cells were distinguishable into three subsets having distinct antigenic phenotypes: HNK+T3-M1-, HNK+T3+M1-, and HNK+T3-M1+. Thus, greater than 70% of the HNK-1+ cells from 13-17 wk fetuses (less than 0.2% of nucleated cells) lacked T cell antigens (e.g., T3, T8, T4, and T6) and the M1 myeloid antigen. Morphologically, the HNK+T3-M1- cells consisted of three different types: small granular lymphocytes (less than 10% of HNK-1+ cells), agranular small lymphocytes with a narrow rim of cytoplasm (70-80%), and agranular giant cells (greater than 15 micrometers) with considerable neutrophilic cytoplasm (15%). The purified fetal HNK-1+ cells exhibited a low level of cytotoxicity against K562 target cells. On the other hand, almost all of HNK-1+ cells in neonatal tissues as well as adult bone marrow, lymph node, and thymus, exhibited the HNK+T3+M1- phenotype, contained sparse cytoplasmic granules, and had an intermediate level of NK functional activity. Only adult blood and spleen contained a majority of mature HNK-1+ cells. These cells had an HNK+T3-M1- phenotype, abundant cytoplasmic granules, and maximum NK function. We propose that human NK cells may generate from a separate cell lineage and that they alter their phenotype, morphology, and functional capability during differentiation.

Excessive prostaglandin E2 production by suppressor monocytes in head and neck cancer patients

The proliferative response of peripheral blood mononuclear cells (PBMC) to the mitogens PHA and Con A significantly depressed in 86% of 45 head and neck cancer patients compared with 44 normal controls. This depression of immune competence was greatest in older patients and in those with more advanced disease stages. The abnormal mitogen responses could be restored toward normal (especially with Con A stimulation) by incubating the cells with either of two prostaglandin synthetase inhibitors (indomethacin or RO-205720). This augmentation of immune response was independent of other factors, including the primary tumor site, disease stage, treatment (surgery, radiation therapy, or chemotherapy) or the patients's age or race. The most likely explanation for this depressed level of immunocompetence was an excessive production of PGE2 by suppressor cells. This was confirmed by the finding that PBMC from patients produced more PGE2 than PBMC from normal individuals (8.4 ng/ml vs. 5.2 ng/ml, p=0.002). This difference was greatest among patients less than 60 years of age whose cultured PBMC produced 91% more PGE2 than controls (p less than 0.0007). Virtually all of the PGE2 was produced by a population of monocytes defined by a monoclonal antibody and purified with a fluorescence-activated cell sorter. Patients with epidermoid cancer of the head and neck thus have an abnormality of immunoregulatory monocytes that can contribute significantly to their depression of cellular immunity by elaborating prostaglandin E2. This abnormality could be partially corrected in vitro by incubating their PMBC with a prostaglandin synthetase inhibitor.

Isolation and characterization of inflammatory cells from the human periapical granuloma

Twelve histologically-confirmed periapical granulomas were evaluated by conventional immunologic rosette assays for the presence of T-lymphocytes and complement receptor-bearing lymphocytes. A technique for dispersing the granuloma cells into suspensions was adopted to facilitate performance of the assays which were not applicable to tissue sections. Differential cell counts by an acridine orange vital dye method disclosed that the cell suspensions contained 30% macrophages, 44% lymphocytes, 15% plasma cells, and 12% neutrophils. Complement receptor-bearing cells comprised 17.9%, and T cells comprised 34.5% of the unseparated inflammatory cells. This study provides the first direct evidence of a predominance of thymic-derived lymphocytes in the lymphocyte compartment of the periapical granuloma. Analysis of the data shows that cell-mediated immunity most likely plays a role in the pathogenesis of the periapical granuloma.

Human T lymphocytes subpopulation as defined by alloantigens and FC receptors a comparative analysis

Human peripheral T cells were fractionated in accordance to their surface receptors for G or M immunoglobulins and analyzed for their reactivity with alloantisera obtained by planned immunization involving HLA-A and HLA-B compatible individuals. These alloantisera were previously shown to recognized polymorphic structure exclusively expressed on T cells. Although the majority of the alloantisera analyzed reacted with different proportions of both T(M) and T(G) populations, some antisera specifically recognized surface structure restricted to either T(M) or T(G) lymphocytes. The various alloantisera consistently reacted with a fraction only of T(G) and T(M) cells, this indicating that these T cell subsets can be further fractionated in accordance to the expression of the alloantigenic determinants recognized by these antisera.

E receptors and T antigens are different antigenic entities on human T lymphocytes

ATS contains antibodies of different specificity directed against E receptors and T specific antigens, respectively. E-receptors are trypsin-sensitive, T-antigens are trypsin-resistant. Absorption of ATS with trypsinized thymocytes thus removes anti-T, but leaves anti-E antibodies unaffected. The rosette inhibitory potential of the absorbed antiserum (anti-E) remains unaltered. Immunization with trypsinized thymocytes on the other hand results in the production of anti T-cell sera highly specific in immunofluorescence and cytotoxicity tests without contaminating anti-E antibodies and, therefore, also lacking any rosette inhibitory capacity. E receptors and T antigens are independently mobile within the cell membrane as shown by differential capping.

Isolated marrow lymphoma: an entity of possible T-cell derivation

Seven adults had a distinct clinicopathologic type of lymphoproliferative disorder of the bone marrow. All patients presented with weakness and pancytopenia; no evidence of gross extramedullary involvement was found. In 5 cases severe and prolonged bone marrow hypoplasia was associated with combination chemotherapy; 1 patient died of infection during initial therapy. In 6 of the 7 cases, clinical improvement occurred following therapy. As a terminal event, 2 patients developed a leukemic phase. Tumor cell from 4 patients were studied immunologically, and in 2 patients surface marker characteristics suggestive of T-cell tumor origin were found. In 2 cases, ultrastructural studies of lymphoid cells were compatible with a T-cell neoplasm. The above data suggest that these cases represent a distinct type of chemotherapy-sensitive lymphoma in which conservative initial treatment may induce a response without prolonged bone marrow hypoplasia.

Acute lymphoblastic leukemia in idiopathic refractory sideroblastic anemia: evidence for a common lymphoid and myeloid progenitor cell

Acute leukemia of myeloblastic or erythroblastic morphology occasionally occurs as a complication of idiopathic refractory sideroblastic anemia, but the development of acute lymphoblastic leukemia has not been previously reported in these cases. A patient with idiopathic refractory sideroblastic anemia is described in whom acute lymphoblastic leukemia occurred. The leukemic cells were characterized by typical lymphoblastic morphology on Wright's stain, periodic acid-Schiff-positive cytoplasmic clumps, elevated levels of deoxynucleotidyl transferase (143 units/10(8) cells), high numbers of specific glucocorticoid binding sites (16,845 sites/cell, Kd = 5.40 x 10(-9) M), non-B, non-T cell immunologic characteristics and clinical responsiveness to therapy with vincristine, prednisone, and methotrexate. Ultrastructural studies of the lymphoblasts identified ferruginous material in lysosomes and occasional mitochondria similar to but less abundant than that seen in abnormal sideroblasts. The concurrence of these two disorders supports the theory that in humans both lymphoid and myeloid cell lines arise from a common pluripotent stem cell.

Myelopoiesis in immunologically classified subgroups of childhood acute lymphocytic leukemia

Soft agar culture studies of 43 immunologically characterized patients with childhood acute lymphocytic leukemias (ALL) are presented. The immunologic subsets studied include "null"-cell, pre-B-cell, and T-cell leukemias. Abnormal myelopoiesis, including high peripheral blood and low marrow, colony-forming cell numbers, low colony-stimulating activity, and normal maturation of colony-forming cells in vitro was noted in each group as previously described for immunologically uncharacterized ALL. We conclude that immunologic subsets of childhood lymphoblastic leukemia cause similar abnormalities of myelopoiesis. Lack of differences in growth characteristics among immunologic subsets of ALL make it impossible to use this tissue culture technique in subclassification of these leukemic disorders.

"Ia-like" antigens on human T cells

Human T lymphocytes have been tested for cell surface p. 28,33 "Ia-like" heteroantigen and DRw alloantigens. Small numbers (1--5%) of sheep (E) rosette or T antigen-positive, surface immunoglobulin-negative (E+, T+, smIg-) T cells were Ia+; these cells appeared to be restricted to the TG subset. Following activation by allogeneic lymphocytes or sperm, or by purified protein derivative of tuberculin (PPD), the proportion of positive T cells increased substantially. DRw typing indicated that Ia specificities on activated T cells were not acquired passively from the stimulator cells, suggesting therefore that either "selection" of a small DRw+ cell subset or derepression and/or exposure of DR locus gene products occurs during T cell activation.

Phenotypes of 'null' lymphoid cells in human blood

F(ab')2 antibody fragments of heteroantisera directed against p28,33 (or 'Ia-like') antigen, T-cell antigen(s) (T), myeloid antigen (M), and immunoglobulin have been used along with rosetting techniques to analyse the antigenic heterogeneity of 'null' or 'unclassified' lymphoid cells purified 'negatively' from human blood by E rosette depletion of T cells and B removal on an anti-immunoglobulin immunoabsorbent. The results confirm that considerable heterogeneity exists within the 'null' cell population; the majority of cells are p28,33+ and Fcgamma-receptor-positive, and a proportion but not all of these p28,33+, Fcgamma+ cells are also C3-receptor-positive but negative for the other heteroantigens (T and M). 2-6% were 'pre-B' by the criteria of immunofluorescent staining for cytoplasmic IgM in the absence of detectable cell surface Ig. 1-3% stained intensely with anti-IgM, anti-IgG or anti-IgA, or anti-k plus anti-lambda and were presumed to be plasma cells or their immediate precursors. No null cells stained with antibody to terminal deoxynucleotidyl transferase enzyme, a marker for early T lineage cells, and less than 1% expressed an acute ('non-T, non-B') lymphoblastic-leukaemia-associated membrane antigen which is believed to be an 'early' lymphoid lineage differentiation marker. A minor subpopulation made sheep 'E' rosettes, and another made mouse 'E' rosettes after neuraminidase pretreatment of the lymphoid cells. A small proportion of 'lymphoid', 'null cells' were reactive with an anti-myelomonocytic (M) antibody. It is suggested that 'null' lymphoid cells in blood are heterogeneous and that most are not immature T or B precursors but either a relatively mature B lymphocyte population with a very low density of membrane immunoglobulin or a distinct non-T, non-B cell type.

Recent advances in human cellular immunobiology

Several recent advances in human cellular immunology will have increasing impact on surgical science. First, lymphocytes are composed of diverse subpopulations with different biological properties. Second, lymphocytes and phagocytes expressed distinctive cell surface markers that reflect the specialized function of each cell. Third, different subpopulations of lymphocytes probably have one or only a few specific functions rather than being multipotential. Despite the seemingly complex heterogeneity of the immune system, the component parts collaborate in a highly integrated fashion. The recent elucidation of suppressor cells and their interaction with effector cells, for example, is a major conceptual advance. Fourth, the technology of immunologic science has advanced significantly. More discriminating methods for detecting lymphocyte markers and the ability to physically separate and analyze lymphocyte subpopulations will permit increasingly more refined insights into normal and abnormal immune responses. A number of important advances at the molecular level involving the disciplines of immunogenetics and immunochemistry have also been described but are beyond the scope of this review. Much work remains, however, in correlating these in vitro observations in the laboratory with in viro activity in the patient. It is now evident that the outcome of an immune response (or lack of it) represents a net balance of different components in the immunologic network that determine the time course, intensity of response, and the actual mechanisms of antigen elimination. A better understanding of these component parts of a normal immune response, and their deviations in disease states, is essential for designing more sophisticated therapeutic manipulations of the immune system. Attempts at "immune manipulation" aimed at stimulating or depleting the entire system are no more likely to be successful or reproducible than are attempts to "manipulate" the entire endocrine system. More meaningful results will occur when one can deal with individual components of an immune response (such as suppression or killing) and can precisely monitor the consequences of altering them.

Pre-B-cell leukemia. A new phenotype of childhood lymphoblastic leukemia

Large lymphoid cells containing small amounts of cytoplasmic IgM (clgM) but undetectable surface immunoglobulin (slg) have recently been recognized as precursors of B lymphocytes. They are a small, rapidly dividing pool of normal marrow lymphoblasts. Since lymphoblasts in most childhood acute lymphoblastic leukemias lack slg and other conventional B-lymphocyte and T-lymphocyte markers, we examined the possibility that some leukemias represent "pre-B"-cell neoplasms. In four of 22 consecutive patients, leukemic cells had the clgM+.slg- phenotype of pre-B cells. These patients' cells shared "common acute-lymphoblastic-leukemia" antigens and "B-cell" alloantigens, but differed in expression of several developmental features characteristic of the B-cell line. Pre-B-cell leukemias were readily responsive to chemotherapy. We conclude that a distinct subpopulation of previously unclassified leukemias reflects oncogenic transformation at the earliest recognizable stage in differentiation along the B-cell axis.