Subpopulations of human T lymphocytes. V. T lymphocytes with receptors for immunoglobulin M or G in patients with primary immunodeficiency disorders

A familial syndrome with von Recklinghausen's neurofibromatosis, gammopathy and aorta outflow obstruction

Three cases of von Recklinghausen's disease have been observed in the same family comprising four members. Two of the patients, father and son, had aorta outflow obstruction and biclonal gammopathy (IgG(kappa/lambda) and IgA(kappa)/IgG(kappa)). In one of these patients, no concanavalin suppressor cell activity was demonstrated, indicating that the gammopathy may be related to suppressor T-cell deficiency. Further study of the other family lineages showed that aorta stenosis/mors subita occurred frequently, but genetic marker studies failed to reveal any linkage between these entities. The syndrome, which has not been reported previously, was probably restricted to the first kindred studied. Detailed biochemical and immunological studies of the monoclonal components involved are in progress.

Alteration of T-lymphocyte subpopulations in patients with primary renal diseases and systemic lupus erythematosus

Forty-eight patients with a variety of primary renal diseases and systemic lupus erythematosus (SLE) were examined for the proportion of circulating T lymphocytes bearing receptors for IgM (T mu cells) or IgG (T gamma cells). Although the control group showed strikingly similar mean values for both T mu and T gamma cells, the whole group of patients with primary renal diseases and SLE showed a wide scatter of values. Sixteen patients with primary renal diseases and SLE had higher proportions of T gamma cells than the control group, whereas seven patients with chronic glomerulonephritis (CGN), membranoproliferative glomerulonephritis (MPGN), lipoid nephrosis (LN), and SLE showed very marked decrease in the proportions of T gamma cells in the peripheral blood. On the other hand, six out of the total group of patients had low proportions of T mu cells in the peripheral blood. However, no consistent relationship between the proportion of T mu and T gamma cells was found in our study. These findings indicate that there exists a heterogeneity of T-lymphocyte subpopulation distribution in some patients with primary renal diseases and SLE. The possible significance of these phenomena in the pathophysiology of renal diseases is discussed.

Transient T-cell abnormality in a selective IgM-immunodeficient patient with Brucella infection

We describe here one 9-year-old female patient with an unusual form of selective IgM and CD4+ (OKT4+) helper/inducer T-cell immunodeficiency associated with Brucella infection. During the acute phase of Brucella infection, the percentage of infection. During the acute phase of Brucella infection, the percentage of peripheral blood lymphocytes (PBL) displaying OKT3+, OKT11+, and OKT4A+ phenotypes was decreased, and that of the OKT8+ cell was increased. These phenotypic T-cell abnormalities disappeared after antibiotic therapy in a 5-week period. However, the marked deficiency of CD4+ T cells and the IgM deficiency present during the acute phase of illness remained after recovery from illness. In vitro immunoglobulin production experiments during the acute phase of illness demonstrated that the patient's T cells lacked the capacity to provide helper/inducer function for normal B-cell differentiation to secrete IgM. The patient's T cells were also shown to possess IgM-specific suppressor cell activity on normal B- and T-cell differentiations. Thus impaired T-cell function was shown to be responsible for IgM-deficient antibody production. Defective interleukin 2 receptor expression and production by the patient's PBL in response to mitogenic stimulation also were present, indicating a severe defect in the patient's T-cell function.

Selective partial IgM deficiency: functional assessment of T and B lymphocytes in vitro

Seven patients with selective IgM deficiency (SIgMD) were studied for cell surface immunoglobulin (SmIg), T-cell subpopulations, and immunoglobulin (Ig) synthesis in vitro by peripheral blood lymphocytes (PBL). Serum IgM levels were less than 25 mg/dl, while IgA, IgG, and IgD were within normal levels. The patients had respiratory or urinary tract infections and two were diagnosed as having systemic lupus erythematosus (SLE). T/B-cell ratios in PBL were within normal ranges. Percentage ratios of B cells bearing SmIg were normal in five patients and decreased in two; however, normal values were seen after 7 days of culture in the presence of PWM. OKT4/OKT8 ratios decreased in five of seven patients, in whom two were due to a decrease in OKT4 and two to an increase in OKT8 cells. One showed a decrease in OKT4 and an increase in OKT8. Analysis of lymphocyte function for Ig synthesis in vitro, using a coculture of counterpart T and B cells from healthy individuals and patients with SIgMD, revealed that the increased function of IgM isospecific suppressor T cells (Ts) was responsible for the IgM deficiency in all seven patients.

In vitro differences in lymphocyte subpopulation reactivity in lung cancer patients: purified protein derivative-specific suppressor T lymphocytes in patients who have received Bacillus Calmette-Guerin

Antigen-specific responses of lymphocyte to purified protein derivative (PPD) were studied in seven patients with non-small cell lung cancer who had undergone complete resection and received postoperative intrapleural Bacillus Calmette-Guerin. In addition, one patient with unresected lung cancer and reactive tuberculin skin test (PPD +) and five normal PPD- individuals were also studied. Lung cancer patients had significantly fewer responsive peripheral blood lymphocytes, unfractionated T cells, and T cells bearing Fc-IgG receptors (TG + populations) than normal controls. These deficits were most pronounced in the group who had received intrapleural Bacillus Calmette-Guerin but who had failed to develop reactive tuberculin skin tests. In contrast, the TG-populations (FC-IgG receptor-negative T cells) from all patients responded to PPD. TG + cells specifically inhibited TG- -cell responses to PPD in both proliferation and immunoglobulin secretion. Radiosensitive suppressor monocytes were found in other patients. This study shows interesting immune deficits in early lung cancer patients. These patients appear to have PPD-specific suppressor TG + cells which may contribute to the immune deficits in these patients.

Quantitation of Fc receptor-bearing T-lymphocytes (TG and TM) in oral cancer

The lymphocytes from the peripheral blood of 30 untreated patients with oral cancer and 15 apparently healthy normal controls were studied for quantitation of T-cell subsets. When compared to age-matched controls, the patients as a group showed a significant increase in the proportion and number of TG cells (IgG Fc receptor-bearing T-cells) and a significant reduction in the TM cells (IgM Fc-bearing T-cells). The levels of total lymphocytes, T-cells, and B-cells remained in the control range. The discrepancy in the TG subset was evident in the early stages of the disease, while in TM cells, it was evident only in the advanced stages.

The proportion of TA, TG, and TM cells in various immunodeficiency and autoimmune disorders

Patients with various immunodeficiency and autoimmune disorders were examined for the proportions of T cells bearing Fc-IgA, Fc-IgG, and Fc-IgM receptors. These disorders included common variable immunodeficiency, systemic lupus erythematosus, ataxia-telangiectasia, selective IgA deficiency, and the Wiskott-Aldrich syndrome. Abnormal proportions (higher or lower than an interval containing 95% of our normal values) of Fc-IgA receptor-bearing T cells (TA) were found in common variable immunodeficiency, systemic lupus erythematous, ataxia-telangiectasia, and selective IgA deficiency. However, the proportion of T cells bearing Fc receptors did not correlate with their functional activity in in vitro immunoglobulin production assays.

Monocyte-induced inhibition of lymphocyte response to phytohaemagglutinin in progressive systemic sclerosis

In patients with progressive systemic sclerosis (PSS) lymphocyte responses to phytohaemagglutinin (PHA) are abnormal (27.2 +/- 3.5 X 10(-3) counts per minute (cpm) versus 69.8 +/- 4.4 X 10(-3) for normal persons, p less than 0.005). Removal of adherent peripheral blood mononuclear cells improves the response of PSS lymphocytes (42.3 +/- 3.4 X 10(-3) cpm, 155% of control) but diminishes the response of normal lymphocytes (60.3 +/- 5.9 +/- 10(-3), 86% of control). Supernatant fluids from cultures of PSS unfractionated and adherent cells depress normal T cell response to PHA (64% and 55% of control respectively), but supernatant fluids from normal unfractionated and adherent cells do not (104% and 101% of control). Supernatant fluids of PSS and normal adherent cells, cultured in the presence of indomethacin, are not inhibitory to normal T cells (109 +/- 15% and 124 +/- 14% of control respectively). Supernatant fluids from PSS patients are more inhibitory than comparable fluids from patients with systemic lupus erythematosus (60 +/- 8% of control versus 80 +/- 5% of control). These data support the hypothesis that cellular immunity is abnormal in patients with PSS and indicate that adherent mononuclear cells mediate at least one component of the abnormality via an indomethacin-sensitive mechanism.

Increase of T lymphocytes bearing immunoglobulin G receptors during circulation in human renal cell carcinoma

We studied the membrane markers and functions of lymphocytes from venous and arterial blood in kidneys from patients with renal cell carcinoma. The proportion of T lymphocytes that bore the receptors for the Fc portion of immunoglobulin G increased significantly in venous blood compared to arterial blood in kidneys with tumors. The assay of antibody-dependent cellular cytotoxicity demonstrated that lysis of target chicken erythrocytes was significantly less when caused by lymphocytes from the arterial blood (38 plus or minus 18 per cent, standard error) than those from the venous blood (54 plus or minus 21 per cent) in kidneys with tumors. There was no significant difference in the spontaneous lymphocyte-mediated cytotoxicity assay between the venous and arterial blood. Increment of the antibody-dependent cellular cytotoxicity activity seemed to correlate with the increased proportion and absolute number of T lymphocytes bearing immunoglobulin G.

T-cell subpopulations defined with monoclonal antibodies in patients with primary immunodeficiency

Peripheral blood mononuclear cells from 16 patients with common variable immunodeficiency and 4 with selective IgA deficiency were studied for the quantitative analysis of T-cells and T-cell subsets with distinct immunoregulatory properties, using a battery of monoclonal antibodies and the fluorescence-activated cell-sorter. The proportions of OKT4+ cells were decreased and OKT8+ cells were increased in patient groups when compared to normal controls analyzed simultaneously. 14/20 (70%) patients demonstrated a lower OKT4+/OKT8+ cell ratio compared to controls. Imbalance of immunoregulatory T-cells may explain one of the mechanisms of hypogammaglobulinemia in a subgroup of patients with primary immunodeficiency.

Imbalance of T-cell subpopulations does not result in defective helper function in chronic lymphocytic leukemia

The T-lymphocyte subpopulations identified by the Fc receptors for IgG (TG cells) and IgM (TM cells) in 12 patients with B-cell chronic lymphocytic leukemia (CLL) were quantitated and studied for functional capabilities in an in vitro assay. The TG cells in patients were elevated in relation to age- and sex-matched normal controls (P less than 0.05) resulting in an altered TM/TG ratio of 1.8 +/- 0.76 in CLL versus 5.9 +/- 3.7 in controls (mean +/- SD, P less than 0.001). Despite this altered of B cells was found to be normal as reflected by the mean helper-suppressor score of 0.77 +/- 0.13 (+/- SEM) obtained for both patients and controls. This unimpaired capacity of the T cells from CLL patients to help normal B cells mature into immunoglobulin-secreting cells indicated that hypogammaglobulinemia and monoclonal serum immunoglobulins in these patients may be a result of either an intrinsic defect in the B lymphocytes or their replacement by a neoplastic clone rather than a defect in the immunoregulatory T cells.

Imbalances in T-cell subpopulations in myasthenia gravis

Distributions of peripheral blood lymphocyte subpopulations and T-cell subsets were studied in 38 patients with myasthenia gravis (MG) and 23 healthy controls. T cells were detected by rosette formation with sheep red blood cells and B cells with erythrocyte-antibody-complement (EAC) complexes. T mu cells were identified by rosette formation of T cells with Ox RBC-IgM complexes, and T gamma cells with Ox RBC-IgG complexes. The means of total lymphocyte count and active T cell percentage were marginally significantly lower in MG patients than in normal controls (0.05 less than P less than 0.1). The mean percentage of T mu cells was higher in MG patients than in controls (50.2 +/- 11.8% vs. 38.5 +/- 15.3%, P less than 0.01), whereas that of T gamma cells in the former was lower than that in the latter (20.4 +/- 7.1% vs. 27.6 +/- 6.2%, P less than 0.001). Thus, the loss of regulatory suppressor T cells and the increase of helper T cells in the patients are in favour of regarding MG as an autoimmune disease. The fact that the percentage of T gamma cells was significantly decreased in MG patients after autologus serum incubation, and that no such a phenomenon was seen in normal controls, may suggest a possible role of serum factors in the pathogenesis of MG.

Suppressor cell activity in melanoma patients. II. Concanavalin A-induced suppressor cells in relation to tumor growth and suppressor T-cell subsets

The relative proportions of T, B and T gamma suppressor cells were determined sequentially in peripheral blood of melanoma patients before and after surgery. Concanavalin A (Con A)-induced suppression against lymphocyte mitogenesis of melanoma patients and age matched controls was measured concurrently. The mean percentage of T gamma cells was significantly higher (p less than 0.001) in melanoma patients before surgery (21.8 +/- 5.4) compared to a group of age-matched controls (14.9 +/- 5.4). There was a tendency for the proportion of T gamma cells in patients to decrease after surgery, although the relative levels of T gamma were still significantly elevated (p less than 0.05) 6-8 weeks after surgery when compared to normal controls. The mean percentage of T and B cells in melanoma patients before and after surgery was comparable to that observed in normal controls. The degree of Con-A-induced suppression in patients increased significantly after surgery particularly at 6-8 weeks (p less than 0.02). No difference in con-A-induced suppressor cell activity was observed between melanoma patients and controls before or after surgery. An inverse relationship was found between the amount of Con-A-induced suppression and percentage of T gamma cells in melanoma patients before surgery. Similar associations were not apparent in patients after surgery or in normal control populations. The inverse correlation of Con-A-induced suppression with T gamma cell numbers suggests that the former may measure potential suppressor cell activity whereas the T gamma cells may indicate active suppressor cells. The significance of these findings for the monitoring of suppressor cell activity in vivo and their role in suppression of immune responses in melanoma patients is discussed.

T-lymphocyte subpopulations in the peripheral blood of patients with Crohn's disease

Samples of peripheral blood from 26 patients with Crohn's disease (CD) and 26 healthy age- and sex-matched controls were tested simultaneously for B and T lymphocytes and T-lymphocyte subpopulations with receptors for IgM (TM) and IgG (TG). Patients with CD had reduced proportions of T lymphocytes, and this reduction showed a significant correlation to the CD activity index (r = -0.65, p less than 0.01). There was slight reduction of TM only (p less than 0.05) inpatients with highly active disease but not in the total population of patients studied. Proportions of B and TG cells were similar in patients and controls. Patients with no clinical or radiological but histological signs of active disease had T lymphocytes and subpopulations like patients with inactive disease. This suggests that the reduction of T cells and T-cell subpopulations in CD are secondary effects. With regard to T-lymphocyte subpopulations, our results are in contrast to a recently published report and do not suggest that analysis of T cells according to the expression of Fc receptors helps in the understanding of functional changes in the T-cell system in patients with CD.

Surface markers of lymphocytes infiltrating seminoma tissue

Infiltrating lymphocytes were separated from human seminoma tissue obtained surgically. The relative distributions of B and T lymphocytes, and a subset of T lymphocytes with IgG-Fc receptors were measured by the rosette-forming method in peripheral blood and in seminoma tissue from 7 patients with pure seminoma of the testis. The proportions of T and TG cells were increased in seminoma tissue compared to those of peripheral blood from the same patients, whereas the proportion of B cells did not change. This result might correlate with the favorable prognosis of seminoma usually accompanied with lymphocytic infiltration.

Subpopulations of T lymphocytes in patients with ankylosing spondylitis

Subpopulations of human blood T lymphocytes were determined in 20 patients with ankylosing spondylitis and in 20 healthy individuals. The proportion of T lymphocytes with receptors for the Fc portion of IgG (TG cells) was increased in 9 patients. The proportion of T lymphocytes bearing receptors for the fc portion of IgM (TM cells) was within the range found in healthy controls in all but 4 patients, who had a decreased level of TM cells.

An anti-human t-lymphocyte antiserum. Further characterization of the specificity for T-cell subpopulations and a comparison of methods for identification of T-lymphocytes in tissue sections

An anti-human T-lymphocyte antiserum has been further studied for specificity for T-cell subpopulations and application in tissue sections. Using a complement-dependent microcytotoxicity assay about 60% of normal peripheral blood T-cells were found to be sensitive to lysis, while 40% were resistant. When the T-cell suspensions were depleted of TG-cells using EA (Ripley) rosette sedimentation, the remaining cells demonstrated an increased percentage of lysis-sensitive cells, while the T-cells enriched in EA-RFC demonstrated a decreased percentage of cells sensitive to lysis, indicating that the antiserum was primarily directed against the non TG-cells, i.e. probably the TM helper cell population. This was further supported by functional studies. In order to quantitate T-cells, cytocentrifuge preparations were made from cell suspensions with known T-cell percentages and the T-cells determined with both the immune adherence technique using AET-treated sheep erythrocytes, as well as the indirect immunofluorescence technique using anti-T antiserum. The results of the two methods correlated well, suggesting that both methods can be used to determine T-cells in situ in infiltrate-like clusters of cells.

Lymphocyte subpopulations in patients with various immunodeficiencies

We have studied patients with various immunodeficiencies for the occurrence of blood lymphocytes bearing six different surface markers: the affinity to sheep erythrocytes (Es) to identify T cells, the presence of surface-bound immunoglobulins (sIg) to distinguish B cells, the affinity to mouse erythrocytes (Em) as a second B cell marker, and the receptors for the Fc part of IgM (IgM-FcR), the Fc part of IgG (IgG-FcR) and for complement (CR). IgG-FcR bearing lymphocytes were present in normal proportions and the same was found for CR-positive lymphocytes. None of the patients with congenital agammaglobulinaemia had sIg-bearing or Em-binding B lymphocytes. Four patients with ataxia teleangiectasia had low B cells and 3 out of 4 also had low proportions of IgM-FcR-bearing (T) cells. A child with partial DiGeorge syndrome did not have a grossly abnormal marker pattern although there appeared to be a shift in the T/B cell ratio in favour of the B cells. In a patient with selective cellular immunodeficiency associated with a purine nucleoside phosphorylase deficiency, who was followed during reconstitution therapy with plasma and red cells, a positive change in the marker pattern was seen. Similar observations were made in a child with combined immunodeficiency during treatment. The findings are being discussed in the light of the current knowledge of the functions and ontogeny of lymphocyte subsets.