Sister chromatid exchange: variation by age, sex, smoking, and breast cancer status

Sister chromatid exchanges in smokers and smokers with alcohol habit

Aim:

Sister chromatid exchange (SCE) test is a sensitive, biomarker of genotoxic substances. The present study was conducted to observe the frequency of SCEs in peripheral blood lymphocytes of 30 males with and without the habit of cigarette smoking and alcohol consumption.

Materials and Methods:

Subjects for this study were males aged between 25-50 years and were selected from the students, employees and the patients attending the outpatient department of Ragas dental college and Hospital, Chennai.

Results:

Controls, smokers, and smokers with alcohol habit were divided into two age groups as ≤30 years and ≥30 years. In controls the mean frequency of SCEs/cell in ≤30 years and ≥30 year's age group was 5.80 and 6.05, respectively. In Smokers SCEs/cell in ≤30 years and ≥30 year's age group was 7.7 and 8.8, respectively. In Smokers with alcohol habit SCEs/cell in ≤30 years and ≥30 years age group was 10.1 and 12.8, respectively.

Conclusions:

In this study, the duration of the smoking habit has shown a positive correlation with the mean SCE frequency. Whereas, frequency of the habit did not show any influence on the SCE levels. In smokers with alcohol habit, both the duration and frequency of their smoking habit has shown a significant effect on the SCE levels suggesting a synergistic effect of alcohol and smoking leading to excessive DNA damage.

Spontaneous and gamma-ray-induced sister chromatid exchanges in patients with carcinoma of cervix uteri

The aim was to investigate whether there are differences in the spontaneous and gamma-ray-induced genomic instability in peripheral blood lymphocytes between untreated cervical cancer patients and healthy women using the sister chromatid exchange (SCE) assay as an indicator of chromosomal instability. Lymphocyte cultures from whole venous blood of 10 patients with cervical neoplasia and 10 healthy female volunteers were cultivated in vitro and irradiated using a 60Co-gamma source. Slides were prepared using the standard air-drying procedure and stained by the fluorescence-plus Giemsa (FPG) technique. The number of SCE and the number of chromosomes were assessed in second-division metaphases. A radiation dose-dependent increase of SCE/cell and SCE/chromosome values were found in healthy women as well as in patients, while statistical analysis has shown significantly higher SCE frequencies in healthy women as compared with patients. Cellular kinetics expressed as replication indices (RI) calculated from the frequency of cells in first cell division (M1), second cell division (M2) and third cell division (M3) were also significantly different, while observed RI were higher for patients than for control individuals. The results suggest that patients with carcinoma of the cervix uteri have chromosomal stability changes reflected in statistically different levels of spontaneous and induced SCE in comparison with healthy individuals. Despite the unknown mechanisms of SCE formation, it is felt that the changed SCE frequency, especially after mutagen treatment, may be used as a marker of increased cancer risk.

Sister chromatid exchange analysis in workers exposed to noise and vibration

Workers chronically exposed to whole-body vibration and noise are known to develop pathophysiological and psychological disturbances. The frequencies of sister chromatid exchanges (SCEs) and of cells with high frequencies of SCEs (HFCs) were analyzed in lymphocytes of 50 workers occupationally exposed to vibration and noise and of 34 controls. The exposed group included: individuals operating hand-vibrating tools (group 1), 'test-cell operators' (group 2) and 'run-up' operators (group 3) from an air base and helicopter pilots (group 4). The statistical analysis of the mean SCE count per cell was carried out by multiple regression analysis, comparing various predictor variables: exposure group, duration of exposure, age and cigarette consumption. Only cigarette consumption and exposure group were found to be significantly correlated with the mean SCE frequency. After allowing for the effects of smoking, the analysis indicates that: (1) there was no significant difference between group 1 and controls (p > 0.05); (2) the differences between group 2 and group 0, group 3 and group 0 and group 4 and group 0 were all highly significant (p < 0.001); (3) there was no significant difference between groups 2 and 3 (p > 0.05), nor between groups 2 and 3 combined and group 4 (p > 0.05); (4) exposure groups 2, 3 and 4 combined, had a significantly elevated mean SCE frequency compared to the control group (p < 0.0001). Statistical analysis of the proportion of HFCs was consistent with these results. Our data suggest that chronic exposure to whole-body vibration and noise may lead to an increase in the level of SCEs in man. The observed effects may not reflect a direct action of these physical agents on DNA. Alternative explanations may include some of the whole-body vibration and noise-induced or stress-induced pathophysiological alterations which may indirectly induce SCE formation.

Sister chromatid exchange (SCE) studies in breast cancer patients: a follow-up study

Sister chromatid exchanges (SCEs) were studied in 20 patients with breast cancer (stage II) before surgery, one month after surgery, and after three years as a follow-up study. Data from 50 age-matched, normal healthy females, preferably from the affected families, served as controls. In each patient, 50 well-spread metaphases were scored for SCEs. The mean values of SCEs per metaphase were 5.80, 4.69, and 5.98 in breast cancer patients before surgery, one month after surgery, and after a gap of three years as a follow-up, respectively. The one-way analysis of variance was applied and it was found that there was a highly significant difference in the frequency of sister chromatid exchanges in these patients before surgery, one month after surgical removal of cancerous tissue, and after three years as a follow-up study. The elevated level of SCEs three years after surgical removal of cancerous tissue predict the chances of development of another type of cancer.

Sister chromatid exchange frequencies in carcinoma of the human oral cavity: effect of treatment

Spontaneous and mitomycin-C-induced sister chromatid exchange frequencies were studied in the lymphocytes of 25 oral cancer patients. For these patients, the mean spontaneous SCE value was 8.31 (+/- SD), which was significantly higher than the value of 6.60 (+/- SD) obtained for the controls (p < 0.001). But there was no significant difference between the Mitomycin C induced mean SCE values of oral cancer patients and controls. Seven of these 25 oral cancer patients were selected for second sampling after surgical removal of the tumor. Six of these seven patients showed a decrease in mean SCE/cell value following surgery, which was almost equal to the SCE values obtained for the controls. This indicates that the increased spontaneous SCE rates in oral cancer patients might be due to the metabolic stress imposed by the tumor on the host body or by some clastogenic product of the malignant cells. Surgical removal of the tumour might have resulted in normalization of the lymphocytic SCE rates in postoperatively studied patients.

Sister chromatid exchange frequency in breast cancer cases

Sister chromatid exchange (SCE) were studied in 22 patients with breast cancer (i.e., four stage II; 12 stage III, six stage IV) and 10 normal healthy females as age-matched controls. The data obtained in these cases followed a Poisson distribution. An apparent increase in the average rate of SCE/cell was observed with the advancing stage of breast cancer.

Sister chromatid exchange frequencies in a group of individuals with unfavorable reproductive health

Sister chromatid exchange (SCE) frequencies and other cytogenetic parameters were investigated in peripheral blood lymphocytes from 92 subjects comprising 44 parents of malformed offspring or repeated fetal wastage (Group I) and 48 controls, age and sex matched, having normal reproductive health (Group II). The karyotypes were normal and the mean mitotic indices were comparable in both groups. The mean frequency of SCE per metaphase in Group I (8.67 +/- 0.32) was significantly higher than the mean for group II (6.65 +/- 0.16), and the cellular replicative index in Group I (1.78 +/- 0.04) was significantly different from that of Group II (1.66 +/- 0.03). The results are discussed in the light of the present understanding of the etiology and mechanism of production of sister chromatid exchanges.

Cytogenetic surveillance of tobacco-areca nut (mava) chewers, including patients with oral cancers and premalignant conditions

Three cytogenetic endpoints were studied in non-chewing healthy controls and 3 groups of tobacco-areca nut chewers, viz. normal chewers, chewers with oral submucous fibrosis and chewers with oral cancer. Frequencies of sister-chromatid exchanges and chromosome aberrations in peripheral blood lymphocytes and of micronucleated cells in exfoliated buccal mucosa were evaluated. All the parameters showed statistically significant elevations in all 3 groups of chewers compared to the controls. The data indicate possible application of the parameters as sensitive endpoints for monitoring tobacco-areca nut chewers, the group of individuals at higher risk of developing oral cancer, the commonest cancer among Indian males.

Sister chromatid exchange and proliferation pattern in lymphocytes from newborns, elderly subjects and in premature aging syndromes

Sister chromatid exchange (SCE) frequency and cell proliferation were examined in lymphocyte cultures from a group of newborns, a group of elderly subjects and from patients with syndromes who exhibit progeriform characteristics (progeria, Cockayne syndrome, Rothmund-Thomson syndrome and Christ-Siemens-Touraine syndrome) by using the bromodeoxyuridine incorporation differential staining technique. We observed a significantly increase in basal SCE frequency and a less intensive cell proliferation in cultures from elderly subjects than from newborns, as shown by the significant increase in percentage of cells in first generation simultaneous with a reduction of cells in more advanced generations. Lymphocyte cultures from each one of the patients studied also showed a decreased cell proliferation in relation to their respective control and to newborn cultures. Each of these syndromes showed higher baseline SCE levels than the control and than the newborn and elderly groups. Only the patient with progeria showed values similar to those for the elderly group. Thus, in addition to showing clinical characteristics similar to those observed during the normal aging process, these progeriform syndromes also show cytogenetic characteristics similar to those of older individuals.

Induction of nuclear aberrations by smokeless tobacco in epithelial cells of human oral mucosa

Cytologic and cytogenetic studies were performed to assess the prevalence of somatic cell genetic damage in 48 young adults equally divided to represent users and nonusers of smokeless tobacco. Exposure was ascertained by measuring saliva cotinine using capillary gas chromatography. Squamous epithelial cells sampled from the oral mucosa demonstrated significant cytologic alterations associated with tobacco exposure. The frequency of micronucleated cells was significantly (P less than .01) higher in the labial mucosa of exposed (2.22%) compared to unexposed (0.27%) individuals. The frequency of micronuclei varied widely between exposed subjects but was higher in heavily (2.48%) compared to lightly (1.29%) exposed individuals as measured by saliva cotinine levels. Morphologic classification of epithelial cell nuclei showed that the frequency of cells with normal nuclear structure was significantly (P less than .01) reduce in exposed individuals. Analysis of oral epithelial cells of five additional nonusers of smokeless tobacco but wearers of orthodontic appliances to stimulate abrasion demonstrated no difference from the nonexposed control group. Unlike the case with cigarette smokers, peripheral lymphocyte sister-chromatid exchange frequency was not affected by exposure to smokeless tobacco. The oral cytology data, however, support an interpretation of exposure-dependent nuclear alterations, including micronuclei, in the oral epithelium associated with the use of smokeless tobacco. Altogether, results suggest that use of smokeless tobacco may cause genetic damage to cells in the oral epithelium.

Increased spontaneous and mitomycin C-induced sister chromatid exchanges in patients with cancer of the cervix uteri, with special reference to stage of cancer

The frequencies of spontaneous and mitomycin C (MMC)-induced sister chromatid exchange (SCE) were examined in 35 patients with cancer of the cervix uteri (stage 0, eight cases; stage I, nine cases; stage II, nine cases, and stage III, nine cases) before they had undergone cancer treatment, as well as in seven patients with uterine myoma and 18 healthy women as controls. The frequency of SCE was analyzed in reference to the stage of cancer in the cancer group and in reference to chromosome group in the cancer and normal groups. The frequencies of spontaneous and MMC-induced SCE in the cancer group were 10.0 +/- 1.8 and 20.7 +/- 2.6, respectively, and both were significantly higher than in the myoma (8.1 +/- 0.8 and 17.6 +/- 1.8) and normal (7.6 +/- 0.8 and 17.6 +/- 2.3) groups. Furthermore, the frequency of SCE in the cancer group increased with cancer stage. All chromosome groups contributed equally to the increase in SCE in the cancer group. These results indicate that an increase in the frequency of SCE in patients with cervical cancer is related to the presence of cancer, but is not related to a predisposition to cancer.

Cytogenetic analysis of blood lymphocytes from X-ray radiographers

Cytogenetic analysis was performed on blood lymphocytes from 46 healthy radiographers exposed to an annual dose of X-rays below the Maximum Permissible Occupational Limit (MPOL 5 rem/year) for a period ranging from 6 months to 26 years. Total chromosomal aberrations including dicentric and ring forms was 10.18%, which was significantly higher (P less than 0.01) than that (1.17%) of 50 healthy unexposed individuals (controls). A significant increase in the frequency of SCEs in cells from radiographers (11.2 +/- 0.9 SCE/cell) was noticed as compared with the controls (6.9 +/- 0.2 SCE/cell). There was a significant difference in lymphocyte proliferation between the two groups. These results indicate the importance of monitoring the health status of radiation workers.

Chromosome fragility of lymphocytes from breast cancer patients in relation to epidemiologic data

The chromosomal fragility of peripheral blood lymphocytes from 50 women, undergoing operations for breast tumors (47 carcinomas, 2 intraductal papillomatoses and 1 malignant lymphoma) was studied to ascertain the association between chromosome fragility and epidemiologic data, such as a family or personal history of cancer, hormonal status, etc. Under conditions of folic acid and thymidine depletion, the average number of gaps and breaks on the patients' lymphocyte chromosome was 6.02 +/- 5.28 and that in the control medium was 2.0 +/- 2.0 while those of healthy controls were 5.8 +/- 5.5 and 1.36 +/- 1.22. These gaps and breaks were mostly seen in group A chromosomes (4.1 +/- 2.6) in 24 patients, including the 2 with benign tumors and the 1 with the lymphoma as well as 11 healthy controls. They were frequent in group B (3.0 +/- 0) in 3 patients, in group C (4.3 +/- 2.9) in 11 patients, and in groups D (2.0 +/- 1.0) and E (3.0 +/- 1.0) in 3 patients from each. This different distribution of gaps and breaks correlated neither with the patients' age nor with their tumor's histology, but patients having a late menarche were distributed in non-A groups. There was low inducibility of breaks in patients with a family history of breast cancer and/or relatively rare cancers. The availability of common fragile sites for studying an individual's susceptibility to cancer is discussed. One patient showed a bromodeoxyuridine-requiring heritable 10q25 fragile site. Another, with triple primary cancers, showed a constitutional translocation of t(5;19)(q15;q13).

Increased frequency of sister chromatid exchanges in lymphocytes of breast cancer patients

Spontaneous and mitomycin-C (MMC)-induced rates of sister chromatid exchanges (SCEs) were studied in peripheral blood lymphocytes (PBLs) of 40 patients with cancer of the breast and 40 healthy female volunteers as controls. Spontaneous SCE per cell value in PBL cultures was 7.72 for the breast cancer patients, which was significantly higher (p less than 0.001) than the 6.28 SCEs per cell scored for the controls. Eight of the patients were studied a second time, 3 to 6 months following surgical removal of the tumour. A significant (p less than 0.05) reduction in SCE per cell value was observed following mastectomy. MMC-induced frequencies of SCE remained comparable in patients and controls. Cellular kinetics, calculated as average generation time (AGT) from the frequency of cells in M1, M2 and M3 cycles, were comparable in patients and controls.

Factors that influence formation of sister chromatid exchanges in human blood lymphocytes

Sister chromatid exchange (SCE) reflects an interchange of DNA sequences between helices in a replicating chromosome. This was initially accomplished by Taylor and colleagues (1957) using tritiated thymidine incorporation followed by autoradiography. The development of an elegant technique for differential staining of sister chromatids by incorporating a thymidine analog, 5-bromodeoxyuridine (BrdU) has greatly simplified the detection of SCEs in metaphase chromosomes. In recent years, the analysis of SCE has been considered to be a highly sensitive and additional (i.e., with chromosome aberrations) end point for measuring mutagenic/carcinogenic potential of various environmental agents and is increasingly being used to detect and differentiate among chromosome fragility human diseases that predispose to neoplasia. Attention has been focused to see if the induction of SCEs in lymphocyte cultures can be used as a reliable "biological dosimeter" for genetic risk assessment and to monitor the exposed populations. Several physical or preparatory as well as biological factors that modify the response and formation of SCEs make the monitoring difficult. The purpose of this article is to review and analyze these factors to facilitate an effective development of a standard protocol for SCE testing and for appropriate evaluation of test results. This may also provide clues to understand the yet unknown molecular mechanism(s) and biological significance of SCE formation.

Evaluation of sister chromatid exchange as an indicator of sensitivity to N-ethyl-N-nitrosourea-induced carcinogenesis in rats

Sister chromatid exchange (SCE) frequencies in peripheral lymphocytes are a frequently used endpoint to indicate exposures to genotoxins in groups of humans. The aim of this study was to ascertain, in an experimental design, whether or not SCE rates have any association with the risk of cancer at the individual level in rats exposed to a known carcinogen. Individual SCE rates were determined in three consecutive analyses in cultured blood lymphocytes of 50 adult male Wistar rats. Analyses were done before as well as 24 hr and 7 days after a single intraperitoneal administration of 0, 25, 50, or 75 mg/kg of N-ethyl-N-nitrosourea (ENU). The animals were followed until death; also, the relationship between SCEs and carcinogenic outcome, i.e., the presence or absence of tumors, and their latency period were examined. ENU significantly decreased the life expectancy of the rats. The tumor types most clearly associated with ENU treatment were various gliomas and thyroid-gland and testicular tumors. ENU induced a moderate (maximally 1.6-fold) increase in the mean frequency of SCEs/cell at both sampling times after treatment. The effect was somewhat more pronounced 1 day rather than 1 week after treatment. The mean SCE rates in rats with ENU-specific cancers or in animals with early or multiple tumors did not differ from those in animals that survived no less than 65 weeks or longer without developing tumors. In ENU-treated animals with tumors, no relationship was found between the mean SCE rate and survival time. It is concluded that in outbred Wistar rats the SCE response in cultured lymphocytes does not indicate individual susceptibility to the carcinogenic action of ENU. On a group basis, however, animals with high SCE rates were shown to have increased risk of cancer.

Sister chromatid exchange induction by benzo(a)pryene in cultured peripheral blood lymphocytes of lung cancer patients and healthy individuals with or without familial history of neoplasms

The inducibility of sister chromatid exchanges (SCEs) by benzo(a)pyrene (BP) was studied in cultured peripheral blood lymphocytes of 15 untreated lung cancer patients and 25 healthy persons including 11 high- and 14 low-cancer-risk individuals tentatively classified by the familial history of lung cancer and other neoplasms. The baseline SCE frequency in cultured lymphocytes was significantly high in lung cancer patients, as compared with all healthy persons or low-cancer-risk individuals. Following exposure to BP, the lymphocytes of lung-cancer patients and high-cancer-risk individuals exhibited significantly greater SCE yields than those of persons at low risk, although no significant difference was observed in the lymphocyte SCE yields when the levels of lung cancer patients were compared with those of all healthy persons. A comparison of the net SCE increase (delta SCE) in BP-exposed lymphocytes among the study groups, however, revealed a significant difference in delta SCE values only between high- and low-cancer-risk individuals. The present findings on both the observed SCE yields and delta SCE values suggest that lymphocytes of high-risk individuals may be more susceptible to BP-induced DNA damage than those of persons at low risk, and that such a chromosomal hypersensitivity to genotoxins may be associated with a high risk of neoplasms.

Studies on sister chromatid exchanges in patients with Hodgkin's disease

Sister chromatid exchange frequencies were analyzed in bone marrow cells and in stimulated peripheral blood lymphocytes from 20 patients with Hodgkin's disease. Sister chromatid exchange studies were also carried out in the bone marrow of eight and peripheral blood of 11 normal subjects separately. Among the patients, ten were newly diagnosed and ten patients were survivors who had received therapy 30-64 months prior to studies. The mean sister chromatid exchange frequencies in bone marrow and peripheral blood of untreated patients were 3.93 +/- 0.7/cell and 4.09 +/- 0.91/cell, respectively, which were not significantly different from those of normal subjects (3.22 +/- 0.7/cell and 5.16 +/- 1.3/cell in bone marrow and peripheral blood, respectively). The mean sister chromatid exchange frequencies in bone marrow and peripheral blood in five of the untreated patients 3-4 months after initial therapy and in a treated (30-64 months after therapy) group were close to the sister chromatid exchange values of the untreated group. Analysis of the distribution of exchanges per chromosome or chromosome groups showed a nonrandom distribution of exchanges in chromosomes #1, #2, and #3, and in E-, F-, and G-group chromosomes in the normal controls and in Hodgkin's disease patients.

A study of multiple biological markers in twins

Genetic and environmental influences on the phenotypic expressions of several biological markers were studied in 18 monozygous (MZ) and 8 dizygous (DZ) twin pairs. Zygosity was determined using ABO, Rh, and HLA. The biomarkers studied included: T & B lymphocytes, suppressor and helper T lymphocytes (T gamma, T mu), T cell (PHA) mitogen activation (MA), serum immunoglobulins (IgA, IgM, and IgG), plasma carcinoembryonic antigen (CEA), aryl-hydrocarbon hydroxylase (AHH) and sister chromatid exchange (SCE) in lymphocytes. Temporal variation of markers over a 6-month period was not significant. The mean absolute differences between levels from first and second blood draws were less than one standard deviation. Variability associated with age was not significant. Females had higher levels of T lymphocytes than males. A gender related association was observed for the IgM immunoglobulin test: females had a higher mean level of IgM. Smoking was found to influence the levels of SCE, T helper lymphocytes and mitogen activation. The variability of these biomarkers within and between twin pairs was quantified. Immunoglobulin levels, particularly that of IgM, showed statistically greater similarity within MZ twins than within DZ twins. Several other markers suggested heritability.

Sister-chromatid exchange (SCE) report on control subjects in a study of occupationally exposed workers

The range and distribution of Sister-Chromatid Exchange (SCE) scores in 479 control persons were determined. All SCE readings were performed in a single laboratory according to the same protocol and regularly checked by referee readers to assure consistency. A mean SCE per cell value of 9.9 and a 95th percentile of 13.4 were established for this study sample. The range of SCE scores across all non-exposed individuals tested was 5.0-17.5 SCE per cell. Differences in SCE scores were associated with reader, smoking, sex, and, to a small extent, age. Individual test results showed reasonable consistency across the entire control group, but, as with most clinical measurements, care should be taken to avoid placing too much emphasis on a single test result when communicating with an individual. This report on the largest control group studied to date provides necessary normative data for further SCE investigations in occupational settings.

Sister-chromatid exchanges in association with occupational exposure to ethylene oxide

Sister-chromatid exchange (SCE) frequencies in employees potentially exposed to ethylene oxide (ETO) were compared with those in unexposed control groups. Three worksites where the previous environmental control of ETO was known to have differed were chosen. Within these worksites, subjects were categorized into high potential exposed, low potential exposed and control groups. An additional community control group was obtained. Blood samples for chromosome studies of peripheral lymphocytes were drawn at several time points over a period of 24 months. The effects on SCE of age, sex, smoking habits and reader variation were considered. Worksites I, II and III, respectively, represented increasing levels of exposure. At Worksite III large differences among groups persisted over 24 months. At Worksite II, the SCEs in the high potential exposed workers were higher than those in the other groups. At no time was the low potential exposed group at Worksite II statistically significantly higher in mean SCE than the worksite controls. No consistent differences among groups were noted in Worksite I.

The SCE test as a tool for cytogenetic monitoring of human exposure to occupational and environmental mutagens

The sister chromatid exchange (SCE) test system using human peripheral lymphocytes is proposed as a valuable tool for the cytogenetic monitoring of exposure to potential chemical mutagens in the occupational environment. We examined the SCE frequencies in organic solvent-exposed workers and reviewed the effects of occupational and environmental chemicals on SCE frequencies. The results obtained in these exposed populations are rather contradictory, which may be related to confounding factors, such as personal life style (smoking, drinking, and drugs) of the examinees, tissue culture conditions and the number of subjects examined. We discussed some practical problems for exposure estimation and sample size determination and are led to the following conclusions. 1) The possible combined effects of potential mutagens and cigarette smoking should be taken into consideration when using the SCE test system. 2) Cell cycle kinetic analysis by differential chromatid staining would provide valuable information as a biological indicator for the monitoring of the workers exposed to xenobiotics. 3) By appropriately setting the number of examinees, monitoring would become more efficient in detecting an increased SCE frequency in the exposed populations. Further studies are also required to enhance the sensitivity of the SCE test system for monitoring purposes.

Sister-chromatid exchange frequency in lymphocytes of smoking and nonsmoking mothers and their newborn infants

Sister-chromatid exchange (SCE) frequency in lymphocytes of 8 smoking mothers and their 9 newborns (one subject bearing twins) was compared to 6 mothers who had never smoked and their 6 newborn infants. Mothers in the first group were required to have smoked throughout pregnancy and to have a minimum of 15 pack-years smoking history. Results confirm our earlier smoking effect reported for adults, deny an effect on the newborn, and concur with other studies that show neonates have consistently lower SCE frequencies than adults. Overall, results are consistent with the idea that toxic substances in tobacco smoke interact with chromosomal DNA of circulating human lymphocytes.