Leukocyte migration in vitro and its relationship to human renal allograft rejection and enhancement

Human leucocyte migration inhibition

Within the last decade a variety of techniques have been developed and used for the detection of cell-mediated immunity in man by means of leucocyte migration inhibition in vitro. A detailed description of the leucocyte migration capillary tube technique (LMCT) and the leucocyte migration agarose technique (LMAT) is given. The procedure for selecting and using the proper antigen concentration is described. A description is also given of the indirect LMAT and the technique for determination of concanavalin A-induced lymphocyte release of leucocyte migration inhibition factor. Applications of these techniques are mainly intended for the exploration of the immunobiology of lymphocytes and cellular interactions associated with the immune response and the investigation of clinical conditions in man, i.e. infectious diseases, autoimmune diseases, transplantation states, tumour diseases, contact hypersensitivity and immunological deficiency states. Selection and adaptation to suit the experimental aim is necessary to obtain optimal results with these techniques. Their usefulness may be increased through more extensive use of purified antigens and indirect assays.

Cell-mediated immunity to a serologically defined (SD) HL-A antigen panel in kidney-transplanted patients

The graft-directed, cell-mediated immunity in kidney-allografted patients was examined with a seriologically defined (SD), donor-unrelated panel of antigenic material in clinical steady state, soon after transplantation, and during acute rejection episodes. The SD antigens were selected from the panel on the basis of predictions hypothesized from the SD match of donor and recipient. The cell-mediated immunity was measured by the direct leukocyte migration agarose test (LMAT). Positive reactions in kidney-transplanted patients were induced particularly by one preparation (antigen 52) and were unpredictable on the basis of SD classification. The investigation shows that other antigenic determinants, different from SD antigens, probably play an important role as inducers of cell-mediated, graft-associated immunity in kidney-transplanted patients.

Evaluation of rosette inhibition test in renal transplantation

Serial rosette inhibition tests were performed on 11 renal transplant patients in an attempt to predict graft rejection. The rosette inhibition titre was higher in immunosuppressed patients than in normal subjects. The test was of predictive value in only two out of 12 rejection episodes, where a fall in titre to normal levels occurred 48 hours and 24 hours, respectively, before biochemical evidence of rejection. In two further rejection episodes the titre fell at the time of rejection. The titre changes in all tests were small and there were frequent inconsistencies in the results of individual tests. A study of the variables was undertaken, with standardization of the technique, and improvements were made in reading the test. Despite these changes the test was still not sufficiently accurate or reliable to be used as the basis of treatment of rejection episodes.