Cell-mediated immunity in patients with malignant melanoma

Leukocyte migration inhibition of leukemia-associated antigen in children with acute leukemia and their family members

The leukocyte migration inhibition assay has been widely used as an in vitro test cell mediated immunity to various substances. Using a leukemic cell line (RPMI 8402) as the source of antigen, we assayed leukocyte migration inhibition in seven children with acute lymphocytic leukemic (ALL), their family members (14 patients and 13 siblings), and 17 healthy adult controls. In six families, the patients showed stronger inhibition than their family members or controls. The patients differed significantly from their family members (P = 0.003) and all other persons without leukemia (P = 0.02). These results suggest that patients with ALL have developed a specific cellular immune reactivity to an antigen or antigens on leukemic cells, while their family members have not.

Comparative histological studies of regional lymph nodes of 201 melanoma patients. (Microscopic features in relation to individual age, site, and metastatic spread)

Since May 1968 a total of 2.108 regional lymph nodes (l.n.) dissected from 201 melanoma patients (86 axillary, 107 groin, and 8 neck) have become available for study. The purpose was to detect histological differences between the l.n. of 134 patients lacking and those of 67 patients exhibiting l.n. metastases, histologically verified in 104 of 706 nodes. The main finding is a more than six-fold increase in number and an eleven-fold increase in total area (evaluated by a microscope micrometer) of germinal centers in the lymph follicles of patients with, as compared to those without, l.n. metastases (P less than or equal to 0.05). Paracortical areas were found to be diminished in 56.7% of cases with metastatic spread. Accumulations of plasma cells were mainly seen in the nodes of elderly patients (48.4%) and of those exhibiting regional metastases (47.8%). The observation of numerous and dilated blood vessels in the interfollicular regions noticeably corresponded to the occurrence of lymphatic metastases (P less than or equal to 0.01), suggesting a "tumor angiogenic factor". A negative correlation with metastatic involvement was found as to histiocytosis of marginal sinuses and with respect to the observed fibrinoid hyalinosis of pulp vessels (P less than or equal to 0.01). The marked hyperplasia of lymph node B-lymphocyte regions as opposed to diminished T-lymphocyte areas prevailing in cases with metastatic melanoma is in accord with findings of humoral immunologic blocking activity and impaired T-cell response in advanced malignant melanoma.

Human malignant melanoma antigenic properties of phenol water extracts

Tumor-associated antigens were demonstrated in phenol water extracts of human malignant melanoma by migration tests with leukocytes from melanoma patients and controls: in 25 out of 60 melanoma patients weak reactivity was observed, usually stimulation of leukocyte migration, while leukocytes from 37 controls were negative in 100 tests. The frequency of positive reactions did not differ significantly in patients with and without metastases. Humoral antibodies against antigens of phenol water extracts were not detectable in melanoma patients. Rabbits did not produce antibodies against tumor typical substances after immunization with phenol water extracts. Tumor associated antigens of phenol water extracts are presumably not targets of antitumor immune reactions that can influence the clinical course.

Leukocyte migration inhibition responses in canine lymphosarcoma

The leukocyte migration inhibition (LMI) responses of 16 cases of canine lymphosarcoma were assessed at several stages of a combined chemotherapy immunotherapy regime. Pooled allogeneic lymphosarcoma cells used in treatment together with other allogeneic lymphosarcoma cells and autochthonous tumour cells were employed as antigens. Positive inhibitions were detected at all stages of treatment when medium controls were used but were not detected in five normal dogs with the same control. There was no association between relapse and remission and LMI response. When a normal lymph-node cell control was used only four dogs produced positive responses, all of which occurred after allogeneic cell administration. These positive responses could not be completely accounted for by sensitization to histocompatibility antigens but as they occurred both in remission and in relapse, including very advanced cases necessitating euthanasia, they were of no value in determining prognoses.

Cellular hypersensitivity in patients with adenomatous hyperplasia and adenocarcinoma of the endometrium

Cellular hypersensitivity was studied in patients with adenomatous hyperplasia and adenocarcinoma of the endometrium with the use of dinitrochlorobenzene (DNCB) skin tests and inhibition of leukocyte migration by homologous and autologous tumor antigen. Inhibition of leukocyte migration by homologous endometrial carcinoma antigen was found in two of five patients with adenomatous hyperplasia and eight of 11 patients with endometrial adenocarcinoma. A comparable degree of inhibition was found with autologous antigen. DNCB skin reactions were found to be strongly positive in patients with adenomatous hyperplasia, and a lesser degree of reactivity was observed in patients with endometrial adenocarcinoma. No correlation was found between leukocyte migration tests and DNCB reactions, and no correlation was observed between these tests and the age of the patient, clinical stage of disease, or histologic grade of the tumor.

[Cellular immunity in melanomalignome (author's transl)]

Cellular immunological reactivity was examined in 20 patients having melanomalignoma at different clinical stages, using Leukocyte-Migration-Inhibition-Test. As antigens three homologous melanoma-extracts were used, produced by our own method. Independent from the clinical stages cell-migration inhibition could be established in 15 out of the 20 patients. In this way, these tumor extracts have been shown to contain melanoma-associated antigens. Regardless of the clinical stage of the disease, the melanomalignomas patient produces cellular immunity against those tumor-antigens. It is note-worthy that the actual course of the disease seems not to be influenced by immun-mechanisms.

Chronic mucocutaneous candidiasis treated with transfer factor

A patient with chronic mucocutaneous candidiasis resistant to all tropical therapy has had extensive tests of immunological function carried out before and after administration of transfer factor. Immunological testing has been both specific, directed at responses to candida antigen, and non-specific, directed at general assessment of the patient's immune status. Transfer factor has been administered on three occasions in the past year. After each treatment temporary clinical improvement accompanied by changes in both specific and non-specific immunological responses have been observed. The possible mode of action of transfer factor in this case is discussed.

Lymphocyte stimulation in the cellular inflammatory reaction of some human skin tumours

By labelling dermal infiltrate cells with H3-thymidine, two types of skin tumours can be distinguished: one type with many labelled cells in the infiltrate (H3-thymidine labelling index, H3-I), the other with few labelled cells. Type I includes malignant melanoma (H3-I = 2.2%) and hemangioendothelioma (2.8%). Type II includes metastases of malignant melanoma (1%), squamous cell carcinoma (1.1%), basel cell epithelioma (0.5%), nevus cell nevus (0.6%), and nevoid lentigo (0.4). The number of labelled cells in the cellular reaction of Type II tumours does not differ significantly from that in normal human corium (0.75%), though there may be a dense cellular reaction. DNA-synthesizing cells were classified with the aid of characteristical stainings and histochemical methods. A vast majority of them were found to be lymphocytes. Our research underlines the special importance of cellular inflammatory reaction, i.e. cellular immunity, im malignant melanoma and probably in hemangioendothelioma.

Leukocyte adherence inhibition and specific immunoreactivity in malignant melanoma

The leukocyte adherence inhibition (LAI) test has been used to assess specific anti-tumour immunoreactivity in 80 patients with malignant melanoma, 21 of whom had apparently been successfully treated by surgery, and 44 control subjects. Reaction with melanoma extracts in vitro enabled the activity of blood leukocytes to be detected by inhibition of their adherence to glass, while serum was tested for factors which modified this inhibition. Of the patients with tumours (ranging from primary melanoma in situ to advanced disseminated disease), 22/24 had active leukocytes and 50/58 has serum blocking factor; two of the sera, from patients with regressing tumours were unblocking. After surgery with no clinical recurrence, leukocytes continued to be active except when tested several years after operation. Blocking factor rapidly disappeared in 16/20 patients tested, and in several patients examined serially the serum became unblocking. In three cases, persistence of serum blocking was followed by clinical diagnosis of metastases. Leukocyte activity was nerver detected in control subjects (0/10), many of whom had other kinds of tumours or skin lesions. Blocking activity in serum was found in only 3/38 controls with no history of melanoma (1 had a fibrosing cellular blue naevus and 2 had liver disease). Thus the LAI test correlated well with clinical and pathological findings, and shows great promise for the reliable, rapid and specific immunodiagnosis of malignant melanoma.

[Mitogenic activity of melanoma extracts in leucocyte cultures (author's transl)]

From a mixed cell suspension of five primary melanomas an aqueous sterile extract was made and added to homologue leucocyte cultures of eight melanoma patients and seven controls. The extract had a blastogenic and mitogenic effect in all cultures. There was no significant difference between the responses of patients and controls. In experiments with an equally prepared extract of normal skin, added to homologue leucocyte cultures of nine persons, none but one had a positive reaction. This indicates, that the motigenic principle of the melanoma extract is not related to the histocompatibility antigen nor caused by chemical or bacterial contamination of the primary cell suspensions. It seems to be derived from the cytoplasmic fraction of melanoma cells. Other experiments to solve the problem were impossible because of lack of material. There are several reports in the literature which by using different methods indicate, that there might be an immunological reaction to melanoma associated principles in healthy persons, too.

Serum anti-tumour antibodies and auto-antibodies in vitiligo

Anti-tumour antibody was sought in the sera of three groups of patients; idiopathic vitiligo, malignant melanoma and miscellaneous skin disorders. No precipitating antibody to a series of prepared pigmented tumour antigens was demonstrated. All sera were tested for a number of auto-antibodies. No significant differences were detected between the groups. The evidence for an immunological factor in the causation of vitiligo remains circumstantial only.