Characterization of lymphocytes isolated from non-lymphoid human malignant tumours

Natural killer activity and serum immunosuppressive acidic protein levels in esophageal and gastric cancers

The natural killer (NK) activity of peripheral blood mononuclear cells and serum immunosuppressive acidic protein (IAP) levels were examined in patients with esophageal or gastric cancer, before and after surgery. Patients with stage IV esophageal or stage IV gastric cancer had significantly lower NK activity (39.5 +/- 14.8% and 37 +/- 11.6%, respectively), and also higher serum IAP levels (778 +/- 264 micrograms/mL and 633 +/- 156 micrograms/mL, respectively), than the corresponding control values (50 +/- 5.6% and 375 +/- 26 micrograms/mL, respectively). Patients with esophageal or gastric cancer who underwent curative resection had high NK activity (54.8 +/- 11.6% and 54.8 +/- 8.0%, respectively), and low IAP levels (471 +/- 116 micrograms/mL and 490 +/- 42 micrograms/mL, respectively), compared with those who underwent non-curative resection. Patients who underwent non-curative resection had lower NK activity and higher serum IAP levels than those who underwent curative resection, even 1 month after surgery. Mononuclear cells in the regional lymph nodes and tumor specimens showed significantly lower NK activity than those in the peripheral blood and spleen. Thus, NK activity and the IAP level reflected the immunocompetence, clinical course, and surgical curability of those patients. NK cells appeared not to have any significant antitumor activity in the regional lymph nodes or in the tumor itself, although they were still active in the peripheral blood.

Treatment with tumour infiltrating lymphocytes and interleukin-2 in patients with metastatic melanoma: a pilot study

Tumour infiltrating lymphocytes (TIL) were isolated and expanded from biopsy samples of 4 patients with metastatic melanoma. The patients were treated with autologous expanded TIL and continuous or bolus infusion of Interleukin 2 (IL-2) at a dose of 18 x 10(6) International Units/m2/day for 5 days starting 36-48 hours after administration of cyclophosphamide at a dose of 1 g/m2. The number of TIL infused ranged from 10(10) to 5.56 x 10(10) cells. Two patients had stable disease (SD) lasting for 2 1/2 and 4 months respectively and they died 24 and 13 months after therapy. One patient died during therapy due to a pseudomonas septicaemia and another patient developed progressive disease (PD). He died 3 months after the start of therapy. The side effects were substantial but most of them were reversible upon cessation of the treatment. The majority of the expanded TIL of all patients were of the CD8+ phenotype. Cutaneous metastases from two patients, removed after treatment with IL-2 and TIL, showed moderate lymphocytic infiltration also mainly of CD8+ T cells. The treatment with IL-2 and TIL is feasible, but further investigations should continue in an attempt to improve the efficacy of the therapy, to reduce toxicity and to diminish the costs and labour of the culture methods.

Immunohistochemical characterization of seminoma and its inflammatory cell infiltrate

Monoclonal antibodies and the avidin-biotin immunoperoxidase technique were used to study the expression of major histocompatibility complex antigens and the nature of the inflammatory cell infiltrate in 10 testicular seminomas. Tumor cells did not react with anti-HLA-A,B,C, anti-HLA-DR, anti-HLA-DQ, and anti-beta 2 microglobulin antibodies to major histocompatibility antigens. All of the 10 tumors contained a slight to marked inflammatory cell infiltrate at the periphery of the tumor, in the connective tissue septa, and in the tumor lobules. The lymphocytes were predominantly T cells; B lymphocytes were rare. The tissue available for study from seven tumors showed tumor lobules separated by delicate fibrovascular septa; T lymphocytes with a cytotoxic-suppressor phenotype predominated in this area in six tumors. In the four tumors in which peripheral tissue was available for study, cells with a helper-inducer phenotype predominated at the tumor margin. Tissue from three tumors showed stromal sclerosis and a dense lymphohistiocytic infiltrate separating individual and small nests of tumor cells; T cells with a helper-inducer phenotype predominated in these cases. Aggregates of macrophages that expressed OKM-1 and Leu-M3 were present in eight of 10 tumors. These findings indicate that two types of immune reactions may be operating: a delayed-type hypersensitivity response at the periphery and a cytotoxic-suppressor effector mechanism in the tumor lobules. Furthermore, major histocompatibility complex antigens are not involved in eliciting the inflammatory response.

Separation, phenotyping and limiting dilution analysis of T-lymphocytes infiltrating human solid tumors

Tumor-infiltrating lymphocytes (TIL) were obtained by a combination of mechanical release and enzymatic disaggregation from 35 human solid tumors. The number of lymphocytes in TIL-enriched suspensions varied from 1 X 10(4) to 7.6 X 10(6) per wet gram of tumor. The TIL preparations separated by differential centrifugation on Ficoll-Hypaque gradients contained 10-95% of T11+ cells (mean 50%), and tumor cells accounted for the other major cellular component. Macrophages, NK cells, B cells and granulocytes were infrequently seen. Morphologically, TIL-T were small non-activated cells. They expressed the T11 and T3 antigens but not the receptor for IL-2 (IL-2R) or HLA-DR antigens as determined by double immunofluorescence staining. Rare T11+/IL-2R+ cells were recovered only from colon and lung carcinomas. The mean T4/T8 ratio in 12 TIL preparations was 1.1 +/- 0.8. Immunohistology with monoclonal antibodies (MAbs) performed in 31/35 tumors confirmed that the T11+ cells infiltrating solid tumors rarely expressed the IL-2R and that the cell content of suspensions enriched in TIL was comparable to that determined in situ. The recovered TIL were cloned in a microculture system that permits proliferation of nearly all normal peripheral blood T lymphocytes (PBL-T). Under these culture conditions, frequencies of the proliferating T lymphocyte precursors (PTL-P) were depressed in both the TIL preparations (less than 0.01 to 0.39) and patients' PBL-T (0.05 to 0.5). These low frequencies of PTL-P were seen in patients with all tumor types, both primary and metastatic.

Quantitation of proliferative and cytotoxic precursor cells directed against human tumours: limiting dilution analysis in peripheral blood and at the tumour site

Blood and tumour-infiltrating lymphocytes (TIL) from 16 cancer patients have been examined under limiting dilution conditions to determine the frequency of cells responding in mixed tumour-lymphocyte cultures (MLTC) to autologous tumour and Interleukin-2 (IL-2). Tumour-derived lymphocytes showed a high spontaneous response to IL-2 alone 1/1,900 in TIL; 1/6,000 in PBL suggesting the presence of "activated" T cells in situ. Proliferative frequencies were increased in MLTC in both blood (1/3,779) and TIL (1/1,084). Phenotypic analyses showed that total T-cell contents of the responder populations were comparable but TIL were enriched for the OKT8+ subset with a corresponding reduction in OKT4+. TIL showed increased numbers of OKMI+ and Tac+ lymphocytes. The major cytotoxic precursor expanding under these conditions was reactive against autologous tumour. K562 (NK) were present at a lesser frequency--particularly in TIL. The data show a concentration and activation of reactive lymphocytes at the tumour site and establish conditions for the clonal expansion of specifically cytotoxic T cells.

Cells bearing Fc receptors in human malignant solid tumours

Fc-receptor-bearing cells forming EA rosettes with antibody-coated human erythrocytes (Ripley) were studied in cell suspensions and in purified preparations of mononuclear cells (MC) from 20 human malignant tumours. The EA rosettes were studied in preparations made by cytocentrifugation and the rosette-forming cells identified by their nonspecific-esterase activity and phagocytic capacity. Fc receptors were found on 16 +/- 20% of all cells in the primary cell suspensions. Significantly more tumour-infiltrating lymphocytes had detectable Fc receptors normal control subjects (14 +/- 6%). There was a significant correlation between the proportion of lymphocytes lacking T and B markers (null cells) and the proportion of lymphocytes with Fc receptors. Fc receptors were also found on most tumour-infiltrating macrophages, on some T lymphocytes and polymorphonuclear cells and on a smaller percentage of the tumour cells. The significance of the Fc receptor and its usefulness as a marker of "host infiltration" into the tumours is discussed.

Canine transmissible venereal sarcoma: distribution of T and B lymphocytes in blood, draining lymph nodes and tumours at different stages of growth

The levels of T, B and null lymphocytes in the peripheral blood, draining lymph nodes, and tumour masses at different growth stages in dogs transplanted with canine transmissible venereal sarcoma (CTVS) were determined by immunofluorescence techniques. The tumours were classified at excision into "progressor", "steady state", and "regressor" stages of growth. The percentage of B cells in the lymphocytes infiltrating into the progressively growing tumours (n = 10, 37.3 +/- 7.4%) was significantly higher (P less than 0.025) than that in regressing tumours (n = 21, 26.1 +/- 1.9%). In contrast, the percentage of T cells in the lymphocytes infiltrating into the regressing tumours (n = 21, 61.2 +/- 2.6%) was significantly higher (P less than 0.005) than that in the progressively growing tumours (n = 10, 34.0 +/- 5.1%). The tumours at the steady-state growth stage (n = 9) had 50.8 +/- 5.7% infiltrating T-cells, which was significantly higher (P less than 0.005) than the progressors and lower (P less than 0.005) than the regressors. The percentage of null cells of progressors (n = 10, 26.0 +/- 6.9%) was significantly (P less than 0.025) higher than in regressors (n = 21, 13.5 +/- 2.9%). The draining lymph nodes of progressor dogs (n = 5) had significantly fewer (P less than 0.025) B cells (8.2 +/- 2.3%) than in normal (n = 5, 16.1 +/- 3.1%), regressors (n = 12, 19.1 +/- 1.7%) and steady-state dogs (n = 5, 15.8 +/- 2.6%). Although there was slight lymphopenia and fluctuation of null cells, no significant differences in T- and B-lymphocyte levels were noted in the peripheral blood of the tumour dogs (n = 44) studied.

The local cell response to human lung carcinomas

Non-malignant inflammatory cells were studied in tissue sections and cell suspensions from 21 human lung carcinomas. The different cell types were identified and quantified by means of histochemical and immunohistochemical methods. All tumours were surrounded and to a lesser degree also infiltrated by lymphocytes, macrophages, plasma cells containing IgG, IgA, or IgM, and a small number of mast cells. No evident signs of cell necrosis were present in association with these mononuclear cell infiltrates. Central tumour necroses were dominated by large numbers of neutrophils and macrophages, a reaction considered to be secondary to ischemic necroses in rapidly expanding tumours. The weakest mononuclear cell infiltrates were found in tumours with extensive necrotic areas. Of the tumour lymphocytes 3-67% (mean 37%) were T-lymphocytes, 4-32% (mean 19%) were B-lymphocytes. The relation between these markers did not always correlate with the findings in peripheral blood: low percentages of T-lymphocytes were found in some tumours even when the percentage of T-lymphocytes in peripheral blood was within the normal range. The demonstration of both T-lymphocytes and macrophages in and around the tumour tissue may reflect a local immune response against the neoplastic cells, while the presence of plasma cells in all tumours supports the theory that the tumour also induces a local production of immunoglobulin which may interfere with the cellular immunity.

In situ identification of inflammatory cells in malignant, non-lymphoid human tumours

Inflammatory cells (the term is considered to include lymphocytes, plasma cells, macrophages, mast cells and PMN) were identified and quantitated in sections from human carcinomas. Two types of cellular infiltrates are described. In the stroma surrounding the cancer tissue (peritumoural) and, to a lesser degree, also within the malignant tissue (intratumoural), lymphocytes, plasma cells, macrophages and mast cells dominated, whilst numerous polymorph nucleated cells (PMN) and aggregates of macrophages characterized central tumour necroses. The demonstration of both T-lymphocytes and macrophages in and around the cancer tissue supports the view that a local immune reaction is initiated by the tumour, and the consistent finding of IgG, IgA and IgM plasma cells at the borders of the carcinomas, indicates that plasma cells are also part of an immune response at the tumour site. This view is further supported by the demonstration of an increased proportion of IgG containing plasma cells in the stroma of colon tumours, compared with normal mucosa.

In vitro response to Corynebacterium parvum of human effusion lymphocytes isolated from patients with malignant and benign disease

Non-adherent effusion cells (EC), mostly lymphocytes, were isolated from the pleural effusions of 8 patients with malignant and 7 patients with benign disease. Corynebacterium parvum (Cp) induced increased methyl-3H-thymidine (methyl-3H-TdR) incorporation in EC cultures, but the response was lower than that usually found with autologous or allogeneic normal human blood lymphocytes. Experiments with highly purified effusion lymphocytes indicated that the response to CP was influenced by the presence of adherent cells, probably macrophages. Normal human monocytes incubated in vitro with supernatants of unstimulated EC cultures expressed slightly increased ability to suppress methyl-3H-TdR-incorporation in a human tumour cell line. Supernatants of Cp-stimulated EC induced a further increase in monocyte-mediated cytostatic activity. Cell-free effusion fluid from 8 patients were largely inactive when tested for induction of monocyte-mediated cytostatic activity in the same system, and the effusion fluid reduced monocyte methyl-3H-TdR-incorporation in vitro. Thus, Cp seems to be able to induce DNA-synthesis and release of mononuclear phagocyte-activating lymphokines in human effusion lymphocytes.

Structure and function of human effusion macrophages from patients with malignant and benign disease. 1. Isolation, morphology, proliferation and phagocytosis

The inflammatory cell composition of pleural or ascitic effusion fluids from 13 patients with malignant disease and 8 patients with benign disease was analyzed. The macrophage content in the effusions was 4.1 x 10(5) +/- 1.3 cells/ml (mean +/- SEM), with large variation (range 0.1 - 27.9 x 10(5) cells/ml) among patients. Major blood cell contamination was excluded by the finding of low red blood cell/nucleated cell ratios in the effusions. Effusion macrophages were isolated by Ficoll/Isopaque centrifugation and plastic adherence. Monolayers of > 90% alpha-napthyl-esterase-positive and/or phagocytic cells were produced in most experiments. Adherent effusion cells incorporated low amounts of methyl-3H-thymidine (methyl-3H-TdR). Most cells in DNA-synthesis were removed by trypsin, indicating that they were not macrophages. Lymphokine supernatants induced increased methyl-3H-TdR incorporation in adherent cells in 3 of 8 experiments, and microscopic proliferation of phagocytic cells was evident in one experiment. Endotoxin and Corynebacterium parvum reduced adherent cell DNA-synthesis slightly. Effusion macrophages ingested more 125I-labelled Candida albicans than peripheral blood monocytes. The ability to degrade ingested Candida and the cell adherence after phagocytosis were found to be greater in the macrophages than in monocytes. Effusion macrophages with monocyte-like, undifferentiated appearance differentiated like monocytes in vitro. Further in vitro differentiation of macrophages with more differentiated appearance often seemed to be blocked, the cells dying gradually after 4-8 days in vitro.

Content and distribution of macrophages and lymphocytes in solid malignant human tumours

The relative content of lymphocytes and macrophages was studied in 20 solid malignant human tumours. Mechanically prepared tumour-cell suspensions contained both lymphocytes (0.2-4.0%) and macrophages (0.2-7.0%). Macrophages were characterized as esterase-positive, phagocytosing cells. The distribution of the cells within the tumours was studied on cryostat sections. A modified esterase method, using alpha-naphthyl butyrate as substrate, always gave an intensive staining of tissue-infiltrating macrophages, even in malignant tissues where some neoplastic cells exhibited a weak to moderate esterase activity. Tumour-infiltrating lymphocytes were studied in HE-stained tissue sections. The study demonstrates that both cell types were usually more numerous in the stroma surrounding the tumour tissue and in the stromal septa between the cords of malignant cells (peripheral infiltration) than in the central areas of the tumours. No signs of cell necrosis were seen near the lymphocyte zones or the stromal macrophages; however, some central necrotic areas contained aggregates of macrophages, lymphocytes and PMN.

Human monocyte-mediated cytotoxicity to K-562 cells: activation by lymphokines

Human monocytes purified by adherence and prolonged in vitro monolayer culture were activated by supernatants of autologous lymphocytes stimulated with live bacillus Calmette-Guérin or killed Corynebacterium parvum. Activated monocytes expressed increased ability to lyse K-562 cells prelabelled with methyl-3H-thymidine in a 48 h assay. Activation could be detected at a 1:64 dilution of lymphokine supernatants. Target cell killing by activated monocytes was strongly influenced by the density of the monocyte monolayer. Monocytes at an intermediate stage of in vitro differentiation seemed to be most response to lymphokine activation. Morphological studies indicated that a considerable number of K-562 cells attach firmly to monocytes. The monocyte-mediated lysis of K-562 seems to be extracellular, as phagocytosis was not observed. Freshly isolated adherent blood mononuclear cells (greater than 90% monocytes) were strongly cytostatic to K-562 cells, as determined by inhibition of methyl-3H-thymidine uptake. Considerable cytolytic activity was also found with freshly isolated adherent cells, strong enhancement being produced by performing the assay in the presence of newborn calf serum, as opposed to human AB serum.

Isolation and characterization of lymphocytes and macrophages from solid, malignant human tumours

In mechanically prepared cell suspensions from 17 solid, malignant human tumours, 0.5-5.0% (mean 2.0%) lymphocytes and 1.0-28.0% (mean 7.4+) macrophages were found. Mononuclear cells (MC) were isolated using the Böyum technique. From each biopsy weghing 1-4 g, on average, 1.3 x 10(6) lymphocytes and 0.8 x 10(6) macrophages were recovered. The tumour-infiltrating lymphocytes (TIL) were characterized with regard to T and B markers. The proportion of TIL-forming rosettes with SRBC (T cells) was 43%, which was significantly less than for peripheral blood lymphocytes (PBL) from cancer patients (58%), or normal controls (80%), On average, 15% of the TIL were B cells, whereas 42% had no T- or B-cell markers. Macrophages (TIM) were identified by non-specific esterase staining and phagocytosis. In four cases the tumour cells were also stained with alpha-naphthyl butyrate. Corresponding findings were made on esterase-stained cryostat sections from four tumours. Macrophages were found within and around the tumour tissues, occasionally localized to necrotic areas, but in most cases with no sign of necrosis of the surrounding cells. In some tumour cell suspensions typical clusters of lymphocytes and macrophages were seen. Total lymphocytes and T-cell were markedly reduced inthe peripheral blood of cancer patients, whereas total monocyte counts were within the normal range.