T-cell subset analysis by monoclonal antibodies in primary immunodeficiencies

Flow cytometric analysis of lymphocyte subpopulations in infants with congenital heart disease

Premortem diagnosis of the DiGeorge syndrome and its partial variants relies on the demonstration of a primary defect in cell-mediated immunity, generally in the setting of an infant with congenital heart disease, hypocalcemia, absence of a thymic shadow, and typical dysmorphic features. Although T-cell enumeration is considered a vital part of the diagnostic evaluation, no studies to date have addressed the issue of appropriate reference data in infants with congenital heart disease. We therefore undertook a prospective descriptive study of lymphocyte phenotype analysis in 27 nontransfused infants undergoing diagnostic cardiac catheterization. Striking differences were seen between patients and adult controls in means percentages and numbers of most lymphocyte subsets analyzed. Few differences were found in comparing the patient data to values for age-matched control infants without heart disease. The data are discussed with reference to published values for patients with partial DiGeorge syndrome. It is concluded that lymphocyte phenotype analysis in the diagnostic evaluation of patients with suspected DiGeorge syndrome must utilize appropriate reference values.

Enumeration of human lymphocyte subsets by monoclonal antibodies and flow cytometry: a comparative study using whole blood or mononuclear cells separated by density gradient centrifugation

Enumeration of lymphocyte subpopulations by combined use of flow cytometry and monoclonal antibodies is influenced by the separation method used. T or B lymphocyte antigen frequencies do not differ in samples of whole blood or after separation on Ficoll-Paque or Percoll, but there is a significant increase of Leu+ Leu11+ lymphocytes showing strong natural killer activity at the sample-separation medium interface. At the bottom of the tubes a selective loss of OKT+, Leu7+, Leu11- cells is found; at this level cytotoxicity is very low. Our data suggest that Leu7+ cells could be subdivided into 2 subpopulations differing in reactivity with the monoclonal antibody to Leu11, natural killer activity and density. Differences observed in the percentages of Leu7+, Leu11+ lymphocytes between whole blood and separated cells could be due to an enrichment produced by centrifugation or to the presence in whole blood of a factor interfering with antibody binding.

The influence of common variables on T cell subset analysis by monoclonal antibodies

Normal values for T cell subsets as defined by the most commonly used monoclonal antibodies of the OKT series were determined in a group of 142 unrelated normal individuals. In most age classes females had significantly greater portions of OKT3 and OKT4 antigen bearing lymphocytes and accordingly a higher T4/T8 index. The range of individual normal values within the control population was remarkably wide. Intra-individual differences between the T subset composition remained rather constant over a period of 2 months. Time of day, food absorption and physical exercise had no influence on the results of subset analyses. Storage of the blood sample and freezing of isolated lymphocytes can result in significantly reduced OKT3 and OKT4 positive cell numbers. If lymphocytes were isolated soon after the blood was taken and resuspended in a stabilization medium they exhibited only minimal change.

Specific in vitro antimannan-rich antigen of Candida albicans antibody production by sensitized human blood lymphocytes

We have developed a new antigenic system for the induction of specific in vitro antibody response in man. The antigen used was purified from the cell wall of Candida albicans strain A and contained greater than 96% polysaccharide mannan. Peripheral blood mononuclear cells from Candida-sensitized donors produced specific antimannan antibodies during a 7-d culture in the presence of mannan absorbed with methylated bovine serum albumin. Two methods were used to detect antimannan antibody responses. Antimannan antibody-producing cells were identified by radioautography with tritiated mannan. Antibody concentration in culture supernatants was measured by an enzyme-linked immunosorbent assay. In both methods, specific IgM and IgG (but not IgA) antibodies were detected. The antibody production to mannan was specific, since an antigenically unrelated polysaccharide (pneumococcal antigen S III) did not bind to methylated bovine serum albumin-mannan-induced blast cells and did not induce antimannan antibody-containing cells. Furthermore, a pulse with an excess of unlabeled mannan abolished [3H]mannan binding, whereas an excess of unlabeled S III did not. Similarly, no antimannan antibody was obtained in influenza virus-stimulated cultures and mannan-stimulated cultures were not inducing antiinfluenza antibodies. The antimannan antibody production was shown to be a T cell-dependent phenomenon. The T helper effect appeared to be radiosensitive. It was under a genetic restriction as it occurred only in autologous or semi-identical but not in allogeneic situations. This system is relatively simple, reproducible, and well suited for the study of specific secondary in vitro antibody responses to polysaccharide antigens in humans.

Lymphocyte subpopulations in primary immunodeficiency disorders

Venous blood mononuclear cells from 42 children with primary immunodeficiency disorders and from controls matched for age were studied for lymphocyte subpopulations by E rosetting, surface immunoglobulin, and a panel of anti T cell monoclonal antibodies (OKT series). In 3 cases of severe combined immunodeficiency (SCID) due to adenosine deaminase deficiency, very few circulating T or B cells were found. The other 7 cases of SCID all had normal or, in 3 cases, very high numbers of circulating B cells, but in 6 of these very few cells showed T cell markers. One child had very high numbers of B cells and T cells with an immature pattern of reactivity similar to that found on common thymocytes. In T cell deficient children no consistent pattern was found, but in those with cartilage hair hypoplasia with immunodeficiency there was a low helper (OKT4) to suppressor (OKT8) ratio and high numbers of circulating OKT10 positive cells. In cases of X-linked agammaglobulinaemia circulating B cells were not found but the pattern of T cell markers was normal. In cases of common variable hypogammaglobulinaemia there was a wide scatter of helper (OKT4) to suppressor (OKT8) cell ratios. Five children were studied before and after treatment with the synthetic thymic hormone preparation TP5. There were appreciable alterations in the pattern of staining with anti T cell monoclonal antibodies in 4 of these cases, but in 1 case only was this accompanied by improvements in clinical and immune function.

Immune responses during human schistosomiasis mansoni. IX. T-lymphocyte subset analysis by monoclonal antibodies in hepatosplenic disease

T lymphocyte immunoregulatory subsets (T4+ and T8+ cells) have been analysed in eight cases of hepatosplenic schistosomiasis mansoni, and compared to parallel analyses of seven intestinal Schistosoma mansoni-infected patients and four uninfected control subjects. The mean T4+:T8+ ratio in hepatosplenic cases was markedly less than observed in other groups (0.94 vs 1.86 vs 2.22, respectively). Proliferative responses stimulated by a soluble adult worm extract correlated directly with the observed T4:T8 ratios. Normal levels of E rosette-positive and surface immunoglobulin-bearing lymphoid cells were observed in intestinal patients, while hepatosplenic patients demonstrated normal B lymphocyte proportions but highly erratic E rosette-positive percentages. Curiously, in hepatosplenic patients the percentage of E rosette-positive cells often did not correlate with the proportion of T3+ cells.

Enumeration of human lymphocyte subpopulations by immunofluorescence: a comparative study using automated flow microfluorometry and fluorescence microscopy

These studies reveal that the enumeration of peripheral blood mononuclear cells by fluorescence microscopy and automated flow microfluorometry show a high degree of correlation whether the cells came from normals, individuals with common variable immunodeficiency, chronic lymphocytic leukemia of B cell origin or chronic lymphocytic leukemia of T cell origin. There was excellent agreement between these two methods when counting positive cells stained by the pan-T monoclonal antibodies OKT3 and Leu-1, the helper T reagents OKT4 and Leu-3a, and the suppressor T antibodies OKT8 and Leu-2a. The values obtained for B cells using a pan-B (HB-2) cell antibody analyzed by fluorescence microscopy and automated flow microfluorometry gave a correlation coefficient of 0.86. The percentage of cells identified by antibodies with reactivities toward peripheral blood monocytes (MMA or Leu-M1), the HLA-DR determinant, and HNK-1 (Leu-7) positive cells gave correlation coefficients of 0.90, 0.90, and 0.80 respectively when compared by the 2 methods mentioned above. These data suggest that comparable values for lymphocyte subpopulations in human blood samples can be obtained using the most convenient and available technology.

Lymphocyte subsets in Chediak-Higashi patients

Peripheral blood lymphocyte subsets were studied in 6 Chediak-Higashi patients and 12 family members. The lymphocyte subsets were characterized by monoclonal antibody reagents and fluorescence flow-cytometry. An increase in OKT8 (suppressor/cytotoxic) and a decrease in OKT4 (helper) cell populations was observed in all patients studied. No correlation was seen between the clinical status (presence or absence of the lymphoproliferative phase) and the percentage of the lymphocyte subsets. The patient's mothers also had an increased percentage of OKT8-positive cells. The significance of these findings is discussed regarding the patients clinical course.