THE IMPACT ON THE DEVELOPING EMBRYO AND NEWBORN ANIMAL OF ADULT HOMOLOGOUS CELLS

Transplant Tolerance, Not Only Clonal Deletion

The quest to understand how allogeneic transplanted tissue is not rejected and how tolerance is induced led to fundamental concepts in immunology. First, we review the research that led to the Clonal Deletion theory in the late 1950s that has since dominated the field of immunology and transplantation. At that time many basic mechanisms of immune response were unknown, including the role of lymphocytes and T cells in rejection. These original observations are reassessed by considering T regulatory cells that are produced by thymus of neonates to prevent autoimmunity. Second, we review "operational tolerance" induced in adult rodents and larger animals such as pigs. This can occur spontaneously especially with liver allografts, but also can develop after short courses of a variety of rejection inhibiting therapies. Over time these animals develop alloantigen specific tolerance to the graft but retain the capacity to reject third-party grafts. These animals have a "split tolerance" as peripheral lymphocytes from these animals respond to donor alloantigen in graft versus host assays and in mixed lymphocyte cultures, indicating there is no clonal deletion. Investigation of this phenomenon excludes many mechanisms, including anti-donor antibody blocking rejection as well as anti-idiotypic responses mediated by antibody or T cells. This split tolerance is transferred to a second immune-depleted host by T cells that retain the capacity to effect rejection of third-party grafts by the same host. Third, we review research on alloantigen specific inhibitory T cells that led to the first identification of the CD4+CD25+T regulatory cell. The key role of T cell derived cytokines, other than IL-2, in promoting survival and expansion of antigen specific T regulatory cells that mediate transplant tolerance is reviewed. The precise methods for inducing and diagnosing operational tolerance remain to be defined, but antigen specific T regulatory cells are key mediators.

60 Years Young: The Evolving Role of Allogeneic Hematopoietic Stem Cell Transplantation in Cancer Immunotherapy

The year 2020 marked the 30th anniversary of the Nobel Prize in Medicine awarded to E. Donnall Thomas for the development of allogeneic hematopoietic stem cell transplantation (allo-HSCT) to treat hematologic malignancies and other blood disorders. Dr. Thomas, "father of bone marrow transplantation," first developed and reported this technique in 1957, and in the ensuing decades, this seminal study has impacted fundamental work in hematology and cancer research, including advances in hematopoiesis, stem cell biology, tumor immunology, and T-cell biology. As the first example of cancer immunotherapy, understanding the mechanisms of antitumor biology associated with allo-HSCT has given rise to many of the principles used today in the development and implementation of novel transformative immunotherapies. Here we review the historical basis underpinning the development of allo-HSCT as well as advances in knowledge obtained by defining mechanisms of allo-HSCT activity. We review how these principles have been translated to novel immunotherapies currently utilized in clinical practice and describe potential future applications for allo-HSCT in cancer research and development of novel therapeutic strategies.

The use of the chick embryo chorioallantoic membrane as experimental model to study virus growth and to test the clonal selection hypothesis. The contribution of Sir Mac Farlane Burnet

Sir Mac Farlane Burnet was the most honored of all Australian scientists. In 1960, Burnet shared the Nobel Prize for Medicine with Peter Medawar of Britain for the discovery of acquired immunological tolerance. He developed techniques for growing influenza viruses in the chorioallantoic membrane of the chick embryo. This became a standard laboratory practice. He continued to work with chick embryos long after the use of cell cultures had become general. His virology research resulted in significant discoveries concerning the nature and replication of viruses and their interaction with the immune system.

Amotosalen/UVA treatment inactivates T cells more effectively than the recommended gamma dose for prevention of transfusion-associated graft-versus-host disease

INTRODUCTION

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication after transfusion of components containing viable donor T cells. Gamma irradiation with doses that stop T-cell proliferation is the predominant method to prevent TA-GVHD. Treatment with pathogen inactivation methodologies has been found to also be effective against proliferating white blood cells, including T cells. In this study, T-cell inactivation was compared, between amotosalen/ultraviolet A (UVA) treatment and gamma-irradiation (2500 cGy), using a sensitive limiting dilution assay (LDA) with an enhanced dynamic range.

METHODS AND MATERIALS

Matched plasma units (N = 8), contaminated with 1 × 10⁶ peripheral blood mononuclear cells (PBMCs) per mL, were either treated with amotosalen/UVA or gamma irradiation, or retained as untreated control. Posttreatment, cells were cultured under standardized conditions. T-cell proliferation was determined by the incorporation of ³ H-thymidine and correlated with microscopic detection.

RESULTS

Range-finding experiments showed that after gamma irradiation (2500 cGy), significant T-cell proliferation could be observed at a 1 × 10⁷ cell culture density, some proliferation at 1 × 10⁶ , and none at 1 × 10⁵ cells/well. Based on these facts, a quantitative comparison was carried out between amotosalen/UVA at the highest challenge of 1 × 10⁷ PBMCs/well, and gamma irradiation at 1 × 10⁶ and 1 × 10⁵ PBMCs/well. Complete inactivation of the T cells after amotosalen/UVA treatment was observed, equivalent to greater than 6.2 log inactivation. Complete inactivation of the T cells was also observed after gamma irradiation when 1 × 10⁵ PBMCs/well were cultured (>4.2 log inactivation). Proliferation was observed when 1 × 10⁶ PBMCs/well were cultured (≤5.2 log inactivation) after gamma irradiation.

CONCLUSION

Amotosalen/UVA treatment more effectively inactivates T cells than the current standard of gamma irradiation (2500 cGy) for the prevention of TA-GVHD.

Medawar's legacy to cellular immunology and clinical transplantation: a commentary on Billingham, Brent and Medawar (1956) 'Quantitative studies on tissue transplantation immunity. III. Actively acquired tolerance'

‘Quantitative studies on tissue transplantation immunity. III. Actively acquired tolerance’, published in Philosophical Transactions B in 1956 by Peter Medawar and his colleagues, PhD graduate Leslie Brent and postdoctoral fellow Rupert Billingham, is a full description of the concept of acquired transplantation tolerance. Their 1953 Nature paper (Billingham RE et al. 1953 Nature172, 603–606. (doi:10.1038/172603a0)) had provided initial evidence with experimental results from a small number of neonatal mice, with mention of similar findings in chicks. The Philosophical Transactions B 1956 paper is clothed with an astonishing amount of further experimental detail. It is written in Peter Medawar's landmark style: witty, perceptive and full of images that can be recalled even when details of the supporting information have faded. Those images are provided not just by a series of 20 colour plates showing skin graft recipient mice, rats, rabbits, chickens and duck, bearing fur or plumage of donor origin, but by his choice of metaphor, simile and analogy to express the questions being addressed and the interpretation of their results, along with those of relevant published data and his prescient ideas of what the results might portend. This work influenced both immunology researchers and clinicians and helped to lay the foundations for successful transplantation programmes. It led to the award of a Nobel prize in 1960 to Medawar, and subsequently to several scientists who advanced these areas. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society.

A systematic review of transfusion-associated graft-versus-host disease

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of blood transfusion. The clinicolaboratory features of TA-GVHD and the relative contributions of recipient and component factors remain poorly understood. We conducted a systematic review of TA-GVHD reports. The HLA relationship between donor and recipient was classified as D = 0 when no donor antigens were foreign to the recipient vs D ≥ 1 when ≥1 donor antigen disparity occurred. We identified 348 unique cases. Criteria for component irradiation were met in 48.9% of cases (34.5% immune-compromised, 14.4% related-donor), although nonirradiated components were transfused in the vast majority of these (97.6%). Components were typically whole blood and red cells. When reported, component storage duration was ≤10 days in 94%, and 23 (6.6%) were leukoreduced (10 bedside, 2 prestorage, and 11 unknown). Among 84 cases with HLA data available, the category of D = 0 was present in 60 patients (71%) at either HLA class I or II loci and was more common among recipients without traditional indications for component irradiation. These data challenge the historic emphasis on host immune defects in the pathogenesis of TA-GVHD. The dominant mechanism of TA-GVHD in both immunocompetent and compromised hosts is exposure to viable donor lymphocytes not recognized as foreign by, but able to respond against, the recipient.

Fashioning the immunological self: the biological individuality of F. Macfarlane Burnet

During the 1940s and 1950s, the Australian microbiologist F. Macfarlane Burnet sought a biologically plausible explanation of antibody production. In this essay, we seek to recover the conceptual pathways that Burnet followed in his immunological theorizing. In so doing, we emphasize the influence of speculations on individuality, especially those of philosopher Alfred North Whitehead; the impact of cybernetics and information theory; and the contributions of clinical research into autoimmune disease that took place in Melbourne. We point to the influence of local experimental and intellectual currents on Burnet's work. Accordingly, this essay describes an arc distinct from most other tracings of Burnet's conceptual development, which focus on his early bacteriophage research, his fascination with the work of Julian Huxley and other biologists in the 1920s, and his interest in North Atlantic experimental investigations in the life sciences. No doubt these too were potent influences, but they seem insufficient to explain, for example, Burnet's sudden enthusiasm in the 1940s for immunological definitions of self and not-self. We want to demonstrate here how Burnet's deep involvement in philosophical biology - along with attention to local clinical research - provided him with additional theoretic tools and conceptual equipment, with which to explain immune function.

Bidirectional alloreactivity: A proposed microchimerism-based solution to the NIMA paradox

The NIMA paradox is the observation that in transplants of allogeneic kidneys or hematopoietic stem cells, siblings benefit from re-exposure to non-inherited maternal antigens (NIMA), whereas re-exposure to a transplant from mother herself, theoretically the ideal "NIMA" donor, does not yield clinical results superior to a father-donated allograft. Recent observations of bidirectional alloreactivity in kidney and cord blood transplantation offer a possible solution to this paradox. If correct, the proposed solution points the way to clinical applications of microchimerism in solid organ and hematopoetic transplants.

Interaction of the B locus and the GVHR-selected lines in the graft-versus-host reaction in chickens

Genetic differences affecting the degree of splenomegaly in the graft-versus-host reaction (GVHR) of chickens were studied. Two B genotypes, B9 B9 and B11 B11, and two GVHR-selected lines, H and L, were examined. The degree of splenomegaly of B9 B9 leads to B11 B11 was significantly higher than that of B11 B11 leads to B9 B9 for all line combinations. In contrast, the inoculation of H into L gave consistently higher splenomegaly than that of L into H. This suggested that the effects of B locus were higher in hosts than in donors, while those of the GVHR-selected lines were higher in donors than in hosts. The analysis of variance revealed that both the differences between the reciprocal combination of B genotypes and between the GVHR line combinations were statistically highly significant. Furthermore, the interaction of B genotypes and GVHR lines was also highly significant.

T cell allorecognition and MHC restriction--A case of Jekyll and Hyde?

A great paradox in cellular immunology is how T cell allorecognition exists at high frequencies (up to 10%) despite the stringent requirements of discriminating 'self' from 'non-self' imposed by MHC restriction. Thus, in tissue transplantation, a substantial proportion of the recipient's T cells will have the ability to recognize the graft and instigate an immune response against the transplanted tissue, ultimately resulting in graft rejection--a manifestation of T cell alloreactivity. Transplantation of human organs and lymphoid cells as treatment for otherwise life-threatening diseases has become a more routine medical procedure making this problem of great importance. Immunologists have gained important insights into the mechanisms of T cell alloreactivity from cytotoxic T cell assays, affinity-avidity studies, and crystal structures of peptide-MHC (pMHC) molecules and T cell receptors (TCRs) both alone and in complex. Despite the clinical significance of alloreactivity, the crystal structure of an alloreactive human TCR in complex with both cognate pMHC and an allogeneic pMHC complex has yet to be determined. This review highlights some of the important findings from studies characterizing the way in which alloreactive T cell receptors and pMHC molecules interact in an attempt to resolve this great irony of the cellular immune response.

Avian thymic hormone treatment of peripheral blood mononuclear cells from young chicks stimulates acute graft-versus-host reaction in chicken embryos

Avian thymic hormone (ATH) is a parvalbumin produced by epithelial cells in the thymic cortex of chickens and circulates in the blood on a 5-day cycle. It stimulates precocious development of cell-mediated immunity. The effect of partially purified extracts of thymus (TE) and purified ATH were tested for their effect on the acute graft-versus-host reaction (GVHR). Treatment of chicks for their first 3-days of life did not enhance the acute GVHR produced by their PBMC in 14-day-old embryos. PBMC from 3-day-old chicks were treated in vitro with TE, ATH, thymosin fraction 5 or thymosin alpha1 for 2 h and injected into 14-day-old embryos. Bone marrow cells and thymic lymphocytes were treated with TE. Only PBMC treated with TE or ATH produced an enhanced acute GVHR. Because ATH targets gammadelta T cells, the data implicate participation of donor gammadelta T cells in the acute GVHR.

Chimerism and tolerance in transplantation

Studies in experimental models (1953-1956) demonstrated that acquired donor-specific allotolerance in immunologically immature or irradiated animals is strongly associated with donor leukocyte chimerism. Bone marrow transplantation in immune-deficient or cytoablated human recipients was a logical extension (1968). In contrast, clinical (1959) and then experimental organ transplantation was systematically accomplished in the apparent absence of leukocyte chimerism. Consequently, it was assumed for many years that success with organ and bone marrow transplantation involved fundamentally different mechanisms. With the discovery in 1992 of small numbers of donor leukocytes in the tissues or blood of long-surviving organ recipients (microchimerism), we concluded that organ engraftment was a form of leukocyte chimerism-dependent partial tolerance. In this initially controversial paradigm, alloengraftment after both kinds of transplantation is the product of a double immune reaction in which responses, each to the other, of coexisting donor and recipient immune systems results in variable reciprocal clonal exhaustion, followed by peripheral clonal deletion. It was proposed with Rolf Zinkernagel that the individual alloresponses are the equivalent of the MHC-restricted T cell recognition of, and host response to, intracellular parasites and that the mechanisms of immune responsiveness, or nonresponsiveness, are governed by the migration and localization of the respective antigens. Elucidation of the mechanisms of nonresponsiveness (clonal exhaustion-deletion and immune ignorance) and their regulation removed much of the historical mystique of transplantation. The insight was then applied to improve the timing and dosage of immunosuppression of current human transplant recipients.

Graft-versus-host reactions in dermatology

Graft-versus-host reactions frequently produce cutaneous and systemic complications in patients receiving bone marrow transplants. Characteristic skin involvement typically heralds graft-versus-host reactions and significantly contributes to the morbidity associated with marrow transplants. Familiarity with these reactions and their treatment is important to dermatologists involved in the care of marrow transplant recipients.

The future of transplantation: with particular reference to chimerism and xenotransplantation

The assumption for the last third of a century that stem cell-driven hematolymphopoietic chimerism was irrelevant to successful conventional whole organ transplantation has prompted alternative inadequate explanations of organ allograft acceptance. This assumption clouded the biologic meaning of successful organ as well as bone marrow transplantation, and precluded the development of a cardinal principle that accommodated all facets of transplantation. Recognition of this error and the incorporation of the chimerism factor into a two-way paradigm have allowed previous enigmas of organ as well as bone marrow engraftment to be explained. No credible evidence has emerged to interdict this interactive concept. If the two-way paradigm is correct, it will allow the remarkable advances that have been made in basic immunology to be more meaningfully exploited for transplantation, including that of xenografts.

Central role of CD4+ T cells in avian immune response

Chicken alpha beta T cells express either CD4 or CD8 accessory molecules, whereas most of the gamma delta T cells do not. The functional significance of the alpha beta T cells is relatively well understood. The CD4+ alpha beta T cells function as coordinators of the immune response, and CD8+ alpha beta T cells are the effector cells in cytotoxic responses, killing infected target cells. In comparison, the role of gamma delta T cells is so far poorly known. In chicken, the gamma delta T cells comprise a large lymphocyte subset. They can be induced to proliferate by various stimuli, but the proliferative response is dependent on CD4+ alpha beta T cells. The CD4+ T cells are also essential for the generation of antibody responses by providing help for the B cells and can influence cytotoxic responses as well. Thus, the CD4+ alpha beta T cells have a central role in the avian immune system, and their activation is a prerequisite for responses by other types of cells, including gamma delta T cells.

Is the immune system necessary for placental reproduction? A hypothesis on the mechanisms of alloimmunotherapy in recurrent spontaneous abortion

Recurrent spontaneous abortion is being treated with alloimmunotherapy which consists of the inoculation of allogeneic mononuclear cells. However the mechanisms explaining the benefits of this therapy are not clear yet. Taking the immunotrophic hypothesis as the paradigm of the field of reproductive immunology, hereby we present a hypothesis to propose a role for the immune system in reproduction and at the same time to explain how alloimmunotherapy may work. We base our view on several facts: first, immunodeficient mice reproduce--albeit their progeny may not be as robust and numerous as that from normal individuals. Second, maternal lymphocytes cross the placenta and may induce graft versus host disease. Third, graft versus host disease in newborn F1 mice inoculated with paternal lymphocytes can be prevented by inoculation of the mother with the same paternal lymphocytes before and during pregnancy. We propose that: 1) the immune system by itself is not necessary for placental reproduction; 2) the immune system plays its major role in reproduction by counteracting the allogeneic response generated against the fetus; 3) recurrent spontaneous abortion represents a type of graft versus host disease induced by maternal cells infiltrating the fetus; and 4) alloimmunotherapy induces an antiidiotypic response necessary to counteract the graft versus host reaction in the fetus.

Glomerulopathy Induced by Graft-Versus-Host Reaction in the Rat. Requirement of Donor CD4+ T Lymphocytes and MHC Class II Incompatibility at the Lymphoid Compartment

Graft-versus-host reactions (GVHR) can be associated with several autoimmune phenomena involving the kidney as a target organ. By transferring lymphocytes of AO rats into complete Freund's adjuvant-pretreated (AO x BN)F1 hybrids, a dose-dependent GVHR with glomerulopathy was experimentally induced. IgM, IgG1, and IgG2a were deposited in the mesangial area and along the glomerular basement membrane. Eluted immunoglobulins from diseased kidneys bound to normal basement membranes and especially to laminin. Anti-laminin reactivity was also present in sera from F1 recipients with GVHR. Parental CD4+ T lymphocytes were required and sufficient to induce GVHR and glomerulopathy in sublethally irradiated F1 hybrids. Using various F1 hybrids, MHC class II incompatibility was shown to be required for the induction of GVHR-associated glomerulopathy. Across MHC class I incompatibility, GVHR without glomerulopathy could be induced, provided that both CD4+ and CD8+ donor T lymphocytes were administered. Finally, MHC incompatibility between donor T lymphocytes and the recipient non-lymphoid compartment was found to be sufficient for the induction of GVHR, but not for GVHR-associated glomerulopathy. The results indicate that alloreactive donor CD4+ T lymphocytes have to interact directly with MHC class II alloantigen bearing host B lymphocytes in order to stimulate the latter to produce (auto-)antibodies. GVHR-induced glomerulopathy shares several immunopathological features with HgCl2-induced autoimmune glomerulopathy in the rat.

Thymic involution with loss of Hassall's corpuscles mimicking thymic dysplasia in a child with transfusion-associated graft-versus-host disease

A 7-year-old leukemic girl developed pancytopenia following chemotherapy and was given several transfusions of nonirradiated blood. Within 2 weeks she developed a maculopapular rash, fever, abnormal liver function, diarrhea, and wasting. She became septic and died 6 weeks later. Transfusion-associated graft-versus-host disease (GVHD) was suspected clinically. At autopsy, changes diagnostic of GVHD were present in the skin and liver. The remarkable feature of the case was the histopathology of the thymus, which was morphologically "dysplastic," i.e., minute, lymphoid depleted, devoid of a corticomedullary demarcation, and completely lacking in Hassall's corpuscles. These changes were virtually identical to those seen in the thymus of children with severe combined immunodeficiency disease (SCID). There was no evidence of preexisting immune deficiency. There is compelling experimental evidence that GVHD can produce changes in the thymus that are identical to those of "thymic dysplasia." These observations have led to the hypothesis that immunodeficiency associated with GVHD may stem, in part, from injury to thymic epithelium resulting in defective T cell maturation. As a corollary of this hypothesis, it has been suggested that the pathogenesis of some forms of SCID may involve GVHD-associated injury to the thymus by a maternal allograft acquired in utero. This report further documents thymic pathology in human GVHD and discusses these changes in the light of these ideas.

Graft-versus-host disease: the need for a new terminology

For some decades, graft-versus-host (GVH) reactions seemed readily comprehensible. It was generally accepted that after introduction of immunocompetent, histoincompatible lymphocytes into an immunodeficient host the grafted lymphocytes would start a 'rejection' response against their host. As a result, GVH disease developed. Acute disease might result in death and survivors became chimaeras with varying pathology--chronic GVH disease. In recent years, however, some intriguing exceptions to the general rules for the development of GVH disease have been reported. These exceptions, particularly the activation of GVH disease by stimuli other than histocompatibility barriers prompted Gerard Bos and colleagues to propose this change in terminology.

Reduction of graft-versus-host disease in neonatal F1 hybrid mice

Pre-immunization of BALB/c (H-2d) mothers with C57BL/10 (H-2b) or CBA/H (H-2k) spleen cells partially protected the F1 hybrid offspring of (BALB/c x C57BL/10) or (BALB/c x CBA/H) matings from graft-versus-host-disease (GVHD) induced by neonatal intraperitoneal inoculation with spleen cells of the paternal strain. The effects achieved were manifest as a reduction in mortality. Experiments to establish whether the phenomenon was antibody mediated were performed by passive pre-immunization of BALB/c mothers with alloantisera obtained from BALB/c previously immunized with C57BL/10 spleen cells. Alloantisera produced an equivalent reduction in GVHD mortality. Some of the F1 mice that survived challenge with paternal strain spleen cells were proven to be haemopoietic chimaeras using immunofluorescence with anti-MHC monoclonal antibodies and polymorphism of the enzyme glucose-phosphate-isomerase present in the strains used. The possible mechanisms of protection from GVHD in our mouse model are discussed.

Histological changes of the liver in experimental graft-versus-host disease across minor histocompatibility barriers. IV. A study of lymphocyte-endothelial interaction

It has been reported in human hepatic graft-versus-host disease (GVHD) that an attachment of lymphocytes to vascular wall, the feature called "endothelialitis", is the most important predictive histologic sign of GVHD. However, its precise nature and significance in GVHD are still unknown. We developed experimental mouse GVHD across minor histocompatibility barriers and examined the lesion during a 14-month period after transplantation. The lesion was transiently found, appearing first at 4 days after transplantation, reaching a maximal level at 2 weeks and disappearing 5 weeks after transplantation. Electron microscopically, an intimate interaction between lymphocyte and endothelial cell was demonstrated. Lymphocytes showed irregular cytoplasmic processes and pseudopods and were in close contact with endothelial cells. Lymphocytes frequently penetrated in between and under the endothelial cells, and migrated into the perivascular spaces. Immunohistochemical analysis revealed that the vast majority of lymphocytes attached to the endothelial cells are helper/inducer T cells, indicating the cardinal role of helper/inducer T cell in lymphocyte-endothelial cell interactions. These results, together with previous evidence of the presence of Ia antigens and an antigen-presenting ability of vascular endothelial cells, suggest that the attachment of lymphocytes to the vascular endothelial cells in the early course of GVHD may represent an in situ morphologic representation of antigen presentation by endothelial cells to helper T cells.

Ea-B and Ea-C cellular antigen genes in Leghorn lines resistant and susceptible to acute cecal coccidiosis

Alloantigen genes B and C of respective loci Ea-B, the major histocompatibility complex (MHC) of chickens, and Ea-C were detected in Leghorn lines R and S selected from common ancestry for resistance and susceptibility to acute cecal coccidiosis, Eimeria tenella (ACC). The lines share genes B2 and C1; R line has B5, Br, and C4, and S line has B1, B3, B4, B6, C2, and C3. Haplotype Br is an apparent recombinant of B2 and B5, possibly F2G2-5. Expression of the F2G2- region of B2 and Br is strong in graft-vs.-host reactions but weak on erythrocytes; in contrast, that of F5G5- of B5 is reduced in graft-vs.-host reactions but strong on erythrocytes. Extinction of B4 in R line and B5 in S line occurred in the last stages of selection, and the frequency of B5 in R line increased as a result of intensification of selection pressure for resistance to coccidiosis. The respective C genes of highest frequency in lines R and S are C1 and C3. The latter is a probable recombinant of C1 and C2. Evidence of roles of the B and C systems in resistance and previous similar evidence for the AE system indicates that genes other than the chicken MHC have measurable effects on infectious diseases.

The functional and histological basis for graft-versus-host-induced immunosuppression

The GvH reaction resulting from the injection of parental strain cells into adult F1 hybrids suppresses both cell-mediated and humoral immune responses and is dependent on the donor-host combination and the number of parental cells used to induce the GvH reaction. The early suppression is due, at least in part, to the increased number of macrophages and the activation of suppressor macrophages which act directly on the T-helper cell and perhaps the B-cell as well. The macrophage suppression is associated with an increase in PGE production. The long-term T-cell immunodeficiency is mediated by GvH-induced thymic dysplasia resulting in a block or an arrest in T-cell differentiation and deficient IL-2 production. The B-cell immunodeficiency is associated with both a decrease in B-cell production from lymphoid progenitors and a decrease in CFU-s production. The GvH reaction induces 2 types of thymic lesion, a stress-related effect causing atrophy of the thymic cortex and a cytolytic process causing severe-to-moderate lesions in the thymic medulla as a consequence of injury to medullary epithelial cells and a loss of Hassall's corpuscles (thymic dysplasia). By employing the NK-cell-deficient beige mutation, it was shown that the severe-to-moderate thymic medullary lesions occurred in F1 mice only in those transplant situations in which the donor inoculum was of the +/bg genotype, regardless of the genotype of the recipient. It is proposed that activation of parental T cells may contribute to the early immunosuppressive events; however, the relatively permanent immunosuppression appears to be associated with NK-like effector cells which are capable of causing injury to lymphoid and epithelial tissue, especially epithelium of the thymic medulla. These studies raise the possibility that the GvH reaction may contribute to some T- and B-cell immunodeficiencies observed in the SCID and AIDS syndromes, as well as in patients following bone marrow transplantation.

Graft-vs.-host reactions: mechanisms and contemporary theories

A graft-vs.-host (GvH) reaction can be initiated by injection of immunocompetent lymphocytes into a histoincompatible host that is unable to reject these cells. The reaction is characterized by splenomegaly, hepatomegaly, lymph node atrophy, body weight loss, dermatitis, and diarrhea, often leading to mortality. The onset and severity of the GvH reaction are determined by differences in histocompatibility antigens between the donor and the acceptor, and by the number and nature of the transplanted allogeneic cells. Many different in vivo and in vitro systems have been devised for experimental studies of the GvH reaction. In several of these models, however, different parameters are measured. Furthermore, the conclusions drawn from these investigations sometimes contradict each other. This paper reviews the experimental data, and discusses the mechanisms underlying the GvH reaction.

Human posttransfusion graft-versus-host disease

Graft-versus-host disease (GVDH) follows blood product transfusions in patients with deficient cell-mediated immunity. The rate of mortality in this adverse effect of blood transfusions is between 90 and 100%. The historical; clinical and pathologic; and mechanism of acute and chronic GVHD are presented. The patients at risk, the clinical and pathologic features of posttransfusion GVDH have been presented in hopes that, with increased awareness of this usually fatal complication, clinicians and transfusion therapists may more intelligently advise and select patients who may need lymphocyte-poor or irradiated blood products and may recognize the syndrome earlier.

Development of the concept of immunologic specificity: IV

We have attempted, in this series of essays on the development of the concept of immunologic specificity, to trace the history of one of the most central ideas in immunology (and indeed in biology in general). The result must be viewed as preliminary and incomplete and as an invitation to others to add, to amend, and even to disprove. Nevertheless, several interesting conclusions may be drawn, which reveal much about the workings of immunology in particular, and perhaps science in general. First, the roots of any important scientific concept (such as that of immunologic specificity) do not grow in isolation; they draw nourishment from many other disciplines. Similarly, the growth of an important concept within a given discipline will have far-reaching implications and fruits for other fields of science. Second, we may note a marked change in the manner in which immunology is currently practiced, compared with that of the end of the last century. The quantum leaps forward in funding, in numbers of scientists, and in masses of crucial data have not been without a certain cost--the substantial reduction in elegant personal style that characterized so many of our scientific forebears, and that makes so pleasant the reading of their reports. Finally, we see again and again how much his philosophical bases and disciplinary upbringing determine a scientist's approach, the questions that he asks, and the type of answers he will accept. Throughout much of immunology's history, as Jerne put it so well (44), cis- and trans-immunologists hardly spoke to one another. Or rather, a cis-immunologist sometimes spoke to a trans-immunologist, but the latter rarely answered! Fortunately, one of the attributes of scientific progress is a merging of these disparate languages, and eventual mutual comprehension.

Graft versus host response as influenced by the origin of the cell, age of chicken, and cellular interactions

Mononuclear cells collected by Ficoll-paque or T cells collected by nylon wool elicited the same magnitude of graft versus host (GvH) response as mononuclear cells collected from the buffy coat (BC). Bone marrow, spleen, or thymic BC cells from day-old chickens did not produce a GvH response. The GvH ability of spleen and bone marrow BC cells increased rapidly during the first 4 weeks and then plateaued. Although at 4 and 12 weeks of age the GvH response produced by thymic BC cells was significantly less than spleen or bone marrow BC cells, thymic BC cells did produce a significant GvH response at these ages. Thymic BC cells from 11-month-old chickens showed significantly higher GvH response than those of previous ages. Corticosterone treatment of chickens eliminated the thymic cortex but did not enhance the GvH reactivity of thymic BC cells. Suppressor effect of thymic BC cells from day-old chickens was not detected. A synergistic effect was noted in the GvH reaction when thymic cells were combined with bone marrow or splenic BC cells of 4-week-old chickens.