Abnormalities of circulating T cell subsets in atopy: influence of specific immunotherapy

The effect of immunotherapy on T-cell subsets in peripheral blood and bronchoalveolar lavage fluid in pollen-allergic patients

The effect of immunotherapy (IT) on T-cell subsets in peripheral blood and bronchoalveolar lavage fluid (BAL) was examined in 15 patients with rhinoconjunctivitis and asthma caused by sensitivity to birch pollen. They were treated with IT for 3 years. Seven patients were treated with highly standardized birch-pollen extract (Pharmacia, Sweden). Eight untreated patients served as controls. Histamine challenge, blood sampling, and BAL were performed before (January, February), and at the peak of, the birch-pollen season (May). The subpopulations of T cells in peripheral blood and BAL fluid were investigated by immunocytochemistry and flow cytometry. During the birch-pollen season, the percentage of CD3+ and CD4+ cells of blood mononuclear cells in the IT patients increased significantly (P < 0.03 and P < 0.02, respectively). The percentage of CD8+ cells remained unaltered. In control patients, no changes of T-cell subsets in the peripheral blood were observed. T-cell subsets in BAL did not change during the season in relation to preseasonal values for either IT-treated or non-IT-treated patients.

The effect of aging on host defences. Implications for therapy

Immunosenescence is a well known physiological phenomenon resulting from reduced efficiency of the immune system in the elderly. It has been studied both in animal models and in humans. In this review attention is focused on T cell responsiveness, since this cell type is both a marker of the immune response and one of the main targets of several drugs. For this latter reason, most studies of the effect of drugs on the immune system have been performed with reference to the effects on T lymphocytes. In the second part of the article experimental data concerning several drugs and drug classes [steroids, calcium antagonists, theophylline, histamine H1- and H2-receptor antagonists, sodium cromoglycate (cromolyn sodium), pirenzepine, rosaprostol, beta 2-mimetics, antibiotics and antibacterials] and immune responsiveness are reviewed. Lastly, the clinical perspectives of pharmacological treatment in aged subjects in relation to immunosenescence are evaluated.

Antiallergic drugs and the immune response. Interactions and possible clinical relevance

Since the pharmacological treatment of allergic diseases is used in patients with alteration of the immune response due to atopy and possible concomitant infections, we have investigated the possible effects of such drugs as cromolyn, theophylline, ketotifen, oxatomide, astemizole, fenoterol, pirenzepine, and rosaprostol on the in vitro immune response, in order to obtain experimental data and, as a consequence, clinical conclusions. In a series of investigations by our group and other authors the following immunological parameters have been considered: T cell activation induced by different pathways (i.e. autologous stimulation, PHA, anti-CD3, -CD2 and -CD28 monoclonal antibodies), and lymphokine production (i.e. IL-1, IL-2 and gamma-IFN). For a more detailed experimental model the experiments have been performed both in bulk culture and by using T cell clones derived from the peripheral blood. The results show cromolyn to have an enhancing effect, theophylline and ketotifen a suppressing effect, whereas the remainder show no effect on the immune response. These data are considered and discussed from the aspect of their possible clinical relevance and also in light of the in vivo data previously reported.

Functional and biochemical characterization of a human T-cell antigen related to the T3-Ti activation pathway

In this report we studied the antigen identified by the 5/9 monoclonal antibody. This antigen is expressed on approximately 15% of resting T lymphocytes with helper activity and increases following T-cell activation both in vivo and in vitro. The 5/9 monoclonal antibody triggered T-cell proliferation in the presence of suboptimal doses of phorbol12-myrisate 13-acetate (PMA) but this effect was strongly inhibited by antibody-induced modulation of the CD3 T-cell-receptor complex. The observation that a number of T-cell lines were brightly stained by the 5/9 monoclonal antibody after being activated with phytohemagglutinin (PHA) and PMA allowed the molecular characterization of the 5/9 antigen as well as the analysis of the biochemical mechanisms occurring after cell stimulation with 5/9 monoclonal antibody (Mab). An activated Jurkat T-cell line was labeled with 125I on the membrane: the monoclonal antibody immunoprecipitated a molecule displaying an apparent molecular weight of 34 kDa. In addition, 5/9 molecules, purified by immunoprecipitation from Jurkat cells, were found associated to a Ca2+ phospholipid-dependent protein kinase activity.

Functional studies of T4+ lymphocyte subsets distinguished by the monoclonal antibody 5/9: suppressor-effector T4+ lymphocytes derive from the 5/9+ subset

Human T lymphocytes bearing the cell surface antigen T4 are functionally heterogeneous, exerting helper/inducer, suppressor-inducer, suppressor-effector, and cytotoxic activities. Other cell surface antigens with a more restricted expression may help separate T4+ lymphocytes into functionally distinct subsets. This report describes the regulatory functions of T4+ lymphocytes fractionated by the monoclonal antibody 5/9, which detects a cell surface antigen present on 50-60% of T4+ lymphocytes. The results indicate that both 5/9+ and 5/9- T4 subsets contain helper/inducer and suppressor-inducer cells. Suppressor-effector activity, however, is found predominantly within the 5/9+ T4 subset. The 5/9 antibody thus identifies the suppressor-effector subset of T4+ lymphocytes, although it does not distinguish between T4+ cells with or without helper/inducer and suppressor-inducer functions.

Evidence of T-lymphocyte functional impairment in Huntington's disease

Huntington's Disease (HD) is a degenerative neurological disorder with autosomal dominant transmission. Although immunological defect(s) have been postulated, no confirmed laboratory evidence for this exists. In the present study we observed activated T cells in the peripheral blood of HD patients (using 4F2 monoclonal antibody), whereas the percentage of T cells bearing T-cell activation markers such as HLA-DR and MLR4 antigens was normal. We then studied T cells of HD patients in some functional assays. Since it has been suggested that autologous mixed lymphocyte reaction (AMLR) includes several immune mechanisms in which distinct cell subsets interact and perform distinct regulatory functions, it is conceivable that the remarkable deficiency of AMLR herein observed in HD patients results from some abnormal immune regulation which may contribute to the pathology of this condition. Additional experiments demonstrated a defect of AMLR in three asymptomatic young sibs of HD patients, and coculture experiments between T cells of patients (as responders) and non-T cells of their sibs (as stimulators), and vice versa, produced no proliferative response. Subnormal responsiveness in allogeneic MLR was also observed. Normal or enhanced PHA-induced production of both IL-2 and IFN-gamma in vitro was detected. These experimental data suggest a cellular branch of the immune system in HD; however, they do not indicate if this defect is primary or secondary to the disease itself.