Persistent immune abnormalities discriminate post-COVID syndrome from convalescence

BACKGROUND

Innate lymphoid cells (ILCs) are key organizers of tissue immune responses and regulate tissue development, repair, and pathology. Persistent clinical sequelae beyond 12 weeks following acute COVID-19 disease, named post-COVID syndrome (PCS), are increasingly recognized in convalescent individuals. ILCs have been associated with the severity of COVID-19 symptoms but their role in the development of PCS remains poorly defined.

METHODS AND RESULTS

Here, we used multiparametric immune phenotyping, finding expanded circulating ILC precursors (ILCPs) and concurrent decreased group 2 innate lymphoid cells (ILC2s) in PCS patients compared to well-matched convalescent control groups at > 3 months after infection or healthy controls. Patients with PCS showed elevated expression of chemokines and cytokines associated with trafficking of immune cells (CCL19/MIP-3b, FLT3-ligand), endothelial inflammation and repair (CXCL1, EGF, RANTES, IL-1RA, PDGF-AA).

CONCLUSION

These results define immunological parameters associated with PCS and might help find biomarkers and disease-relevant therapeutic strategies.

The interplay of viral loads, clinical presentation, and serological responses in SARS-CoV-2 – Results from a prospective cohort of outpatient COVID-19 cases

Risk factors for disease progression and severity of SARS-CoV-2 infections require an understanding of acute and long-term virological and immunological dynamics. Fifty-one RT-PCR positive COVID-19 outpatients were recruited between May and December 2020 in Munich, Germany, and followed up at multiple defined timepoints for up to one year. RT-PCR and viral culture were performed and seroresponses measured. Participants were classified applying the WHO clinical progression scale. Short symptom to test time (median 5.0 days; p = 0.0016) and high viral loads (VL; median maximum VL: 3∙10⁸ copies/mL; p = 0.0015) were indicative for viral culture positivity. Participants with WHO grade 3 at baseline had significantly higher VLs compared to those with WHO 1 and 2 (p = 0.01). VLs dropped fast within 1 week of symptom onset. Maximum VLs were positively correlated with the magnitude of Ro-N-Ig seroresponse (p = 0.022). Our results describe the dynamics of VLs and antibodies to SARS-CoV-2 in mild to moderate cases that can support public health measures during the ongoing global pandemic.

Head-to-head evaluation of seven different seroassays including direct viral neutralisation in a representative cohort for SARS-CoV-2

A number of seroassays are available for SARS-CoV-2 testing; yet, head-to-head evaluations of different testing principles are limited, especially using raw values rather than categorical data. In addition, identifying correlates of protection is of utmost importance, and comparisons of available testing systems with functional assays, such as direct viral neutralisation, are needed.We analysed 6658 samples consisting of true-positives (n=193), true-negatives (n=1091), and specimens of unknown status (n=5374). For primary testing, we used Euroimmun-Anti-SARS-CoV-2-ELISA-IgA/IgG and Roche-Elecsys-Anti-SARS-CoV-2. Subsequently virus-neutralisation, GeneScriptcPass, VIRAMED-SARS-CoV-2-ViraChip, and Mikrogen-recomLine-SARS-CoV-2-IgG were applied for confirmatory testing. Statistical modelling generated optimised assay cut-off thresholds. Sensitivity of Euroimmun-anti-S1-IgA was 64.8%, specificity 93.3% (manufacturer's cut-off); for Euroimmun-anti-S1-IgG, sensitivity was 77.2/79.8% (manufacturer's/optimised cut-offs), specificity 98.0/97.8%; Roche-anti-N sensitivity was 85.5/88.6%, specificity 99.8/99.7%. In true-positives, mean and median Euroimmun-anti-S1-IgA and -IgG titres decreased 30/90 days after RT-PCR-positivity, Roche-anti-N titres decreased significantly later. Virus-neutralisation was 80.6% sensitive, 100.0% specific (≥1:5 dilution). Neutralisation surrogate tests (GeneScriptcPass, Mikrogen-recomLine-RBD) were >94.9% sensitive and >98.1% specific. Optimised cut-offs improved test performances of several tests. Confirmatory testing with virus-neutralisation might be complemented with GeneScriptcPassTM or recomLine-RBD for certain applications. Head-to-head comparisons given here aim to contribute to the refinement of testing strategies for individual and public health use.

From first to second wave: follow-up of the prospective COVID-19 cohort (KoCo19) in Munich (Germany)

BACKGROUND

In the 2nd year of the COVID-19 pandemic, knowledge about the dynamics of the infection in the general population is still limited. Such information is essential for health planners, as many of those infected show no or only mild symptoms and thus, escape the surveillance system. We therefore aimed to describe the course of the pandemic in the Munich general population living in private households from April 2020 to January 2021.

METHODS

The KoCo19 baseline study took place from April to June 2020 including 5313 participants (age 14 years and above). From November 2020 to January 2021, we could again measure SARS-CoV-2 antibody status in 4433 of the baseline participants (response 83%). Participants were offered a self-sampling kit to take a capillary blood sample (dry blood spot; DBS). Blood was analysed using the Elecsys® Anti-SARS-CoV-2 assay (Roche). Questionnaire information on socio-demographics and potential risk factors assessed at baseline was available for all participants. In addition, follow-up information on health-risk taking behaviour and number of personal contacts outside the household (N = 2768) as well as leisure time activities (N = 1263) were collected in summer 2020.

RESULTS

Weighted and adjusted (for specificity and sensitivity) SARS-CoV-2 sero-prevalence at follow-up was 3.6% (95% CI 2.9-4.3%) as compared to 1.8% (95% CI 1.3-3.4%) at baseline. 91% of those tested positive at baseline were also antibody-positive at follow-up. While sero-prevalence increased from early November 2020 to January 2021, no indication of geospatial clustering across the city of Munich was found, although cases clustered within households. Taking baseline result and time to follow-up into account, men and participants in the age group 20-34 years were at the highest risk of sero-positivity. In the sensitivity analyses, differences in health-risk taking behaviour, number of personal contacts and leisure time activities partly explained these differences.

CONCLUSION

The number of citizens in Munich with SARS-CoV-2 antibodies was still below 5% during the 2nd wave of the pandemic. Antibodies remained present in the majority of SARS-CoV-2 sero-positive baseline participants. Besides age and sex, potentially confounded by differences in behaviour, no major risk factors could be identified. Non-pharmaceutical public health measures are thus still important.

Broad T Cell Targeting of Structural Proteins After SARS-CoV-2 Infection: High Throughput Assessment of T Cell Reactivity Using an Automated Interferon Gamma Release Assay

Background

Adaptive immune responses to structural proteins of the virion play a crucial role in protection against coronavirus disease 2019 (COVID-19). We therefore studied T cell responses against multiple SARS-CoV-2 structural proteins in a large cohort using a simple, fast, and high-throughput approach.

Methods

An automated interferon gamma release assay (IGRA) for the Nucleocapsid (NC)-, Membrane (M)-, Spike-C-terminus (SCT)-, and N-terminus-protein (SNT)-specific T cell responses was performed using fresh whole blood from study subjects with convalescent, confirmed COVID-19 (n = 177, more than 200 days post infection), exposed household members (n = 145), and unexposed controls (n = 85). SARS-CoV-2-specific antibodies were assessed using Elecsys® Anti-SARS-CoV-2 (Ro-N-Ig) and Anti-SARS-CoV-2-ELISA (IgG) (EI-S1-IgG).

Results

156 of 177 (88%) previously PCR confirmed cases were still positive by Ro-N-Ig more than 200 days after infection. In T cells, most frequently the M-protein was targeted by 88% seropositive, PCR confirmed cases, followed by SCT (85%), NC (82%), and SNT (73%), whereas each of these antigens was recognized by less than 14% of non-exposed control subjects. Broad targeting of these structural virion proteins was characteristic of convalescent SARS-CoV-2 infection; 68% of all seropositive individuals targeted all four tested antigens. Indeed, anti-NC antibody titer correlated loosely, but significantly with the magnitude and breadth of the SARS-CoV-2-specific T cell response. Age, sex, and body mass index were comparable between the different groups.

Conclusion

SARS-CoV-2 seropositivity correlates with broad T cell reactivity of the structural virus proteins at 200 days after infection and beyond. The SARS-CoV-2-IGRA can facilitate large scale determination of SARS-CoV-2-specific T cell responses with high accuracy against multiple targets.

Prevalence and Risk Factors of Infection in the Representative COVID-19 Cohort Munich

Given the large number of mild or asymptomatic SARS-CoV-2 cases, only population-based studies can provide reliable estimates of the magnitude of the pandemic. We therefore aimed to assess the sero-prevalence of SARS-CoV-2 in the Munich general population after the first wave of the pandemic. For this purpose, we drew a representative sample of 2994 private households and invited household members 14 years and older to complete questionnaires and to provide blood samples. SARS-CoV-2 seropositivity was defined as Roche N pan-Ig ≥ 0.4218. We adjusted the prevalence for the sampling design, sensitivity, and specificity. We investigated risk factors for SARS-CoV-2 seropositivity and geospatial transmission patterns by generalized linear mixed models and permutation tests. Seropositivity for SARS-CoV-2-specific antibodies was 1.82% (95% confidence interval (CI) 1.28-2.37%) as compared to 0.46% PCR-positive cases officially registered in Munich. Loss of the sense of smell or taste was associated with seropositivity (odds ratio (OR) 47.4; 95% CI 7.2-307.0) and infections clustered within households. By this first population-based study on SARS-CoV-2 prevalence in a large German municipality not affected by a superspreading event, we could show that at least one in four cases in private households was reported and known to the health authorities. These results will help authorities to estimate the true burden of disease in the population and to take evidence-based decisions on public health measures.

Packed bed column fermenter and kinetic modeling for upgrading the nutritional quality of coffee husk in solid-state fermentation

Studies were carried out to evaluate solid-state fermentation (SSF) for the upgradation of the nutritional quality of coffee husk by degrading the caffeine and tannins present in it. SSF was carried out by Aspergillus niger LPBx in a glass column fermenter using factorial design experiments and surface response methodology to optimize bioprocess parameters such as the substrate pH and moisture content and aeration rate. The first factorial design showed that the moisture content of the substrate and aeration rate were significant factors for the degradation of toxic compounds, which was confirmed by the second factorial design too. The kinetic study showed that the degradation of toxic compounds was related to the development of the mold and its respiration and also to the consumption of the reducing sugars present in coffee husk. From the values obtained experimentally for the oxygen uptake rate and CO(2) evolved, the system determined a biomass yield (Y(x/o)) of 3.811 (g of biomass).(g of consumed O(2))(-1) and a maintenance coefficient (m) of 0.0031 (g of consumed O(2)).(g biomass of biomass)(-1).h(-1). The best results on the degradation of caffeine (90%) and tannins (57%) were achieved when SSF was carried out with a 30 mL.min(-1) aeration rate using coffee husk having a 55% initial moisture content. The inoculation rate did not affect the metabolization of the toxic compounds by the fungal culture. After SSF, the protein content of the husk was increased to 10.6%, which was more than double that of the unfermented husk (5.2%).

Expression of MAGE, gp100 and tyrosinase genes in uveal melanoma cell lines

In order to determine the possible use of uveal melanoma cell lines as stimulators in immunotherapy, we evaluated the expression of the human genes for MAGE-1, -2 and -3, gp100 and tyrosinase in uveal melanoma cell lines. mRNA expression of the MAGE-1, -2 and -3, gp100 and tyrosinase genes and the HLA class I specificity were determined in five primary and three metastatic uveal melanoma cell lines. Expression of the examined genes was heterogeneous in the primary and metastatic cell lines. The cell lines OCM-1 and OMM-1 expressed MAGE-1, -2 and -3, whereas EOM-3, MEL202, 92-1 and OMM-3 were negative for these antigens. gp100 was expressed in all cell lines, and tyrosinase in all but three (EOM-29, OMM-2 and OMM-3). Except for EOM-3, the HLA-A type of all the cell lines could be determined by complement-dependent microlymphocytotoxicity assay. Since at least two melanoma-associated antigens can be found in uveal melanoma cell lines, as well as the HLA class I molecules, these cell lines may be applicable as immunogens for specific immunotherapy against metastatic uveal melanoma.

Gnotobiotic system for studying rhizosphere colonization by plant growth-promoting Pseudomonas bacteria

A gnotobiotic system for studying tomato rhizosphere colonization by Pseudomonas bacteria was developed. The system is based on sterile seedlings that are inoculated with one or two strains and subsequently grown in a sterile glass tube containing quartz sand. After 7 days of growth in a climate-controlled growth chamber, the number of bacteria present on the root tip was analyzed. The system was optimized with respect to root morphology, inoculation of the seedling, and isolation of root tip bacteria. With this system, rhizosphere colonization on tomato, radish, wheat, and potato was analyzed. For detailed analysis of tomato rhizosphere colonization by some representative plant growth-promoting rhizo-bacteria, the colonization of known poor, moderate, and good potato root-colonizing Pseudomonas strains and of four Rhizobium strains was determined. All strains colonized the root tips when inoculated as single strains. When inoculated in competition with the efficient root colonizer P. fluorescens strain WCS365, many strains were outcompeted. Mutants of Pseudomonas biocontrol bacteria lacking flagella or the O-antigen of lipopolysaccharide (LPS), which were isolated in previous studies and shown to be impaired in potato rhizosphere colonization in field soil systems, showed a reduced colonization ability in the gnotobiotic system also. The gnotobiotic system was used to screen a collection of 300 random P. fluorescens WCS365::Tn5 mutants for colonization-impaired mutants. Three novel mutants were found that were outcompeted by the wild-type strain in tomato root tip colonization but were not impaired in known colonization traits such as motility, amino acid auxotrophy, and presence of the O-antigenic side chain of LPS. One strain appeared to be a thiamine auxotroph, suggesting that the root does not secrete a sufficient amount of thiamine to support growth of this strain. The other two mutants had a reduced growth rate in laboratory media, suggesting that growth rate is an important colonization factor. As the system is gnotobiotic and devoid of field-soil variables, it can also be used to study the effects of selected biotic and abiotic factors on colonization.

Risk assessment of carcinogenesis at implantation sites

Of the 98 foreign-body or scar-related cancers reported in the literature, over 25 percent have developed within 15 years, and over 50 percent within 25 years. Substantial numbers of various implants have now been in place for 10 to 20 years. Since at least 25 percent of cancer cases should already have occurred, the low number actually observed permits the prediction that the incidence of cancers at implantation sites will remain low. This conclusion is supported by studies on 27 specimens of chronic foreign-body reactions against a variety of implants that had been in situ for 1 to 19 years. Employing a cell-culture technique previously developed for experimental mice, an attempt was made to identify specific precancer cells in the tissues. None were detected, in contrast to foreign-body reactions of mice, in which the incidence of foreign-body tumors is high.

[Investigations and review of literature relating to carcinogenesis. I. Communication: Cancer from asbestos, schistosomiasis, and cicatrization (author's transl)]

This review covers the following aspects: Cancer associated with asbestos and other fibers: Epidemiology. - Cancer types and location (mesothelioma; bronchogenic carcinoma; cancer of the upper respiratory tract; abdominal cancer). - Experimental asbestos cancer. - Other kinds of fibers and cancer (wool and cotton; glass; talc; others). - Cancer determining or influencing factors (individual predisposition; species susceptibility; type of material; shape and size of fibers; smoking). - Preneoplastic signs in man (fibrosis; ferruginous bodies; pleural plaques; milky spots). - Preneoplastic development in animals. - Fiber effects on cell cultures (macrophages; fibroblasts). Cancer associated with schistosomiasis: Epidemiology. - Patient age and cancer latency. - Pathology. - Foreign body reaction and preneoplastic development. Scar cancer. Foreign body cancer: In man. - Experimental (species differences in susceptibility; individual genetic differences in tumor incidence and latency; influence of sex, age, nutrition; tumor histopathology and ultrastructure; tumor growth, invasiveness, metastases, transplantability, immunology; search for tumor viruses). - Properties of foreign body materials in relation to tumorigenicity (chemical and physical properties; size and shape; surface properties; porosity). - Investigations and findings concerning the origin of foreign body sarcomas (the foreign body reaction; search for foci of tumor origin; an analytical method; monoclonal tumor origin; heterogenicity of carcinogenic events; surface dependency; identification of originator cells; time and location of the emergence of tumor originator cells; the carcinogenic initiation event; surface-independent and dependent preneoplastic maturation; the carcinogenic role of the foreign body). - Earlier hypotheses and theories in the light of new experimental findings. The results of experimental foreign body tumorigenesis in relation to foreign body-, asbestos-, schistosomiasis-, and scar-cancer in man. (Common factors of promotion; differences regarding induction mechanisms, cells of origin, latencies, frequencies; immune defense). Consequences for prevention: Asbestos cancer. - Fiber cancer. - Schistosomiasis cancer. - Foreign body cancer (assessing the peril in man; testing of materials for carcinogenicity; recommendations).

Foreign-body tumorigenesis in mice: DNA synthesis in surface-attached cells during preneoplasia

(CBA/H X CBA/H-T6)F1 mice were given sc implants of unplasticized vinyl chloride acetate 15 X 22-mm copolymer films. The animals were pulsed with [3H]thymidine at various times during the 15 months following implantation. DNA synthesis occurred in the film-attached cell population, predominantly macrophages, throughout the preneoplastic phase in both females and males. Giant cells with fewer than 10 nuclei were labeled synchronously and asynchronously. No DNA synthesis was detected in giant cells with more than 10 nuclei. Previous studies have shown that phagocytic inactivity and ultrastructural signs of functional dormancy are characteristic for the foreign-body-reactive macrophage. However, this investigation demonstrated that the macrophage was not dormant with respect to DNA synthesis.

Delayed foreign-body tumorigenesis in mice infected with lactate dehydrogenase-elevating virus: Brief communication

Female and male CBA/H mice were infected with lactate dehydrogenase virus (LDV). Two weeks later, these mice and noninfected controls received double sc implants of unplasticized vinyl chloride-vinyl acetate copolymer films (0.2 X 15 X 22 mm). Foreign-body (FB) tumorigenesis was delayed in LDV-infected females and males by 2 months. This result could not be explained by an effect of LDV on cellular immunity, inasmuch as cellular immunity does not influence the course of FB tumorigenesis.

Foreign-body tumors of mice: strain and sex differences in latency and incidence

Sarcomas were induced by sc implantation of unplasticized polyvinylchloride acetate films in female and male mice of strains AKR/J, BALB/cJ, BALB/cWat, CBA/H and CBA/H-T6, C3H/HeJ, C57BL/10ScSn, C57BL/6J-bgj, C57BL/cdJ, DBA/-1J l/LnJ, LP/J, SJL/J, X/Gf, 129/J, and hybrids (CBA/H-T6 X AKR/J)F1, (C57BL/10ScSn x CBA/H or CBA/H-T6)F1, (C57BL/6J-bgj x C57BL/6J)F1. The strains and sexes showed marked differences in incidence and mean latency of resulting tumors. Crucial information was provided for the selection of appropriate mouse strains for the study of interrelationships between genotypes, defined somatic properties, and the multifactorial process of foreign-body tumorigenesis.

Multiphasic incidence of foreign body-induced sarcomas

Single or multiple plastic films (unplasticized vinyl chloride vinyl acetate copolymer) of different sizes and shapes were implanted s.c. in female CBA/H and CBA/H-T6 mice. Tumor incidence increased and accelerated with increased total surface area of multiple implants or with increased size of single implants. Tumor distribution curves over time were generally multiphasic. The profiles changed in proportionate relation to implant size. These findings indicate class differences between tumors according to latency. Since latency is known to be a predetermining characteristic of foreign body-induced tumors, class differences seem to exist at the originator cell level, reflecting diversity of intrinsic carcinogenic factors.

Foreign-body tumorigenesis: in vitro isolation and expansion of preneoplastic clonal cell populations

Foreign-body reactions were induced in coisogenic CBA/H and CBA/H-T6 mice by sc implantation of 15 times 22 times 0.2-mm unplasticized vinyl chloride vinyl acetate copolymer films. At 6 months' post implantation, implants and unopened tissue capsules were transferred to recipient animals of the T6-different partner strain. After another 3 months, part of the film/capsule complex was transferred to (C57BL/10ScSn times CBA/H-T6)F1 mice for tumor development. Capsule-derived and film-attached cells of the other part were separately cultured. Cultures consisting initially of euploid cells were often gradually replaced by different cells with specific aneuploid karyotypes which were identical with, or closely related to, those of the corresponding tumors. The cultured cells implanted in hybrid recipients at different passage numbers frequently gave rise to homologous tumors. Hence, it was possible to prepare in vitro cells with prefixed specific tumor determinants at different stages of preneoplastic maturation.

Foreign-body tumorigenesis induced by glass and smooth and rough plastic. Comparative study of preneoplastic events

Foreign-body (FB) tumorigenesis was induced in female CBH/H and CBA/H-T6 mice and their hybrids by sc implantation of about 0.2-mm thick, large (660-720 mm2) or small (210-400 mm2) pieces of glass, smooth-surfaced plastic, or roughened plastic (rigid unplasticized vinyl chloride vinyl acetate copolymer). The tumorigenic process was analyzed in the various implantation groups by the evaluation of tumor incidences and latencies, and by the determination of 1) frequency of originator ("parent") cells, 2) appearance of preneoplastic cells in FB-reactive capsule tissue, 3) expansion of preneoplastic cell clones throughout the tissue capsule, and 4) pace of cellular preneoplastic maturation in terms of time remaining until neoplastic autonomy. Established methods included transfer of preneoplastic FB-reactive tissue capsules to recipient animals (hybrids of CBA/H and CBA/Br or C57BL/10ScSn). Specific preneoplastic events or stages of FB tumorigenesis were affected differently, depending on the size, material, and surface properties of implants.

Foreign-body tumorigenesis by vinyl chloride vinyl acetate copolymer: no evidence for chemical cocarcinogenesis

We investigated whether vinyl chloride monomers, released from implants of vinyl chloride vinyl acetate copolymer (VCA), exerted cocarcinogenic activity and added thereby to the mechanism of foreign-body (FB) tumorigenesis. CBA/H and CBA/H-T6 mice were used. No evidence was found to indicate that chemical carcinogenic activity partakes in tumorigenesis by VCA implants. Hence it was concluded that VCA plastic is not suitable for the study of the combined process of FB/chemical cocarcinogenesis. Furthermore, experimental results obtained with VCA film implants were representative of FB tumorigenesis in the absence of demonstrable chemical carcinogenic activity.

Etiological factors, stages, and the role of the foreign body in foreign body tumorigenesis: a review

Attempts were made to analyze the process of foreign body (FB) tumorigenesis and to identify etiologically significant factors by correlating information in the literature and recent experimental data from our labroatory. It appears that the process of FB tumorigenesis is dependent on sequence of specific conditions as expressed by the following criteria: (a) cellular proliferation and tissue infiltration during acute FB reaction; (b) fibrosis of the tissue capsule surrounding the FB; (c) quiescence of the tissue reaction, i. e., dormancy and phagocytic inactivity of FB-attached macrophages; and (d) availability of a FB surface for direct contact with clonal preneoplastic cells. There is no indication that the initial acquisition of neoplastic potential and the determination of specific tumor characteristics are based on direct physical or chemical reaction between cells and the FB. These etiological key events occur presumably in mesenchymal stem cells associated with the microvasculature no later than during the acute stage of FB reaction and certainly long before clonal descendants of these cells are first found in contact with the FB surface. In fact, there is no reason to assume that cells with neoplastic determination may be present in normal tissue prior to the introduction of a FB and that the FB would only create the conditions required for stepwise preneoplastic maturation.

Antigenic Analysis of Human Cells and Tissues: Immunodiffusion Studies on Liver Tissue, White Blood Cells and Subcellular Fractions

Antisera were prepared in guinea pigs and other animal species against established human cell strains, human liver tissue and white blood cells. By means of agar-immunodiffusion numerous cellular antigens were discovered and defined. The cellular origin of the antigens was confirmed by excluding human plasma as the source. The distribution of these antigenic components in cell strains, liver tissue, white blood cells, subcellular fractions and on the erythrocyte membrane was studied. Liver tissue contained 19 of 20 antigenic components which had been described previously as a result of antigenic analyses on eight established human cell strains. Seven out of 17 antigenic components present in liver tissue were not demonstrable in three different specimens of human white blood cells. Therefore, the value of leukocytes as direct indicator of tissue antigenicity is questioned. Some of the antigenic components studied by immunodiffusion occur not only in soluble, diffusible form but were also detected on the human erythrocyte membrane as structural constituents. Specific associations between defined antigenic components and subcellular fractions have been established.

Carcinogenesis from polymer implants: new aspects from chromosomal and transplantation studies during premalignancy

Inbred CBA/H and CBA/H-T6 mice received implants of 15 X 22 mm plastic films. Plastic inserts and tissue capsules were cut in thirds at half monthly and monthly intervals. The first portion of the inserts and capsules was left in the original animal. The second portion was separated and individually transplanted into recipients that differed from the original animals with respect to the T6 marker chromosome. The third portion and all tumors which developed in original and recipient animals were examined by karyological, histological, and cultural methods. Film pieces caused tumors in recipient animals up to 9 months after transfer, capsule tissue only up to about 1 month after transfer. Tumors in original and corresponding recipient animals were identical in their chromosomal stemlines and pace of premalignant maturation. The karyotype of the stemline was never discovered among the film-attached cell population because there seemed to be no cell division. This points to the existence of a single, specific premalignant cell clone residing on the film surface in a dormant state of nondivision many months before tumor appearance. At the end, the (pre)malignant cells detached from the film, invaded the capsule tissue, and propagated to produce the tumor within about 4 weeks. The existence of a specific inhibition phenomenon during the premalignant phase is suggested.