Infectious mononucleosis: immunotherapy with EBV-specific transfer factor?
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Biomedical subjects
Publications and source records attributed to G Pizza.
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Twenty-two African children with endemic Burkitt's lymphoma entered a study to evaluate the possible efficacy of a transfer factor (TF) with specific activity against Eptein-Barr virus in preventing disease relapses. Five of eleven patients have so far relapsed in the non TF-treated group as against two of eleven in the TF-treated group. The patterns of relapse and observable increased disease free remission duration in the TF-treated group strongly suggest a beneficial effect particularly in the prevention of late relapses. A larger series of patients treated with this specific TF are needed to confirm these observations in endemic Burkitt's lymphoma.
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A monoclonal antibody (MAb) to human transitional-cell carcinoma of the bladder (TCCB) was obtained by immunization of a BALB/c mouse with formalin-fixed TCCB cells and subsequent fusion of the spleen cells with SP2-OAg14 myeloma line. GF 26.7.3 MAb was selected by indirect immunofluorescence (IIF) as reacting agent with target cells and negative with autologous lymphocytes and Epstein-Barr virus (EBV)-transformed lymphoblastoid cell-line. GF 26.7.3 reacts with a high percentage of bladder and colon carcinomas when examined by IIF and immunoperoxidase techniques and cross-reacts with a determinant expressed on neutrophilic cell lineage. The IIF analysis performed on bone marrow and peripheral blood (PB) from healthy subjects and leukemic patients and on leukemic cell lines showed that the expression of the structure detected by GF 26.7.3 is restricted to the neutrophilic cell lineage and first expressed at the promyelocytic level. Immunoprecipitation and SDS-polyacrylamide gel electrophoresis (PAGE) of 125 I-labelled membrane proteins from target cells were performed, but no bands were detected by autoradiography. In addition, pronase insensitivity and periodate sensitivity suggest the possible involvement of a carbohydrate determinant.
Transfer factor was obtained from four patients having recovered from acute type-B viral hepatitis. It was replicated in vitro using the LDV/7 lymphoblastoid cell line. This in vitro-produced transfer factor specific for hepatitis B (TFdL-H) was administered to 10 randomly selected patients with biochemically and histologically proven HBsAg-positive chronic active hepatitis (CAH) at 15-day intervals over a 6-month period. In three out of four initially HBeAg-positive patients, anti-HBe antibodies appeared when the HBeAg disappeared. In one of these patients and in two other HBsAg-positive patients, the appearance of anti-HBs antibodies was noted. The improvement in several biochemical parameters of the TFdL-H patients was statistically significant when compared with those of another group of 10 randomly selected untreated CAH patients. Liver biopsies in six out of eight treated patients showed a histological improvement at the end of the treatment. These results suggest that TFdL-H may be used with beneficial effect for the treatment of HBsAg-positive CAH.
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Transfer factors against two heterologous antigens, Herpesvirus saimiri and owl monkey kidney cells, were replicated in vitro in a human lymphoblastoid cell line (LDV/7) and injected into rhesus and owl monkeys. Transfer of immunity was demonstrated by the leukocyte migration inhibition assay. This study suggests that heterologous transfer factor, replicated in vitro, can transfer cellular immunity against membrane antigens in rhesus and owl monkeys.
Six bladder cancer patients received intralesional injections by needle, under cystoscopic control, of 1969-4046 units (U) of xenogeneic IL-2 of high biological activity (324 U/ml; 397 micrograms/ml protein; 1.22 protein/U ratio). The treatment was spread over 7-54 days and 0.5 ml was injected each time. In 3/6 patients complete tumour regression was seen 43, 60 and 105 respectively days after the first IL-2 injection. In 2 a 70% regression was observed at days 45 and 75. In the last patient massive necrosis throughout the tumour mass was recorded on day 25 at radical cystectomy. In order to evaluate the minimum IL-2 U required to obtain positive clinical results and/or to assess whether the anti-tumour effect observed could be ascribed to the foreign protein of bovine origin contained in our IL-2 preparation, 4 additional bladder cancer patients were treated in 7-14 days with 156-1404 U of a second IL-2 lot with a much lower biological activity and similar protein content (52 U/ml; 289 micrograms/ml of protein; 5.55 protein/U ratio). No clinical or histological improvement was noted over a 42- to 54-day observation period. When we evaluated the 2 groups of patients by Student's t-test for both total U injected and U/kg of body weight (bw) we found a statistically significant differences (0.0025 less than p less than 0.0005 and p less than 0.0005, respectively). In contrast, no difference was seen for the injected protein amounts. The reported observations are in favour of a dose-dependent anti-tumour action mediated by IL-2 instead of foreign proteins. In none of the patients treated were any early or late adverse clinical side effects observed. Immunological monitoring (E, EAC, E-active rosettes, mitogen lymphocyte stimulations and leukocyte migration inhibition in the presence of allogeneic bladder cancer cells) performed on the peripheral blood (PB) showed significant but contrasting modifications after IL-2 injection. There was no clear correlation with the clinical course. The patients in whom we observed complete regression are still tumour free after 2, 4 and 7 months. In addition, in all the patients of the first group we observed an increase in tumour lymphoid infiltrate after IL-2 injection and in 2 patients lymphoid pseudo-follicles were also noted. In 2 of these patients we also observed scar-like areas in the place of the tumours previously seen.
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Humoral and cell-mediated immunity (CMI) to herpesvirus saimiri (HVS), an oncogenic lymphotropic herpesvirus, was studied in squirrel and rhesus monkeys. Natural antibody to HVS was found in five of six squirrel monkeys but there was no evidence of specific CMI directed against HVS. Rhesus monkeys did not show natural antibody or CMI against HVS antigens. Immunization with HVS, however, produced both antibody and specific CMI in the rhesus monkeys, but no CMI developed in the squirrel monkeys. These findings are important in the development of animal models for the treatment of tumors associated with lymphotropic herpesviruses.
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The presence of tumour-associated antigens in bladder carcinomas has been shown in leucocyte migration inhibition and lymphocyte stimulation using formalin-treated autologous tumour cells as antigen. The treatment of patients with an in vitro produced specific transfer factor enhances their reactivity in these tests. However, when tumour cells from relapses were substituted for those of the primary tumour, the reactivity previously observed was abolished. An antigenic modulation and/or a polymorphic expression of bladder tumour-associated antigens in secondary tumours is suggested and might be responsible for some immunological escapes.
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