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Biomedical subjects

H W Murray

Publications and source records attributed to H W Murray.

At least 127 records · Page 7Linked to original sources
PubMed1987

Experimental visceral leishmaniasis: production of interleukin 2 and interferon-gamma, tissue immune reaction, and response to treatment with interleukin 2 and interferon-gamma.

During the first 2 to 4 weeks of progressive visceral infection with the intracellular protozoan, Leishmania donovani, spleen cells from BALB/c mice failed in response to leishmanial antigen to produce either of the activating T cell-derived lymphokines, interleukin 2 (IL 2) or gamma-interferon (IFN-gamma). Four weeks after infection, however, antigen-induced IL 2 and IFN-gamma secretion emerged and coincided with the onset of control over parasite replication and the subsequent killing of greater than 80% of intrahepatic L. donovani. The development of this immunosecretory activity correlated with the hepatic tissue response at the site of parasitized Kupffer cells. This response progressed from Kupffer cell fusion (week 1) to fusion plus a mononuclear cell infiltrate (week 2) to well-organized granuloma formation (weeks 4 to 8). In contrast, T cell-deficient nude BALB/c mice exerted no control over L. donovani, their spleen cells failed to generate antigen-induced IFN-gamma, and at 4 weeks, their livers were devoid of any tissue reaction. Since spleen cells from 2-week infected normal mice did not produce antigen-stimulated IL 2 or IFN-gamma, these mice were treated with recombinant (r) lymphokines. Various protocols using both high and low dose human rIL 2 had no antileishmanial effect. Hepatic parasite replication was completely halted, however, by macrophage-activating doses of murine rIFN-gamma. These results reemphasize that an intact T cell-dependent response is required for successful defense against L. donovani, indicate that this immune response can be measured at both the cellular (secretory) and tissue levels, and confirm that IFN-gamma can exert an antileishmanial effect in vivo.

Animals↗
PubMed1987

Ribavirin pharmacodynamics in high-risk patients for acquired immunodeficiency syndrome.

Ribavirin was administered orally in escalating doses for 2 or 4 weeks to 15 symptom-free, human immunodeficiency virus seropositive homosexual men with generalized lymphadenopathy. Reverse transcriptase activity was inhibited during therapy when steady-state plasma concentrations were greater than 6 mumol/L. These concentrations were achieved with 1200 or 2400 mg/day for 2 weeks or a loading dose of 2400 mg/day for 3 days followed by 600 mg/day for 4 weeks. Drug accumulation occurred at all doses. The elimination half-life appeared to be approximately 2 weeks. Reversible adverse reactions, principally resulting in central nervous system symptoms and anemia, correlated with dose and duration of therapy. Immunologic enhancement of T-lymphocyte-mediated mitogen-induced responses was observed in the majority of patients who had reduction in reverse transcriptase activity. However, specific T4+ lymphocyte-mediated antigen-induced responses increased to within the normal range in only three patients. Significant enhancement appeared to correlate with the severity of baseline antigen-induced functional impairment. These data indicate that oral ribavirin can be given for at least 1 month with acceptable toxicity at doses that appear to inhibit human immunodeficiency virus replication.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The role of gamma interferon in the generation of human macrophages cytotoxic for Entamoeba histolytica trophozoites.

Upon exposure to Entamoeba histolytica antigen, lymphocytes from patients treated for amebic liver abscess produce lymphokines which activate monocyte-derived macrophages to kill E. histolytica trophozoites. We now demonstrate that gamma interferon (IFN-gamma) is produced by these stimulated lymphocytes and is sufficient but not exclusively necessary to activate monocyte-derived macrophage amebicidal activity. Supernatants from mononuclear cells of 7 patients when stimulated with amebic antigen contained more IFN-gamma than comparable supernatants derived from control cells (1,862 U/ml vs. 174 U/ml geometric means, P less than 0.01); IFN-gamma levels were similar in patient and control supernatants following concanavalin A stimulation. Macrophages activated solely by partially purified IFN-gamma or recombinant human IFN-gamma (300 U/ml) killed 47% of virulent amebae by 6 hr at 37 degrees C. Monocyte-derived macrophages stimulated with lymphokines elicited by amebic antigen or concanavalin A killed 48% and 57% of axenic E. histolytica trophozoites, respectively, over 6 hr at 37 degrees C (P less than 0.001 for each compared to control). Macrophages incubated with the identical lymphokines, but in the presence of monoclonal antibody to IFN-gamma, were only able to kill 18% and 27% of amebae, respectively, at 6 hr (P less than 0.05 to control or when antibody to IFN-gamma was not present). If antibody to IFN-gamma was added to the stimulating lymphokine, more macrophages died during interaction with amebae (P less than 0.05). In summary, IFN-gamma has a major but not exclusive role in activating human monocyte-derived macrophages in vitro to kill virulent E. histolytica trophozoites.

Adult↗
PubMed1986

Oxygen-independent inhibition of intracellular Chlamydia psittaci growth by human monocytes and interferon-gamma-activated macrophages.

We have demonstrated previously that Chlamydia psittaci grows well in human monocyte-derived macrophages, but to a limited extent in lymphokine-or interferon-gamma (IFN-gamma)-activated macrophages. In this investigation, freshly explanted human monocytes inhibited chlamydial inclusion formation by 85% as compared to macrophages, and the level of inhibition was similar to that exhibited by lymphokine-activated macrophages (79%). To determine whether the oxygen-dependent antimicrobial mechanisms of the mononuclear phagocyte were involved in the inhibition, cells were infected with C. psittaci in the presence of agents that either inhibit the respiratory burst (glucose deprivation) or diminish the effect of H2O2 (catalase). These treatments had no effect on the capacity of monocytes and lymphokine-activated macrophages to restrict chlamydial growth. In addition, monocytes and activated macrophages from an individual with chronic granulomatous disease suppressed chlamydial growth as effectively as normal cells. Oxidatively deficient HeLa and endothelial cells, once stimulated by lymphokine, also displayed normal levels of antichlamydial activity. The induction of this apparently oxygen-independent antichlamydial effect by lymphokine was completely neutralized by a monoclonal anti-IFN-gamma antibody, and could be achieved by treatment with recombinant (r)IFN-gamma alone. These results indicate that the primary antimicrobial mechanism of the human monocyte against C. psittaci is oxygen-independent, and that this response can be effectively stimulated in the macrophage by lymphokine (IFN-gamma).

Antibodies, Monoclonal↗
PubMed1986

Patients treated for amebic liver abscess develop cell-mediated immune responses effective in vitro against Entamoeba histolytica.

We studied the afferent and efferent cell-mediated immune response in 15 patients treated for amebic liver abscess. Patients had a lower T4 to T8 ratio (1.25 +/- 0.65) compared with age- and sex-matched controls (1.89 +/- 0.44, p less than 0.01) due to a decrease in T4-"helper" cells and an increase in T8-"suppressor" cells (p less than 0.01). The in vitro proliferative response of patient T lymphocytes to the plant mitogen concanavalin A (Con A) was depressed; responses to phytohemagglutinin were not. The proliferative response of patient lymphocytes to an amebic soluble protein preparation (SPP) was greater than the mitogenic response seen in control lymphocytes (mean of 68,300 delta cpm and 22,300 delta cpm, respectively, p less than 0.001), correlated with the T4 to T8 ratio (p less than 0.05) and the duration of time from initiation of antiamebic therapy (p less than 0.01). Supernatants from patient lymphocytes exposed to the amebic SPP activated normal monocyte-derived macrophages to kill virulent axenic E. histolytica trophozoites (p less than 0.001); patient monocyte-derived macrophages activated by Con A-elicited lymphokine could also kill amebae. Finally, when incubated with the amebic SPP for 5 days, T lymphocytes from patients were able to kill virulent amebae (p less than 0.005); patient T lymphocytes not exposed to the amebic SPP or control T lymphocytes incubated for 5 days with the amebic SPP were not cytotoxic to E. histolytica trophozoites. In summary, after cure of amebic liver abscess, specific cell-mediated immune mechanisms develop that are effective in vitro against the parasite.

Adult↗
PubMed1986

Presence of a macrophage-mediated suppressor cell mechanism during cell-mediated immune response in experimental visceral leishmaniasis.

In susceptible BALB/c mice, systemic intracellular infection with Leishmania donovani provokes generation of adherent spleen cells which can suppress both mitogen- and specific-antigen-stimulated T-cell responses. To characterize the responsible suppressor cell, we irradiated (2,000 R) adherent spleen cells from L. donovani-infected mice or treated them with anti-Thy-1.2 antibody plus complement. Neither anti-T-cell treatment diminished the capacity to inhibit lymphocyte proliferative activity. In addition, as judged by morphologic and functional criteria, 80 to 90% of the adherent cells appeared to be macrophages. Four observations suggested an immunopathogenic role for these suppressor macrophages. (i) Their appearance and disappearance paralleled the establishment and resolution of L. donovani visceral infection in vivo. (ii) Suppressive effects included inhibition of production of the macrophage-activating lymphokine gamma interferon (IFN-gamma). (iii) On transfer into immune mice, suppressor macrophages impaired naturally acquired resistance to L. donovani. (iv) Inhibition of macrophage prostaglandin metabolism by indomethacin reduced suppressor activity in vitro and resulted in a 50% decrease in parasite visceral replication in vivo. In addition, prophylactic cyclophosphamide treatment inhibited the development of suppressor macrophages, and under these conditions visceral infection was rapidly controlled. These results suggested that disseminated L. donovani infection provokes a macrophage-mediated suppressor mechanism which appears to contribute to establishment of visceral leishmaniasis in a susceptible host.

Animals↗
PubMed1986

Cellular resistance to protozoal infection.

Several factors appear to determine cellular resistance to protozoal infection. As judged by the interaction at the cellular level between the oxygen-dependent and -independent antimicrobial mechanisms of the human mononuclear phagocyte and the intracellular protozoa, Toxoplasma gondii and Leishmania donovani, these determinants include the cell's state of maturation and activation, the magnitude of the phagocyte's oxidative burst capacity, the ability of the cell to respond specifically to parasite ingestion with the production of toxic oxygen intermediates, parasite susceptibility to H2O2, and the presence of and protozoan susceptibility to oxygen-independent mechanisms.

Host-Parasite Interactions↗
PubMed1985

Patients at risk for AIDS-related opportunistic infections. Clinical manifestations and impaired gamma interferon production.

We studied 81 men (79 homosexuals and 2 drug abusers) with persistent lymphadenopathy to determine whether those at risk for AIDS-related opportunistic infections could be identified prospectively. (Sixty-nine of 76 [91 per cent] had antibodies to human T-cell lymphotropic virus Type III [HTLV-III], and 76 of 79 [96 per cent] had abnormal T4/T8 cell ratios.) During the follow-up period (mean +/- S.E.M., 12.9 +/- 0.5 months; range, 8 to 19), infections developed in none of 38 patients with lymphadenopathy alone and in only 1 of 15 (7 per cent) with antecedent herpes zoster infection; however, 13 of 28 (46 per cent) with lymphadenopathy accompanied by constitutional symptoms or oral candidiasis or both had opportunistic infections within the follow-up period. Among the results of various T-cell assays, only antigen-stimulated lymphocyte proliferation and gamma interferon generation, which were absent or barely measurable in those in whom AIDS ultimately developed, were of prognostic value. T cells from 15 patients, 11 of whom had constitutional symptoms or thrush, failed to generate antigen-induced gamma interferon; infections developed in 10 of these 15 (67 per cent) within a mean of 8.2 months. These results suggest that patients with AIDS-related complex who are at risk for opportunistic infections within a year can be identified by correlating clinical manifestations with antigen-stimulated T-cell responses--in particular, with the production of gamma interferon.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Liver macrophages in murine listeriosis. Cell-mediated immunity is correlated with an influx of macrophages capable of generating reactive oxygen intermediates.

Sublethal infection of mice with Listeria monocytogenes was accompanied by an influx of immigrant macrophages into the liver and the generation of substantial H2O2 by isolated liver macrophages. H2O2 production paralleled the course of infection and, after resolution of granulomata, returned to the low levels seen in normal livers. To assess the activation status of Kupffer cells and immigrant macrophages in listeriosis, a separation protocol was developed based on the differential adherence properties of the two macrophage populations. As in the steady state, Kupffer cells in listeriosis failed to generate significant levels of H2O2 and did support the replication of internalized toxoplasmas. Immigrant macrophages produced substantial levels of H2O2 and could quantitatively account for H2O2 production by total liver macrophages. Our findings suggest distinct functions for Kupffer cells and immigrant macrophages.

Animals↗
PubMed1985

Murine Kupffer cells. Mononuclear phagocytes deficient in the generation of reactive oxygen intermediates.

Murine Kupffer cells (KC) were isolated by a high yield collagenase perfusion technique. The morphology, surface markers, and secretory products were typical of macrophages in other tissues. However, KC released negligible levels of H2O2 and O-2, in contrast to peritoneal macrophages. KC oxygen consumption was not increased by agents triggering a respiratory burst in peritoneal cells. Moreover, KC capacity to secrete reactive oxygen intermediates (ROI), in contrast to Ia antigen expression, was not enhanced by exposure to lymphokines or recombinant gamma interferon. The selective defect in KC oxidative response was paralleled by impaired in vitro killing of Toxoplasma gondii trophozoites and Leishmania donovani promastigotes and amastigotes. Deficient secretion of ROI by KC might protect hepatocytes and erythrocytes from injury during endocytosis by KC, but might render the liver more susceptible to parasitization by organisms that are primarily killed through oxygen-dependent mechanisms.

Animals↗
PubMed1985

Production of and in vitro response to interleukin 2 in the acquired immunodeficiency syndrome.

To test the hypothesis that deficient interleukin 2 (IL-2) secretion may underlie the impaired capacity of T cells from patients with Acquired Immunodeficiency Syndrome (AIDS) and the AIDS-related complex (ARC) to generate the macrophage-activating lymphokine, gamma interferon (IFN-gamma), we used five specific microbial antigens to examine IL-2 production. Mononuclear cells from only one of 32 (3%) AIDS patients secreted normal levels of IL-2, and 21 (66%) failed to produce any detectable IL-2. For 36 ARC patients, IL-2 generation was normal in nine (25%) and absent in 11 (31%). Given these results, recombinant (r) IL-2 was tested for its capacity to stimulate or enhance IFN-gamma production. rIL-2 (10 U/ml) alone stimulated cells from controls, ARC, and AIDS patients to secrete 93 +/- 25, 99 +/- 33, and 7 +/- 3 U/ml of IFN-gamma, respectively. rIL 2 (10 U/ml) plus antigen induced no change in mean IFN-gamma levels for controls, a 4.4-fold increase for 17 AIDS patients (16 +/- 16 vs. 71 +/- 21 U/ml), and a 7.2-fold increase (18 +/- 5 vs. 130 +/- 27 U/ml) for 19 ARC patients with abnormal IFN-gamma generation to antigen alone. Individual responses indicated that six of the 17 (35%) AIDS patients with opportunistic infections and 12 of the 19 (63%) with ARC were apparent responders to 10-100 U/ml of rIL-2. These results (a) document profound impairment in antigen-induced IL-2 secretion by AIDS and ARC T cells, (b) indicate that, in vitro, mononuclear cells from certain patients can respond to rIL-2 with enhanced IFN-gamma production, and thus (c) suggest that in selected patients rIL-2 might have a potentially beneficial therapeutic (AIDS) or prophylactic (ARC) effect against opportunistic infections.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Salmonella infections in patients with the acquired immunodeficiency syndrome.

Defects in T-cell function have been seen in patients with the acquired immunodeficiency syndrome. Although the cellular immune system plays a key role in host defense against Salmonella, there have been no detailed reports of salmonellosis in patients with this syndrome. We report our experience with salmonella infections in six patients. Salmonellosis in these patients was unusually severe, characterized by widespread infection, bacteremia, and relapse, despite standard antibiotic treatment. Because of the difficulty in eradicating salmonella infection in patients with the acquired immunodeficiency syndrome, long-term suppressive treatment with antibiotics seems warranted.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Human mononuclear phagocyte antiprotozoal mechanisms: oxygen-dependent vs oxygen-independent activity against intracellular Toxoplasma gondii.

To determine if the oxygen-dependent and -independent antiprotozoal mechanisms with which the human mononuclear phagocyte is equipped to act against Leishmania donovani operate against other intracellular parasites, oxidatively intact and deficient cells were challenged with Toxoplasma gondii. Fresh monocytes and lymphokine- or gamma-interferon (IFN-gamma)-activated macrophages from normal individuals killed 35% and 50% of T. gondii within 6 hr, respectively, and each of these cell populations inhibited the replication of surviving parasites 20 hr after infection. This activity was associated with the capacity to release large amounts of H2O2 (572 to 971 nmol/mg) and to respond to toxoplasma ingestion with respiratory burst activity. Impairing the ability to generate oxygen intermediates by glucose deprivation or treatment with superoxide dismutase, catalase, or mannitol inhibited toxoplasmacidal activity by greater than 80% and permitted a 2.6- to 4.3-fold increase in the number of intracellular toxoplasmas. In contrast to normal cells, fresh monocytes from patients with chronic granulomatous disease (CGD) killed less than 8% of toxoplasmas and exerted 50% less toxoplasmastatic activity. However, although associated with the induction of only modest toxoplasmacidal effects (18 to 20% killing), lymphokine stimulation did induce CGD monocytes and macrophages as well as oxidatively inactive human endothelial cells to display near normal levels of toxoplasmastatic activity. Similar to oxygen-dependent mechanisms, the enhancement of oxygen-independent activity by crude lymphokines could be abolished by a monoclonal anti-IFN-gamma antibody and could be achieved by treatment with recombinant IFN-gamma alone. Unstimulated CGD monocytes, however, were found to lose all antitoxoplasma activity after two days in culture, whereas normal cells continued to effectively inhibit T. gondii replication, suggesting that oxygen-independent responses may not actually be required for the normal monocyte to act against T. gondii. Taken together with previous findings with L. donovani, these results indicate that the human mononuclear phagocyte possesses an oxygen-independent antiprotozoal mechanism and that its effects can be enhanced by lymphokines (IFN-gamma), but that nevertheless this cell's primary response to intracellular protozoa is largely oxygen dependent.

Endothelium↗
PubMed1985

Activation of mouse peritoneal macrophages in vitro and in vivo by interferon-gamma.

To determine the role of IFN-gamma in the activation of resident mouse peritoneal macrophages, crude macrophage-activating lymphokines were incubated with a monoclonal anti-murine IFN-gamma antibody. This treatment abolished the capacity of mitogen-induced lymphokines to enhance either H2O2 release or activity against the intracellular protozoa Toxoplasma gondii and Leishmania donovani. All macrophage-activating factor detected by these assays was also removed by passing the lymphokines over a Sepharose column to which the monoclonal anti-IFN-gamma antibody had been coupled. Therefore, pure murine rIFN-gamma was tested both in vitro and in vivo as a single activating agent. After 48 hr of pretreatment in vitro with 0.01 to 1 antiviral U/ml, macrophage H2O2-releasing capacity was enhanced an average of 6.4-fold; half-maximal stimulation was induced by 0.03 U/ml. Resident macrophages infected with T. gondii half-maximally inhibited parasite replication after 24 hr of preincubation with 0.14 U/ml of rIFN-gamma, and near complete inhibition was achieved by pretreatment with 100 U/ml. Half-maximal leishmanicidal activity was induced by 0.08 U/ml of rIFN-gamma, and 67 to 75% of intracellular L. donovani amastigotes were killed after macrophages were preincubated with 10 to 100 U/ml. Eighteen hours after parenteral injection of rIFN-gamma, peritoneal macrophages displayed a dose-dependent enhancement of H2O2-releasing capacity and antiprotozoal activity. Half-maximal enhancement required 85 to 250 U or rIFN-gamma given i.p. Peritoneal macrophages were also activated by rIFN-gamma injected i.v. and intramuscularly. These results suggest that, in the mouse model, IFN-gamma is likely to be a primary factor within mitogen-induced lymphokines responsible for activating macrophage oxidative metabolism and antiprotozoal activity, and indicate that rIFN-gamma is a potent activator of these effector functions both in vitro and in vivo. These findings provide a rationale for evaluating rIFN-gamma in the treatment of systemic intracellular infections, and indicate that murine models are appropriate for such studies.

Animals↗