Letter: Immunopathology of infectious mononucleosis.
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Biomedical subjects
Publications and source records attributed to N R Ling.
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Evidence is presented which indicates a possible reduction in recognition capacity for tumour cell antigens (EB(2) Burkitt lymphoma cell line) by lymphocytes from some patients with longstanding but inactive Crohn's disease. Three out of seven patients tested also showed diminished or absent lymphocytotoxicity when their cells were grown in mixed culture with chromium-labelled lymphoma cells and absent response has never been observed in a large series of controls similarly tested. In both test systems impaired reactivity appeared to be partly caused by a factor present in Crohn's disease serum. Increased tumour incidence in Crohn's disease may in part be attributable to defective immune surveillance and the histology of Crohn's disease could reflect an imbalance between the proliferative and the cytotoxic responses of lymphocytes to various antigens in the bowel lumen in this disease.
The lymphocytes of patients with coeliac disease are shown to have a significant diminution of proliferative and cytotoxic capacity as compared to normal lymphocytes when challenged in vitro with tumour cells from a lymphoma cell line. This impaired responsiveness is partly related to an intrinsic cellular defect but an inhibiting factor in the serum of coeliac patients has also been demonstrated. The impaired coeliac lymphocyte response in this in-vitro test system may serve as an indicator of a comparable defect in immune surveillance in vivo. This would account for the increased incidence of lymphosarcoma known to arise in patients with longstanding coeliac disease and might also explain the raised incidence of other gut-related tumours in these patients.
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