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Lymphocyte subset counting by immunoperoxidase using an automated routine hematologic analyzer.

Using monoclonal antibodies against CD2, CD4, CD8 and CD19 antigens and an automated biotin-avidin immunoperoxidase technique on whole blood samples, we evaluated the technical performance and clinical usefulness of lymphocyte subset counting by the routine hematology analyzer Technicon H*1. Statistical evaluation demonstrated excellent precision and very good correlation with the immunofluorimetric flow cytometer Ortho Spectrum III. Correlation between manual immunofluorescence at the microscope and the H*1 method was much poorer, owing to the high intrinsic imprecision of the manual method. Reference ranges obtained with the H*1 immunoperoxidase method in 44 healthy subjects closely matched those obtained with the Spectrum III. In 46 subjects with or at risk for HIV infection, we found with the H*1 method a significant decrease in CD4+ cells and in the CD4+/CD8+ cell ratio, which was progressively more marked in HIV- negative patients with lymphadenopathic syndrome, AIDS-related complex, and in patients with full-blown AIDS.

Antibodies, Monoclonal↗

Alterations in serum antibody and peripheral T-lymphocyte subsets resulting from treatment of murine immune complex glomerulonephritis with PGE2.

The effects of treatment with 16,16-dimethyl prostaglandin E2 (DMPGE2) on histologic damage, glomerular immune complex deposition, serum total IgG subclass levels, anti-apoferritin IgG levels, and peripheral blood T-lymphocyte subsets were determined in apoferritin-induced immune complex glomerulonephritis of mice. The results demonstrate that doses of DMPGE2 ranging from 2.5 to 10 micrograms twice daily significantly reduced the degree of glomerular damage in a dose-dependent manner. Similarly, these doses of DMPGE2 reduced the amount of immunoglobulin deposition along peripheral capillary loops. Total IgM, IgG1, IgG2a, and IgG2b were unaffected by DMPGE2 administration. Serum anti-apoferritin IgG levels were significantly reduced in mice receiving DMPGE2 at doses of 5 and 10 micrograms twice daily. Nephrotic mice had significantly reduced peripheral blood total T lymphocytes (Lyt-1+) and a reduction of T-suppressor (Lyt-2+) cells. Administration of DMPGE2 at doses of 5 and 10 micrograms twice daily prevented these T-lymphocyte alterations. These studies indicate that treatment of mice receiving apoferritin with DMPGE2 may prevent glomerulonephritis by altering both cellular and humoral immune responses.

16,16-Dimethylprostaglandin E2↗

[T-lymphocyte subsets in 20 cases of uveitis of various type].

Lymphocyte T subsets are determined by system OKT in 20 patients with various types of uveitis (Behçet disease 8, Vogt-Koyanagi-Harada disease 5, anterior uveitis 4, Kirisawa type uveitis 1, uveitis associated with Psoriasis vulgaris 1, undetermined type uveitis 1). Augmentation of OKT 8+ (p less than 0.05) associated with reduction of OKT 4+/OKT 8+ was found as compared with normal individuals. Diminution of OKT 4+/OKT 8+ (p less than 0.05) was noted in 5 patients with Behçet disease in association with augmentation of OKT 8+ (p less than 0.005). In Vogt-Koyanagi-Harada disease there is augmentation of OKT 8+ (p less than 0.05) which is, however, not so marked as in Behçet disease. On the contrary anterior uveitis was characterized by a remarkable rise in OKT 4+/OKT 8+.

Antibodies, Monoclonal↗

Interrelations of lymphocyte subset values, human immunodeficiency virus antibodies, and HIV antigen levels of homosexual males in San Francisco.

Serum and leukocytes from a cohort of homosexual males were analyzed to determine the interrelationships of antibodies to human immunodeficiency virus (HIV), serum HIV antigen levels, and phenotypical differences in lymphocyte subpopulations of HIV antibody-positive (HIV Ab+) and HIV antibody-negative (HIV Ab-) homosexual males. Significant reductions were observed in the percentages of B lymphocytes, CD4+ and CD4+ kappa lambda- T lymphocytes and the CD4+/CD8+ ratios of HIV Ab+ homosexual males in comparison to HIV Ab- homosexual males. Significant increases were observed in the percentages of CD8+, CD8+ CD11b-, CD8+ kappa lambda-, CD8+ DR+, CD8+Leu7+, and Leu7+ lymphocytes of HIV Ab+ study subjects. Statistical analysis revealed that among the immunological variables tested, decreases in the CD4+/CD8+ ratio and in the percentage of CD4+ kappa lambda- lymphocytes showed the strongest associations with HIV-sero-positivity in asymptomatic homosexual males. Only 44 (16.5%) of 267 HIV Ab+ homosexual males had detectable levels of HIV antigen (HIV Ag) in their serum. The percentages of CD4+ or CD4+ kappa lambda- lymphocytes and the CD4+/CD8+ ratios of HIV Ab+ males differed significantly between HIV Ag-positive (HIV Ag+) and--negative (HIV Ag-) homosexual males. These variables, however, did not correlate well with HIV Ag levels,indicating that no clear associations can be drawn between levels of HIV antigen and lymphocyte subset abnormalities of HIV-infected individuals.

Acquired Immunodeficiency Syndrome↗

Cellular immunity and T-lymphocyte subsets in young children with acute measles.

The changes occurring in the T-cell subsets during acute symptomatic measles were examined in ten malnourished and 18 well nourished hospitalized children younger than 5 years of age (median age 14 months). A significant decrease in total lymphocyte count was observed, which was due mainly to a decrease in helper/inducer T lymphocytes, whereas the suppressor/cytotoxic T-lymphocyte subset remained unchanged. Consequently, helper/suppressor ratio decreased significantly during the acute phase of the disease. A reduced response to mitogens (PHA, Con A, PWM) was also observed. Malnourished infants showed a trend toward a deeper depression in both helper and suppressor T cells during the acute phase than well nourished children, whereas the helper/suppressor ratio remained similar in the two groups.

Acute Disease↗

Different Trypanosoma cruzi strains promote neuromyopathic damage mediated by distinct T lymphocyte subsets.

The proliferative response of CD4 and CD8 T lymphocytes obtained from C3H/HeN mice chronically infected with Trypanosoma cruzi strains that differ in virulence, tropism and immunogenicity, was assayed against skeletal muscle, sciatic nerve and spinal cord homogenates. Although both CD4 and CD8 T lymphocytes from mice infected with the RA strain strongly proliferated against the nervous system, no response against skeletal muscle antigens was detected. CD4 and CD8 T lymphocytes from mice infected with the K-98 clone (from CA-I strain) showed low proliferative response against all the antigens assayed. To determine whether the proliferation patterns showed correlation with T cell-mediated neuromuscular damage, passive cell transfer studies were performed. Fifteen days after transfer of CD4 T cells from RA-infected donors (CD4-RA), normal syngeneic recipients displayed exclusively nervous tissue damage, such as perineural, endoneural and/or meningeal inflammatory infiltrates, with predominance of CD4 T cells. Fifteen days after transfer of CD4 T lymphocytes from mice infected with K-98 (CD4-K98), recipients showed inflammatory infiltrates only in skeletal muscle, where CD4 T lymphocytes and macrophages were predominant cells. Recipients of CD8 T cells from RA-infected mice (CD8-RA) showed lesions in both spinal cord and sciatic nerves. Higher percentages of CD8 T cells were observed in comparison with the recipients of CD4-RA or CD4-K98. In contrast, CD8 T cells from K-98-infected donors (CD8-K98) did not induce tissue damage. These results provide evidence that mice infected with T. cruzi populations that differ in their biological characteristics show diverse immune mechanisms that may be involved in the pathogenesis of peripheral nervous system damage.

Adoptive Transfer↗

T-lymphocyte subsets in lymph nodes from homosexual men.

To evaluate further the immunodeficiency of homosexual men, blood and lymph node specimens were obtained from five homosexual men with lymphadenopathy and from seven homosexual men with Kaposi's sarcoma. Monoclonal antibodies were used to identify T-lymphocyte subsets in blood by cytofluorometry and in frozen sections of nodes by immunoperoxidase techniques. The homosexuals with Kaposi's sarcoma had a T-helper/suppressor ratio in blood of 0.7; the homosexuals with lymphadenopathy had a ratio of 0.6, compared with controls of 2.1. Control lymphoid tissue had a ratio of 3.0 in the interfollicular areas compared with the reactive lymph nodes in the homosexuals with lymphadenopathy, which was 0.7, and nodes from patients with Kaposi's sarcoma, 0.9. The nodes from homosexual men had evident numerous suppressor cells in the follicular center and mantle regions, locations in normal lymphoid tissue where suppressor cells were uncommon.

Flow Cytometry↗

Immunoelectron microscopic application of monoclonal antibodies for identification of lymphocyte subsets bearing tubuloreticular inclusions or parallel tubular arrays.

Reactions of mouse monoclonal antibodies with T-cell, B-cell, or NK cell antigens were localized for electron microscopy by the formation of avidin-biotin-peroxidase complexes using direct or indirect labeling techniques. The techniques proved advantageous for identification of lymphocyte subsets bearing two different types of cytoplasmic structures: tubuloreticular inclusions (TRI) which have been related to interferon treatment or to diseases involving systemic immune dysfunctions, and parallel tubular arrays (PTA) which may be normal structures. Mononuclear cell samples were isolated from the peripheral blood of patients with systematic lupus erythematosus (SLE), acquired immunodeficiency syndrome (AIDS), or chronic hepatitis B (CHB). Results depended upon the fixation, the type of specific antibody, and the concentrations employed. Brief fixation in 1% glutaraldehyde/1% paraformaldehyde proved useful for stable preservation of both the inclusion fine structure and surface antigen activity, even after prolonged storage in buffer. The T-cell subset antigens (Leu-2a and Leu-3a) were more labile than the pan-T-cell antigen (Leu-1), the B-cell surface antigen (Leu-10), or the NK cell antigen (Leu-7). Localization of the former was improved by a two-step labeling procedure with primary and secondary antibodies. Both TRI and PTA were identified in T cells. Either type of inclusion could be found in the suppressor/cytotoxic or helper/inducer T-cell subsets. TRI also were found in a few anti-Leu-10 reactive cells. A crystalline form of PTA was identified in anti-Leu-1 and anti-Leu-7 reactive cells.

Acquired Immunodeficiency Syndrome↗

Abnormalities of T-lymphocyte subsets in epileptic patients.

This study concerns the distribution of T-cell subsets as determined by specific monoclonal antibodies in 50 individuals with complex partial seizures (31) and primary generalized tonic-clonic seizures (19), and in 30 healthy controls. The epileptic group had significantly fewer circulating T4 "helper" lymphocytes and significantly greater number of T8 "suppressor" lymphocytes than the controls. The T4/T8 ratio was consistently significantly lower in the epileptic group. There was no relation between lymphocyte subsets or T4/T8 ratio and antiepileptic medication. The results suggest a derangement of cell-mediated immunity in individuals with epilepsy.

Adolescent↗

Distribution of lymphocyte subsets following radiation therapy directed to different body regions.

Local radiation therapy may severely deplete the recirculating pool of lymphocytes as manifested by a reduction of blood lymphocyte counts. There is considerable controversy, however, concerning the changes of the distributions of subsets of blood lymphocytes during the acute and late phases after irradiation. This report provides evidence that radiation therapy directed to different anatomic sites may change the distribution of subsets of blood lymphocytes in different ways. For instance, during the acute phase after radiation therapy for breast cancer there is a more extensive reduction of the proportion of lymphocytes with receptors for C3 than that of lymphocytes with receptors for sheep erythrocytes (characteristics of B- and T-cells respectively). Such a difference, however, was not observed in groups of patients receiving pelvic irradiation. The controversy in the literature concerning the distribution of lymphocyte subsets after irradiation may thus in part be due to the fact that the patients examined have received radiation therapy to different body regions.

Adult↗

Analysis of blood CD4+ and CD8+ T-lymphocyte subsets with monoclonal antibodies. Comparison of the Genetic Systems CD4/CD antigen typing kit with conventional indirect immunofluorescence microscopy and the automated Technicon-H1 Enzyme Immunoassay (EIA).

The Genetic Systems Technique (GS: direct immunofluorescence microscopy with ethidium bromide counterstaining of nuclei) was tested for quantitative analysis of T-lymphocyte subsets in human peripheral blood. The monoclonal antibodies anti-CD4 and anti-CD8 were used for detection of T-helper and T-suppressor cells respectively and the results compared to those obtained by conventional indirect immunofluorescence microscopy and the Technicon Enzyme Immunoassay (EIA) with automated reading. The GS technique provided results correlating well with both indirect immunofluorescence and EIA techniques. Moreover, this method has two advantages: it is less time-consuming than the indirect immunofluorescence microscopy and necessitates less expensive and more commonly available equipment than the automated EIA technique.

Antibodies, Monoclonal↗

Lymphocyte subsets in children with aplastic anemia.

Twenty-four patients with aplastic anemia (AA) were evaluated with immunologic studies. Patients with posthepatitis AA had decreased proportions of T4 cells, increased proportions of T8 cells, and decreased T4:T8 ratios. Patients with constitutional AA had varied immunologic findings. There were no significant abnormalities in lymphocyte subsets in patients with idiopathic AA. Of the 12 patients who were treated with antithymocyte globulin (ATG), six (50%) responded. Nine of these patients are living 3-27 months after treatment; three of the nine are transfusion dependent. T-cell subsets were not helpful in predicting the response to ATG. Measurements of other immunologic mediators may be more useful with regard to pathophysiology and prognosis in AA.

Adolescent↗

Binding of histamine and histamine analogs to lymphocyte subsets analyzed by flow cytometry.

The binding of histamine, 4-methylhistamine (a histamine type 2 receptor agonist), cimetidine (a histamine type 2 receptor antagonist), and telemethylhistamine (an inactive analog) to human peripheral blood mononuclear cell subsets was investigated by flow cytometry by using conjugates of these ligands coupled to fluorescein-labeled human serum albumin. Our results indicate that binding of fluorescent protein conjugates of histamine and its analogs does not selectively identify a lymphocyte subset(s) that mediates the immunomodulatory effects of histaminergic ligands. Conjugates with both low (2.5 to 2.8:1) and high (28 to 57:1) ligand to protein coupling ratios were used. No binding above background could be detected for the low mole ratio reagents. The high mole ratio reagents were bound by 95 to 99% of all lymphocytes when used at ligand concentrations of 50 microM or greater. At lower ligand concentrations, the number of lymphocytes exceeding a set fluorescence threshold was decreased, but fluorescence distributions remained unimodal at all concentrations used (1 to 500 microM). Monocytes also bound the high mole ratio reagents and gave rise to a second high-intensity peak in the fluorescence distribution unless they were excluded by other means. Levels of conjugate binding detected by flow cytometry did not parallel ligand potencies at classical histamine type 2 receptors; at equivalent ligand concentrations, approximately equal amounts of histamine or 4-methylhistamine conjugate were bound per lymphocyte, and only 30% less telemethylhistamine conjugate was bound. Competition with free ligands (10(2)- to 10(4)-fold excess histamine, 4-methylhistamine, cimetidine, or telemethylhistamine) did not significantly decrease the level of binding observed for the high mole ratio reagents at bound ligand concentrations of 1 to 25 microM. Dual staining with fluorescein-labeled conjugate and phycoerythrin-labeled monoclonal antibodies Leu-3ab (anti-helper T), Leu-2a (anti-suppressor T), Leu-M3 (anti-monocyte), or anti-HLA-DR (B cells and monocytes) was also carried out. The extent of conjugate binding to helper and suppressor cells was identical for each of the ligands used, but higher levels of conjugate binding were seen for monocytes and B cells than for T cells in every case. Our data do not exclude the possibility of enhanced conjugate binding to small numbers of activated (HLA-DR positive) T cells that might be involved in mediation of histamine effects.(ABSTRACT TRUNCATED AT 400 WORDS)

Binding Sites↗

Lymphoproliferative responses to mouse mammary tumor virus in lymphocyte subsets of breast cancer patients.

Altered immunologic reactions were observed in breast cancer patients as compared to those in normal subjects. Lymphoproliferative responses to murine mammary tumor virus (MuMTV) were significantly enhanced in peripheral blood mononuclear cells from patients with metastatic disease. These reactivities occurred with mammary tumor virus purified from either mouse milk or infected feline kidney cells but not with Rauscher murine leukemia virus. For the assessment of the role of peripheral blood mononuclear leukocyte subpopulations in the responsiveness to MuMTV, the cell preparations were fractionated according to their ability to form spontaneous rosettes with sheep red blood cells (E-rosettes). The effectiveness of the separation was ascertained by means of cell surface markers, i.e., presence of surface immunoglobulins or a T-cell marker. Leu-1 antigen, and mitogen-induced blastogenesis. The responsiveness to the MuMTV antigen(s) was associated with the T-cell subset, identified as the E-rosetting. Leu-1-positive, and surface immunoglobulin-negative population. Although some subjects with the normal population gave positive reactions, the results reveal an apparent association between high levels of responsiveness to MuMTV within the T-lymphocyte subset and breast cancer disease.

Antigens, Viral↗

Lymphocyte subset ratios and factor VIII usage in haemophilia.

Type and quantity of replacement treatment, together with haematological and immunological parameters were determined in 37 boys with severe haemophilia A and 41 children with other bleeding disorders. The quantity of factor VIII concentrate given to boys with severe haemophilia A (mean U/year) showed a significant inverse correlation with total white cell counts, lymphocyte counts, platelet counts, and the ratio of monoclonal antibody defined T lymphocyte subsets, T4 and T8 (T4:T8). Of the boys with severe haemophilia A, 49% had inversed T4:T8 ratios and 24% had thrombocytopenia. Treatment with high dose factor VIII concentrate (more than 25 000 U/year) was associated with low platelet counts, low lymphocyte counts, low T4:T8 ratios, and hypergammaglobulinaemia. In addition, six patients with severe haemophilia A and factor VIII inhibitors had inversed T4:T8 ratios. Patients treated exclusively with cryoprecipitate or prothrombin complex concentrates had normal T4:T8 ratios and platelet counts. The severity of the haematological and immunological abnormalities observed seems to be associated with high usage of factor VIII concentrates. Similar abnormalities have been described in patients with the acquired immune deficiency syndrome (AIDS). Prospective study of haemophiliacs is required to assess long term sequelae of factor concentrate usage, including the possible development of AIDS.

Child↗

A controlled study of lymphocyte subsets in rheumatoid arthritis.

The purpose of this study was to determine if patients with rheumatoid arthritis (RA) exhibited unique patterns of peripheral blood lymphocyte (PBL) subsets in comparison to patients with osteoarthritis (OA) and, further, if such differences related to disease activity or nondisease factors. Data from 63 RA patients and 47 OA patients revealed that the RA patients had lower absolute numbers of CD2+ and CD4+ lymphocytes. Small differences also were found in selected B-cell subsets and subsets of lymphocytes expressing CD16 and/or CD57 antigens. Further analysis revealed that these differences were due primarily to the effects of cytotoxic medications in the RA group. However, there were also alterations in some subsets independent of medication groups. PBL subsets in RA patients did not relate to chronic low-dose prednisone or measures of disease activity. This study demonstrated the need to control carefully for variables such as age and medication in immunophenotypic investigations of RA.

Aging↗

Immunophenotypic analysis of blood and spleen lymphocyte subsets in rats protected against schistosomiasis by cyclosporin A.

The antischistosomal property of a short course of cyclosporin A (CsA), administered at the time of infection was demonstrated in the rat. In comparison with vehicle-treated controls, no schistosomes were recovered from CsA-treated animals, 18-19 days post infection. Flow cytometric analysis of blood and spleen lymphocyte populations from rats protected by CsA revealed no significant changes in functional T lymphocyte subsets, B cells or Ia-positive cells. Moreover, there were no significant differences in eosinophil numbers between the two experimental groups. These data add credence to the view that the unexplained antischistosomal property of cyclosporins is not mediated immunologically.

Animals↗

Influence of sexual preference and chronic hepatitis B virus infection on T lymphocyte subsets, natural killer activity, and suppressor cell activity.

To determine whether abnormalities of cell-mediated immunity are associated with chronic hepatitis B virus infection or with homosexuality, we studied 15 homo- and 11 heterosexual men with chronic hepatitis B virus infection, as well as 11 homo- and 16 heterosexual apparently healthy men. T lymphocyte subsets, natural killer activity, and suppressor cell activity were determined. Homosexual men had significantly lower peripheral blood T4/T8 ratios resulting from a significant increase in T8-positive (suppressor/cytotoxic) cells, and they also had lower natural killer activity. These effects of homosexuality were independent of chronic hepatitis B virus infection, which caused no significant changes independent of homosexuality, and they were not caused by infection with human immunodeficiency virus (formerly HTLV-III/LAV). Suppressor cell function was unaltered in this study. We conclude that studies of cellular immunity in hepatitis B virus infection must take male sexual preference into account.

Acquired Immunodeficiency Syndrome↗