Search

Background: Accurate survival stratification in early-stage non-small cell lung cancer (NSCLC) could inform the use of adjuvant therapy. We developed a clinically implementable mortality risk score incorporating distinct tumor microenvironmental gene expression signatures and clinical variables., Methods: Gene expression profiles from 1106 nonsquamous NSCLCs were used for generation and internal validation of a nine-gene molecular prognostic index (MPI). A quantitative polymerase chain reaction (qPCR) assay was developed and validated on an independent cohort of formalin-fixed paraffin-embedded (FFPE) tissues (n = 98). A prognostic score using clinical variables was generated using Surveillance, Epidemiology, and End Results data and combined with the MPI. All statistical tests for survival were two-sided., Results: The MPI stratified stage I patients into prognostic categories in three microarray and one FFPE qPCR validation cohorts (HR = 2.99, 95% CI = 1.55 to 5.76, P < .001 in stage IA patients of the largest microarray validation cohort; HR = 3.95, 95% CI = 1.24 to 12.64, P = .01 in stage IA of the qPCR cohort). Prognostic genes were expressed in distinct tumor cell subpopulations, and genes implicated in proliferation and stem cells portended poor outcomes, while genes involved in normal lung differentiation and immune infiltration were associated with superior survival. Integrating the MPI with clinical variables conferred greatest prognostic power (HR = 3.43, 95% CI = 2.18 to 5.39, P < .001 in stage I patients of the largest microarray cohort; HR = 3.99, 95% CI = 1.67 to 9.56, P < .001 in stage I patients of the qPCR cohort). Finally, the MPI was prognostic irrespective of somatic alterations in EGFR, KRAS, TP53, and ALK., Conclusion: The MPI incorporates genes expressed in the tumor and its microenvironment and can be implemented clinically using qPCR assays on FFPE tissues. A composite model integrating the MPI with clinical variables provides the most accurate risk stratification., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

RA is a chronic inflammatory disease characterized by the persistent expression of inflammatory cytokines from macrophages, which may be mediated, in part, through TLR2 signaling. Earlier studies demonstrate a role for TLR2 signaling in dampening the arthritis in IL-1Ra-/- mice, which was mediated through T cells. This study was performed to determine whether TLR2 signaling plays a role in the pathogenesis of T cell-independent arthritis triggered by transferring serum from K/BxN mice. We documented more severe arthritis in Tlr2-/- mice compared with WT controls. The Tlr2-/- mice also demonstrated increased inflammation, erosion, pannus formation, and osteoclastogenesis, as well as increased IL-1β and decreased IL-10 within the joints. In vitro bone marrow-differentiated macrophages expressed comparable levels of activating and inhibitory FcγRs, however when stimulated with immune complexes, the Tlr2-/- macrophages expressed decreased IL-10 and reduced activation of Akt and ERK. Our findings indicate that Tlr2-/- promotes the effector phase of arthritis through decreased IL-10 by macrophages, which is important, not only as an anti-inflammatory cytokine but also in restraining the differentiation and activation of osteoclasts.

Monocyte activation in response to recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) was examined in vitro in septic shock patients. These monocytes exhibited a greater respiratory burst activity than monocytes from healthy subjects; the response to secondary stimulation with bacterial stimuli was attenuated. GM-CSF restored the ability of monocytes to respond appropriately to secondary stimulation. Expression of certain integrin adhesion molecules, L-selectin, and Fcgamma receptors was increased on monocytes of septic shock patients; expression of CD11c was reduced. GM-CSF up-regulated integrin expression and decreased L-selectin, FcgammaRII, and FcgammaRIII expression. Septic patients exhibited greater biologic activity of monocyte tissue factor than did healthy subjects. Priming monocytes with GM-CSF accelerated tissue factor activation following stimulation with lipopolysaccharide and bacterial culture supernatant. Certain parameters of monocyte function may be restored by exposure to GM-CSF. This benefit may be offset by an increase in monocyte procoagulant activity.

Data from a previous study suggested that peripheral blood monocytes in patients with rheumatoid arthritis (RA) may be activated. Therefore, in this study we sought further evidence of 'presynovial' activation of monocytes. Our results show that phenotypic changes are demonstrable in peripheral blood monocytes in patients with RA, including increased expression of CR3 (CD11b/CD18) and FcRI (CD64). However, changes are most extensive in synovial monocytes/macrophages and especially for HLA-DR and intercellular adhesion molecule-1 (ICAM-1) (CD54). We conclude that monocyte/macrophage activation is most evident within the joint, and that 'presynovial' changes occur but are of limited extent.

The lymphomyeloid cells isolated from normal first trimester pregnancy decidua may be separated into a CD56+ population of natural killer (NK)-lineage cells with the morphology of granulated lymphocytes, and a CD56- population which includes other cell types. Unlike CD56+ NK cells in peripheral blood, decidual CD56+ cells lack type III Fc receptors (CD16) and did not express significant levels of either type I FcR (CD64) or type II FcR (CDw32). By contrast to the decidual CD56- cells, CD56+ cells could release biologically active transforming growth factor (TGF)-beta in vitro, detectable using an normal rat kidney fibroblast colony-forming assay. The CD56+ cells could be stained using an antibody specific for TGF-beta 2, and similarly staining cells could be detected in intact biopsies of normal pregnancy decidua. Bioactive TGF-beta is known to suppress the generation of cytotoxic cells in vitro, and high performance liquid chromatography fractionation of supernatants conditioned by CD56+ but not CD56- cells contained reproducible peaks of immunosuppressive activity at 40-45 and 15-20 kDa, similar to the TGF-beta 2 immunosuppressive activity in supernatants conditioned by unfractionated decidua.

The Fc receptor (FcR) for immunoglobulin has been assigned a major role in the ingestion of Borrelia burgdorferi, the Lyme disease spirochete, by macrophages. Yet macrophages readily take up and kill B. burgdorferi that have not been opsonized. By use of doubly-labeled macrophages infected with spirochetes and analyzed by confocal fluorescence microscopy, simultaneous localization of both FcR and spirochetes (opsonized and unopsonized) was quantified. After infection with unopsonized spirochetes, bacterial surface antigen and the FcR remained distinct, confirming the expectation that unopsonized uptake of B. burgdorferi is largely independent of the FcR. A similar lack of colocalization was seen when opsonized spirochetes were ingested by macrophages whose FcRs were sequestered by an immune complex-coated substrate. Furthermore, comparable efficiency of uptake was observed whether or not the FcR was engaged.

We investigated the effect of human immunodeficiency virus type 1 (HIV-1) recombinant gp120 (rec.gp120) on phenotype and function of cultured monocytes. Rec.gp120 significantly reduced the accessory function of monocytes to stimulate autologous lymphocytes with anti-CD3, the Fc receptor-mediated chemiluminescence of monocytes, and the expression of CD4 and Fc receptor I/II, while the expression of the monocyte marker CD14 and major histocompatibility complex class I and II was not influenced. According to these phenotypic results, preincubation of monocytes with rec.gp120 depressed anti-CD3 antibody-induced T cell stimulation and Fc receptor-mediated phagocytosis as determined by chemiluminescence. Interferon-gamma release of lymphocytes induced by purified protein derivative of tuberculin was enhanced by gp120. These effects of isolated gp120 on monocyte immune functions in vitro might contribute to the understanding of the pathophysiology of HIV-1 infection in vivo.

We analysed the peritoneal cellular immune system 24-48 h before the onset of a clinical peritonitis. Peritoneal cells were obtained from the overnight dialysis effluents 1 or 2 days (day-1 and day-2) preceding the day of peritonitis, the last overnight effluent before the peritonitis effluent (day P), and the first peritonitis effluent. Nine peritonitis episodes of six patients were studied. The number of Fc receptor positive cells, the chemotactic activity, and immunophenotype of the peritoneal cell population at day-2 and day-1 were similar to the postperitonitis control effluent. However, immunophagocytosis and phagocytosis capacity of the peritoneal macrophages was decreased in five of six episodes at day-2 and -1 compared to control peritoneal macrophages. The overnight effluents of day P revealed a moderate influx of neutrophilic granulocytes and an increase of bacterial killing capacity and chemotactic activity. Activation of the peritoneal T cells at day P was shown by the increase in MHC class II positive T cells and an increase in the CD4/CD8 ratio. Bacterial cell cultures of the effluents were positive in three episodes 24-48 h before peritonitis, and of all overnight effluents at day P. These results indicate that malfunctioning of phagocytosis by peritoneal macrophages may contribute to the development of a CAPD peritonitis.

The mechanism of transmission of HIV from the male to the female genital tract or in the reverse order is not clear. CD4 glycoprotein is the receptor for HIV and Langerhans cells and the related dendritic cells could play a role in the initial transmission of HIV. Fc receptors (FcR) for IgG might be involved in antibody-mediated binding of HIV. We carried out an immunohistological study of normal human cervical and vaginal epithelia for the presence of CD4 glycoprotein, Langerhans cells and FcR to IgG. CD4+ glycoprotein was not found in the vaginal or cervical epithelium, with the exception of a few endocervical epithelial cells. A small number of CD4+ mononuclear cells were found in the endocervical epithelium of a third of the specimens but a large number of CD4+ cells was found in the submucosa of most of the cervical and vaginal specimens. Langerhans cells expressing CD4, HLA class II, Fc gamma R2 and Fc gamma R3 were detected in most vaginal, ectocervical and transformation zone epithelia and in 9/14 endocervical tissues. Fc gamma R3 was detected in about two-thirds of the columnar endocervical epithelium and the transformation zone. A smaller number of specimens expressed Fc gamma R2 in these epithelia, but Fc gamma R1 was not detected. We then demonstrated mRNA for Fc gamma R3 in the columnar endocervical epithelial cells and transformation zone by in situ hybridization, using a CD16-RNA probe. Fc gamma R3 and Fc gamma R2 gene transcripts were also found in fetal cervical tissue by applying the polymerase chain reaction to amplify portions of the Fc gamma R3 and Fc gamma R2 coding sequences in cDNA prepared from fetal RNA. HLA-DR was found in the endocervical cells, transformation zone and in Langerhans cells of all specimens. The presence of Langerhans cells, Fc gamma receptors and HLA class II antigen offers three potential mechanisms for cervico-vaginal HIV transmission: (i) direct HIV infection of Langerhans cells, (ii) binding of HIV antibody complexes to cervical epithelial Fc gamma receptors and (iii) binding of HIV infected CD4+ cells to cervical HLA class II antigen which may infect these or the adjacent CD4+ cells.

The low affinity IgE receptor Fc epsilon RII (CD23) is important in several aspects of T and B cell function. In this study serum levels of soluble CD23 (sCD23) were measured in three groups: 26 female patients with systemic lupus erythematosus (SLE), 21 females with primary Sjögren's syndrome (pSS) and 25 normal healthy females. The concentration of sCD23 was determined using an enhanced chemiluminescent sandwich ELISA developed in this laboratory. Increased levels of sCD23 were observed in pSS and in SLE patients compared with controls (median 23.0 versus 8.6, P less than 0.0002 and 18.1 versus 8.6, P less than 0.002 respectively). While the median level of sCD23 was found to be higher in pSS than in SLE the difference was not statistically significant. Patients with SLE and pSS on glucocorticoid treatment had significantly lower levels of sCD23 than patients not on this treatment (median 28.9 versus 14.4, P less than 0.05). Amongst the control patients sCD23 was inexplicably lower in the female members relative to the males (median 8.5 versus 12.3, P less than 0.05). Although serum IgG and IgA levels were significantly elevated in pSS and SLE patients relative to controls there was no direct correlation between sCD23 and the serum levels of these immunoglobulins. We conclude that B cell hyperactivity which occurs in both pSS and SLE is associated with raised levels of sCD23.

The expression of a range of surface molecules/receptors that are important in the host response to infection and foreign antigens was examined using peritoneal macrophages isolated from patients on continuous ambulatory peritoneal dialysis (CAPD) with peritonitis. The macrophage phenotypic profile was compared with that of normal peripheral blood monocytes. Consistently there was increased expression by macrophages of CD14, ICAM-1 (CD54), Fc gamma RI (CD64), Fc gamma RII (CDw32), Fc gamma RIII (CD16), transferrin receptors (CD71) and tissue factor. Increased expression of MHC class II was marginally significant. There was no detectable expression of either the p55 (CD25) or p70 chains of the IL-2 receptor. The expression of the complement receptors, CR1 (CD35) and CR3 (CD11b, CD18), was reduced. The activity of well-known inflammatory cytokines, rather than uraemic molecules, can account for the phenotypic profile of these extravasated peritoneal macrophages. The results of this study indicate that peritoneal macrophages from CAPD patients with peritonitis display a phenotype consistent with them being in vivo-derived inflammatory macrophages, and that they are appropriate for use in studies of anti-inflammatory agents.

The European collaborative study of HIV-infected pregnant women in Europe now indicates a 13% risk of fetal HIV infection (originally thought to be about 30%, and possibly higher in some countries). Several reports suggest trans-placental passage. However, the detailed mechanisms associated with such vertical transmission have not yet been clarified. We have examined the possibility that HIV enters placental tissue from maternal blood via binding to CD4 and Fc receptors (FcR) at the trophoblast level, allowing intraplacental infection. Here we report the detection of several FcR with distinct localization in the placental villus as well as CD4 surface expression on human trophoblast cells. In addition, we show that trophoblastic cells interact specifically with the gp120/gp160 viral envelope protein. By their tissue localization, these receptors could be responsible for the entry of HIV into the fetal placental cells. Furthermore, purified placental cells can be directly infected by HIV in vitro, and the infection is inhibited by soluble CD4. This suggests a crucial role of the CD4 receptor but an additional way of entry cannot be excluded. Such an in vitro model may be suitable for further studies concerning placental HIV transmission and its prevention.

The B and T cell responses were investigated in IgA nephropathy before and after immunization with tetanus toxoid (TT). Both IgA and IgG anti-tetanus toxoid antibodies were elicited, but the IgA antibodies were significantly greater in patients (92.6 +/- 11.7 ELISA units) than in the controls (49.2 +/- 7.5 ELISA units). This was associated with a significantly greater proportion of IgA+ B cells in patients than controls before immunization. However, a significant increase in the proportion of IgA1 binding CD4 and CD8 cells was also found. The proportion of CD3 cells with gamma delta T cell receptors (CD3+TCR gamma delta +), was significantly greater before immunization in the IgA nephropathy patients (37.0% +/- 2.4), compared with controls (10.0% +/- 2.3; P less than 0.001). Immunization with TT further enhanced the CD3+TCR gamma delta + cells in patients to 45.8% +/- 7.2 compared with controls (16.3% +/- 4.5), with a corresponding decrease in CD3+TCR alpha beta + cells in the patients (P less than 0.001). CD3+TCR gamma delta + cells are upregulated by common microbial antigens and clinical exacerbations of IgA nephropathy are frequently associated with mucosal infections and a rise in serum IgA concentration. The increased TCR gamma delta expression may be responsible for the enhanced IgA antibody response in IgA nephropathy. The increase in IgA antibodies may than exert a controlling effect by binding to augmenting T cells and thereby inhibiting their function.

The increased susceptibility of newborns to infection may in part be related to impaired in vitro functions of neonatal polymorphonuclear neutrophils (PMNs). To evaluate early steps in the activation cycle of bovine PMNs we determined the expression of Fc receptors (FcRs) with an erythrocyte rosetting assay utilizing bovine anti-sheep immunoglobulin G2 IgG2 and the accumulation of ligand receptor complexes or "caps" with fluorochrome-coupled concanavalin A (Con A caps) on neutrophils from adult (A-PMN) and newborn (N-PMN) bovines. In addition, the levels of myeloperoxidase (MPO) and alkaline phosphatase (AP) were determined. FcR expression is reduced in N-PMNs (P less than .001), in contrast to results observed with human N-PMNs. Basal capping of Con A binding sites is reduced (P less than .05) in N-PMNs but is enhanced (P less than .001) upon pretreatment with colchicine (0.5, 5.0, and 50.0 microns). These findings are again contrary to results observed with human N-PMNs. Consistent with findings in human neonates, however, are reduced levels of cellular MPO (P less than .05) and elevated cellular AP (P less than .001) in the neonate. The functional significance of elevated AP levels and altered Con A capping in N-PMNs is unclear. However, diminished expression of FcR could potentially contribute to impaired adherence and phagocytosis of bacteria, and reduced activity of neutrophil MPO could indicate weaker microbicidal capacity of neonatal cells. The demonstrated impairment of N-PMN functions could potentially contribute to reducing the effectiveness of the cellular host defense system in neonatal calves.

In vitro Fc epsilon RII expression was examined in patients with atopic dermatitis, those with non-atopic eczematous dermatitis and normal individuals following stimulation of peripheral blood cells with recombinant IL-4 (rIL-4), phytohaemagglutinin (PHA), or PHA plus rIL-2. At various days cells were stained with MoAbs to human lymphocyte Fc epsilon RII and to lymphoid cell-surface antigens and analysed by flow cytometry. rIL-4, but not rIL-2, specifically induced Fc epsilon RII on T cells as well as B cells in atopic dermatitis, eczematous dermatitis and normal individual groups. Both atopics and non-atopics generated comparable proportions of Fc epsilon RII+ T cells (T epsilon cells), whereas the frequency of B cells bearing Fc epsilon RII(B epsilon cells) was significantly higher in patients with extensive atopic dermatitis than in those with mild atopic dermatitis and other subjects. Comparable levels of T epsilon cells were detected in both atopic and non-atopic donors following stimulation of peripheral blood cells with PHA or pre-activation of the cells with PHA plus subsequent incubation with rIL-2. Whereas both CD8+ and CD4+ subsets were present in T epsilon cell populations induced specifically by rIL-4, PHA and PHA plus rIL-2, patients with atopic dermatitis had a greater tendency for Fc epsilon RII expression on CD8+ T cells compared with patients with eczematous dermatitis and normal individuals. Recombinant interferon-gamma (rIFN-gamma), but not rIFN-alpha or prostaglandin E2 (PGE2), suppressed the generation of T epsilon cells by rIL-4 in atopics and non-atopics to the same degree. These results suggest the aberrant control of Fc epsilon RII expression on T cells, especially those bearing CD8, in atopic dermatitis.

This study shows that normal human large granular lymphocytes (LGL) secrete tumor necrosis factor (TNF) in response to Mycobacterium avium-intracellulare complex (MAI). Percoll density gradient fractionation of peripheral mononuclear cells showed TNF activity in the fractions corresponding to LGL and not T cells, even when 5% monocytes were added to the T lymphocytes for accessory function. TNF release was not abrogated by treatment of the crude LGL preparations with anti-Leu M3, -CD4, and -CD8 antibodies (Ab) plus complement (C), but was abrogated by anti-CD16 and -CD2 Ab, as expected. Interestingly, anti-HLA-DR monoclonal antibody (mAb) treatment significantly diminished TNF activity from LGL, but maintained natural killer (NK) cell function unmodified as opposed to CD2+ and CD16+ cell depletion. Panning studies demonstrated that TNF secretion upon MAI stimulation resided only in the HLA-DR+ LGL and not the DR- LGL population. These results indicate that normal fresh HLA-DR+ LGL, as well as monocytes, are also responsible for rapid TNF secretion during early MAI infection. These DR+ cells appear to be distinct from those expressing NK function.

Quantification of human peripheral blood NK subsets has been made in a group of Kenyan adults and children with acute P. falciparum malaria. Results were compared with data obtained from three age- and sex-matched control cohorts: parasitaemic but asymptomatic children; aparasitaemic children and adults; and adult Caucasians with no previous history of malaria. Separated NK subsets were tested in vitro for cytotoxicity to erythrocytic schizonts of P. falciparum in the presence and absence of cytokines. There was a statistically significant quantitative and qualitative depression of the CD3-CD56+ subset in patients with acute malaria and this was accompanied by an expansion of the 'non-functional' CD3-CD57+CD16-CD56- subset. Both CD3-CD16+ and CD3-CD56+ NK cells from all patients and donors lysed schizonts, and this cytotoxicity was enhanced by the addition of recombinant interferon-alpha and/or IL-2, notably with the CD3-CD56+ subset. Interestingly, asymptomatic donors had the highest levels of CD3-CD56+ NK cells, which also demonstrated an enhanced response to cytokine stimulation. Cytotoxicity to schizonts was accompanied by the release of soluble NK cell lytic factors. Neomycin suppressed cytotoxicity in a dose-dependent manner, indicating that the lysis of schizonts by NK cells involves phospholipase C-mediated phosphoinositide metabolism. Our findings define a role for NK cells in immunity to malaria through the lysis of infected erythrocytes as a first-line defence against the parasite.

Large subsets of leucocytes were recently shown to express the low affinity receptor for the Fc portion of IgE. Because Langerhans cells (LC) are epidermal leucocytes, we investigated whether LC of normal human subjects might express this receptor. Whereas conventional immunofluorescence on epidermal sheets gave negative results, highly sensitive immunoelectron microscopy revealed that a subset (about one-third) of freshly isolated LC express the CD23 molecule.

Cells expressing Fc receptors for IgE (Fc epsilon RII) were identified in the peripheral blood from patients with atopic dermatitis and with eczematous dermatitis, and normal non-atopic subjects by using monoclonal antibodies to human lymphocyte Fc epsilon RII, and to lymphoid cell-surface antigens by immunofluorescence staining. Based on the extent of the dermatitis patients were classified as severe (greater than 50% skin surface involved), moderate (50-10%) and mild (less than 10%). Patients with severe and moderate atopic dermatitis had 5.9% and 5.7% Fc epsilon RII+ peripheral blood mononuclear cells (PBMC), respectively, that were significantly higher than percentages in mild atopic dermatitis patients (2.6%), severe to moderate eczematous dermatitis patients (2.3%), mild eczematous dermatitis patients (2.2%) and normal individuals (1.7%)(0.05 greater than P). In severe and moderate atopic dermatitis patients, 10% of Fc epsilon RII+ PBMC were T cells that preferentially expressed CD8, and the remainder B cells and monocytes. Fc epsilon RII+ T cells comprised 1% of peripheral T cells, while half or more of peripheral B cells expressed Fc epsilon RII. In mild atopic dermatitis patients, eczematous dermatitis patients and normal subjects. Fc epsilon RII were expressed exclusively on 25-35% of peripheral B cells. Short-term treatment and long-term follow-up of atopic dermatitis patients revealed that changes in the skin condition were related closely to fluctuations in the proportion of Fc epsilon RII+ PBMC. Total serum IgE levels and atopic respiratory allergy did not influence the percentage of Fc epsilon RII+ PBMC. These findings suggest that the percentage of Fc epsilon RII+ PBMC reflects the extent of atopic dermatitis.

B lymphocytes from patients with systemic lupus erythematosus (SLE) secreted high levels of immunoglobulin spontaneously when cultured in vitro. Addition of the cytokines interleukin-2, interleukin-4 and interleukin-6 either alone or in combination failed to augment spontaneous immunoglobulin synthesis. Percoll-separated low-density SLE B lymphocytes matured into immunoglobulin-secreting cells also independent of exogenous interleukins. During maturation these cells became enlarged and less dense, and began to express CD23. This was in contrast to normal B cells, which did not secrete immunoglobulin spontaneously but synthesized IgM after interleukin stimulation. These results indicate that in vitro immunoglobulin synthesis by SLE B cells is already initiated in these cells and progresses independently of further stimulatory manoeuvres.

Flavone acetic acid is a synthetic benzopyrone derivative with an unknown mechanism of action. Thirty-eight patients (30 men and 8 women) were treated once a week for 4 weeks every 5 weeks with doses of flavone acetic acid ranging from 0.33 to 12.5 g/m2. At doses less than or equal to 3.9 g/m2, the drug was administered intravenously over 1 hour; at doses greater than or equal to 5.28 g/m2, the infusion period was lengthened to 6 hours. Treatment of all patients included hydration before and after treatment and alkalization to maintain urine pH at greater than or equal to 6.5. A dose-limiting toxic effect was hypotension at 10 g/m2. Pharmacokinetic studies revealed linear behavior in the eight patients studied, beginning at 3.9 g/m2. Peak plasma levels ranged from 125 to 630 micrograms/mL, with a mean terminal half-life of 22.4 hours. Immunologic monitoring was performed in three patients at 10 g/m2. A transient increase in CD16- and/or Leu-19-positive cells was noted in all three patients. In one patient, this increase correlated with a 10-fold increase in K562 cell killing. There were no objective tumor responses seen in this trial. The recommended phase II dose on this schedule is 8 g/m2. Further studies to elucidate the drug's mechanism of action and to define its immunologic properties are recommended.

Rat and human natural killers (rtNK and huNK, respectively) were compared in quantitative antibody-dependent cellular cytotoxicity (ADCC) assays for their capacity to recognize mouse and rat IgG monoclonal antibodies (MAb) of different subclasses. NK from these two species exhibit considerably different patterns of IgG subclass recognition as determined by the relative antibody concentrations required for comparable levels of target cells lysis. ADCC assays with a panel of 16 MAb revealed that the efficiency of rtNK-mediated target lysis diminished according to IgG subclass in the following order: molgG1 greater than rtlgG2a greater than molgG2b approximately molgG2a greater than rtlgG2b greater than molgG3. By comparison, huNK recognized the same antibodies with nearly the opposite order of efficiency: rtlgG2b much greater than molgG2a greater than molgG3 greater than molgG2b much greater than rtlgG2a approximately molgG1. Only molgG2a antibodies were equally potent with rtNK and huNK. The contrasting difference in IgG subclass recognition by rat and human NK reflects the comparatively low protein sequence homology between their respective IgG Fc receptors (Fc gamma R).

Although it is known that macrophage (M phi) functions such as phagocytosis and antigen presentation are depressed following hemorrhage and resuscitation, the mechanism remains unknown. The aim of this study was to determine, using scanning immunoelectron microscopic techniques, whether there is any alteration in the Fc receptors on the M phi after hemorrhage. To study this, male C3H/HeN mice were bled to a mean blood pressure (BP) of 35 mm Hg and maintained at that pressure for 1 hr, then resuscitated with their own blood and adequate fluids. Twenty-four hrs later, Kupffer cells from livers and splenic adherent cells were isolated, incubated for 16 hr, and then exposed to polysterene beads conjugated with antimouse IgG that specifically binds to Fc receptors. The cells were then prepared for observation by scanning electron microscopy. At least 100 cells from each animal were examined. The number of Kupffer cells from posthemorrhage mice that exhibited specific receptor labeling was significantly decreased (41.0 +/- 2.6, P less than 0.05) compared with control (64.2 +/- 7.5). The number of splenic adherent cells from posthemorrhage mice exhibiting specific receptor labeling was also significantly decreased (35.7 +/- 2.5, P less than 0.01) compared with control (61.2 +/- 3.9). The internalization of markers was also seen in some cells. The cause of the decrease in receptor labeling following hemorrhage may be the loss, inactivation, and/or internalization of receptors. Thus the decreased number of functional macrophages may contribute to the depression of antigen presentation and to the enhanced susceptibility to sepsis following hemorrhage.

A cloning technique was used to estimate the frequency of proliferating T cell precursors, the growth capacity of clone-forming cells and the functional activity of clones established in vitro from peripheral blood lymphocytes of young and old people. The mean frequency of proliferating precursors was lower in the elderly as was the proliferative capacity of CD8+ clones. In contrast, CD4+ and CD16+ clones showed a proliferation similar to that obtained from young subjects. When the clones were examined for their functional activity, CD4+ clones from both groups failed to show any cytolytic activity, while CD8+ clones exerted cytolysis against K562 and in antibody-dependent cell-mediated cytotoxicity but this function was reduced in clones derived from old subjects. Similarly, CD16+ clones from the elderly showed a decreased activity at some effector-to-target cell ratios. We conclude that the impaired functional activity (T or NK-dependent) found in the peripheral blood of aged subjects persists after in vitro selection when these cells are analysed at clonal level.

Guinea pig polymorphonuclear leukocytes (PMNs) possess two distinct types of Fc gamma receptor (Fc gamma R): Fc gamma 1/gamma 2R for both IgG1 and IgG2, and Fc gamma 2R for IgG2 alone. The Fc gamma 2R was previously shown to differ antigenically from homologous macrophage (M phi) Fc gamma 2R by the use of a monoclonal antibody to M phi Fc gamma 2R (VIIAI IgG1), though the Fc gamma 1/gamma 2R cross-reacts with a monoclonal antibody to homologous M phi Fc gamma 1/gamma 2R (VIA2 IgG1). Recently, we obtained a monoclonal antibody (MP-2) secreted by a hybridoma prepared by fusion of the splenic cells of mice immunized with guinea pig PMNs with a myeloma cell line. This antibody completely inhibited both the Fc gamma 2R-mediated rosette formation of PMNs with IgG2 antibody-sensitized sheep erythrocytes and the Fc gamma 2R-mediated binding of ovalbumin (OA)-complexed IgG2 antibody to PMNs. When the antigen of MP-2 was isolated by affinity chromatography with the antibody-Sepharose, it gave a single band with a molecular weight of 120,000 on SDS-PAGE. The number of antigen molecules per PMN was estimated to be 9 X 10(4) by measuring the binding of 125I-MP-2 Fab. This value was essentially the same as that obtained by measuring the binding of OA-complexed IgG2 antibody to the PMNs treated with the Fab' of VIA2 IgG1. These results strongly suggest that MP-2 is a monoclonal antibody to PMN Fc gamma 2R.

A possible role for autoimmunity in the pathogenesis of HIV infection has been suggested, based upon the certain degree of homology shared by HIV gp41 and MHC class II molecules. A number of humoral markers of autoimmunity have since been found in seropositive subjects. We have evaluated the cellular autoreactive response in HIV-infected individuals. Our study demonstrates the existence of a cytolytic activity, present in seropositive but not in seronegative subjects. This activity is mediated by CD3+ T cells, which only occasionally express the CD8 or the CD4 surface markers. Effector cells do not appear to exert their activity in a MHC-restricted fashion, since allogeneic target cells could also be killed, recovered from allogeneic seropositive as well as from seronegative subjects. Several types of target cells were lysed: T cell blasts and Epstein-Barr virus (EBV) transformed B cells, suggesting that the target antigen is common to at least these two cell types. The fact that cells from seronegative individuals were lysed argues against the recognition of an HIV-specific antigen. The nature of the target determinants and the identity of the effector cells are discussed.

We evaluated the toxic, hematopoietic, and immunomodulatory effects of recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF). The rHuGM-CSF was administered at doses up to 50 micrograms/kg by daily 2-hour intravenous infusions to 11 patients with advanced malignancy. It induced dose-related increases in cells of the myeloid series, but it had no significant effect on reticulocyte or platelet counts. Bone marrow cellularity increased with higher doses of rHuGM-CSF, but there was a dose-related decrease in the number of colony-forming units--granulocyte-monocyte--and colony-forming units--granulocyte-erythrocyte-monocyte-megakaryocyte--per 10(5) bone marrow cells. The rHuGM-CSF caused transient increased expression of CD11b and CD16 on granulocytes but increased expression of HLA-DR and decreased expression of the high-affinity Fc receptor on monocytes and no change in monocyte production of H2O2. Thus, rHuGM-CSF has potent effects on granulocyte, eosinophil, and monocyte numbers in the peripheral blood and bone marrow. In addition, it enhances the expression of monocyte and granulocyte activation-associated surface markers.

The distribution of receptors for immunoglobulins of several different isotypes was examined for group A streptococcal isolates derived from skin and nasopharyngeal sites. Although human IgG-Fc receptor activity was a variable property of group A streptococci, found among 61% of all isolates tested, it was largely restricted to well-defined subpopulations. Human IgG-binding activity was observed among nearly all impetigo isolates examined. In addition, the expression of the class II M protein molecule (one of two broad antigenic classes of the major virulence factor) and opacity factor (a lipoproteinase) was almost invariably accompanied by human IgG binding, regardless of tissue site of infection. In contrast to class I impetigo isolates, class I nasopharyngeal isolates were relatively devoid of human IgG-binding activity. The data suggest that the presence or absence of human IgG-binding activity correlates with certain diseases caused by group A streptococci.

The modulation of soluble CD16 titers in human immunodeficiency virus (HIV)-infected patients' serum, with an initial increase in Centers for Disease Control (CDC) clinical stage II and III patients followed by a dramatic drop in patients with AIDS (CDC clinical stage IV), is reported. These changes are statistically correlated with the CDC staging system, the number of CD4+ cells, the amount of p24 antigen in serum, and the anti-p24 antibody titers, indicating the potential value of soluble CD16 titer as an easily available serum marker of disease progression. To evaluate a possible link between this observation and the expression of membrane-associated CD16/FcRIII, flow cytometry immunofluorescence analysis was performed on peripheral blood lymphocytes from patients in three CDC stages; no specific changes in the number of natural killer cells expressing CD16+ antigens or in the total number of Leu19+ cells were found. However, there was a statistical correlation between the absolute number of T cells expressing CD16 antigens (CD3+/CD16+) and the modulated titers of soluble CD16 in HIV-infected serum.

The human monocyte (M phi subset rosetting with anti RH-coated human erythrocytes via high-affinity, 72 kD receptors (FcRI+), contains the PGE2-producing immunosuppressive subpopulation, while the non-rosetting M phi subset (FcRI-) is the major plasminogen activator-producing and antigen-presenting M phi. This study gives additional evidence for the functional disparity of the FcRI- and FcRI+ M phi subsets. We are demonstrating that the normal human M phi subset isolated by rosetting via the FcRI receptor (FcRI+) produces greater quantities of tumor necrosis factor (TNF) than the non-rosetting (FcRI-) M phi. TNF production by the FcRI+ M phi subset is greater than that of the FcRI- M phi subset whether secreted (P less than .001) or cell-associated (P less than .001) TNF is assessed. The rosetting M phi subset that expresses high densities of FcRI (FcRI+) produced the majority of normal human peripheral blood M phi TNF whether the stimulation was an interferon gamma (IFN gamma) prime followed by MDP or followed by interleukin-2 (IL-2). The Fc rosetting technique itself resulted in some TNF induction in the FcRI+ M phi subset accounting for some of the increased TNF production of this subset. However, increasing the stimulation level of the FcRI very-low-density (FcRI-) M phi subset did not induce it to produce TNF levels equivalent to the moderately stimulated FcRI+ M phi subset. These data, therefore, imply that only stimulation through the type I Fc gamma receptor can augment or induce TNF activity. The difference in the M phi subset's TNF response remained even after the FcRI- M phi subset received a 2.5-fold increase in stimulation with the classical M phi induction regimen of IFN gamma plus bacterial cell wall product. Although stimulation of the FcRI+ M phi subset via crosslinking of their FcRI receptors might represent a unique TNF stimulation pathway, this stimulation does not occur in the low-density FcRI (FcRI-) M phi subset, again indicating functional disparity between these subsets. Greater TNF production by the FcRI+ M phi subset was induced concomitant to elevation of its prostaglandin E2 production. Since both TNF and PGE2 are increased in some patient groups, a pathological shift in the FcRI+ versus FcRI- M phi ratio in these patients coupled to the functional differences in FcRI+ and FcRI- M phi subsets could be one mechanism for the development of immunoincompetence.

Autoimmunity may be due to augmentation of immune responses by human CD8 cells which bind the lectin Vicia villosa (VV). We have investigated T cells in rheumatoid arthritis (RA) by double immunofluorescence flow cytometry, in order to assess VV-binding CD8 and CD4 cells from the peripheral blood and synovial fluid. A significant increase in CD8+VV adherent (P less than 0.0001) and CD4+VV adherent cells (P less than 0.001) was found in synovial fluid, as compared with peripheral blood from patients with RA. A significant increase in VV-binding CD8+ or CD4+ cells was, however, not found in the blood of patients with RA, as compared with controls. We suggest that the lack of VV-binding T cells separated from blood, in contrast to those from synovial fluid, may be due to an inhibiting agent expressing N-acetyl D-galactosamine. Indeed, IgA1 is rich in N-acetyl D-galactosamine, it inhibits VV binding to T cells and is significantly bound to CD8 cells (P less than 0.001). The IgA1 was then characterized and in about half the patients J chains and secretory component was found, suggesting that the IgA1 is of the polymeric and secretory variety. IgA bound to the T cells engaged the Fc alpha receptors and a significant decrease in the Fc alpha receptors was found in CD8 cells (P less than 0.0001) and CD4 cells (P less than 0.01). Desorption studies were then carried out on CD8 and CD4 cells which showed that a loss of cell-bound IgA1 was associated with an increase in VV binding. Conversely, adsorption of IgA to T cells was associated with a loss in VV binding. The results suggest that the failure of VV binding to CD8+ and CD4+ cells from peripheral blood of patients with RA can be ascribed to cell-bound IgA1. Cytophilic IgA1 may inhibit the function of CD8+VV binding cells, thereby preventing augmentation of the systemic immune response, consistent with the lack of extra-articular disease in these patients with RA.

Thirty-five adult persons with moderate to severe atopic dermatitis and increased levels of IgE in serum were studied for the presence of Fc-IgG (T gamma) and Fc-IgM (T mu) receptor-carrying T lymphocytes in peripheral blood. When T lymphocytes from the patient were kept in vitro cultures a reduced expansion of the Fc-IgG receptors was found after 24 hr of incubation, but not after 48 hr of incubation. No difference was observed concerning Fc-IgM-carrying T lymphocytes. In 19 patients we studied Con A-induced suppressor activity of blood lymphocytes using autologous PHA-stimulated lymphocytes as target cells. Following stimulation with Con A, 1 microgram/ml, for 2 and 4 days, lymphocytes from atopic patients had a reduced non-specific suppressor activity in vitro. If however, the concentration of Con A was increased to 10 microgram/ml, then lymphocytes from atopic patients exhibited a normal suppressor activity.

Normal human and rabbit sera, and the IgG isolated from them, have been shown by immunofluorescence to react with bovine and human heart valve fibroblasts. Analogous results were obtained with sera of children under the age of 2. Positive reactions were observed also with fibroblasts, chondrocytes and osteocytes of human fetal joint tissues. The reactions are mostly due to monomeric immunoglobulins, since soluble immune complexes give much weaker reactions with the fibroblasts. The reactions are apparently dependent on the presence of Fc receptors on these cells. This conclusion is confirmed by positive reactions with IgG Fc fragments, with pure antibodies to ovalbumin and with human monoclonal IgG. The monoclonal IgG1 possesses the strongest ability to bind with fibroblast Fc receptors. No Fc-IgG receptors have been revealed on the fibroblasts and other structures of the interstitial connective tissue of human and bovine myocardium.

The T-colony-forming capacity of different T lymphocyte subsets was studied in normal peripheral blood. Unfractionated lymphocytes (after 'Lymphoprep' separation) gave rise to a mean of 150 +/- 27 . 7 s.d. T colonies per 1 x 10(5) cells, while purified T lymphocytes by sheep RBC rosetting formed 110 +/- 32 . 2 colonies. Two subpopulations of T lymphocytes were further isolated according to the presence of Fc receptors for IgG (T gamma) or IgM (T mu) by ox RBC rosetting. T gamma cells were found to have a very low or absent T colony-forming capacity (23 +/- 26 . 2), while T mu cells produced normal colony numbers (106 +/- 28 . 4). Co-culture experiments showed that T gamma cells do not inhibit the T colony growth of normal T cells in our system. Our findings indicate that in human peripheral blood not all T lymphocytes are capable of forming T colonies and that this property is confined to the T mu (helper) lymphocyte subset.

The distribution of T-lymphocyte subpopulations bearing receptors for the Fc portion of IgG (TG) or IgM (TM) was monitored in 22 renal allograft recipients treated with immunosuppressive therapy and in 10 uraemic patients on haemodialysis. No significant difference in the distribution of T cells and T-cell subsets was found between normal controls and haemodialysed patients. In transplanted patients, however, a significant reduction of the total T-cell percentage (P less than 0.005), of TM subset percentage (P less than 0.025) and absolute number (P less than 0.005) and of TG absolute number (P less than 0.05) was observed. Considering patients with allografts functioning for more than 1 year only, the reduction in TM cells in terms of percentage (P less than 0.0005) and absolute number (P less than 0.025) was significant, while TG subset levels did not change significantly. In patients transplanted less than 1 year previous to our study, total T cells and T-cell subsets were reduced significantly only as absolute numbers. During the 1st year we observed several increments of TM values towards normal levels, especially in the first 2 months after transplantation. During this period, TM subset levels sharply increased at acute rejection crisis and returned to previous values with rejection reversal. Our results suggest that the TM subset plays a prominent role in the mechanisms involved in the immunological response to allografts, and therefore repeated TM cell monitoring could be useful in the follow-up of renal transplant patients.

Fifteen patients with seasonal allergic pollenosis and five controls were investigated to elucidate the role of the T gamma-cell population in the in vitro IgE response by peripheral blood lymphocytes (PBL). In vitro IgE production by PBL of atopic patients after antigenic stimulation was measured in culture supernatants. The optimal dose for antigenic stimulation was found to be 0.16 micrograms/20 X 10(6) cells of purified antigen. No difference was found when comparing the percentages of T cells (E rosettes) between the two groups: mean per cent for controls was 69.2 +/- 5.76 versus 69.54 +/- 4.42 for the allergic group. With regard to the T gamma-cell population, the values obtained by rosetting with ox erythrocytes sensitized with IgG antibody were 12 +/- 0.71% in normals and 9.8 +/- 1.32% in those with allergic pollenosis. This difference, although significant, may not be enough to explain the different pattern when the in vitro IgE production of both groups investigated was compared. In order to detect the role of T gamma cells in this system, lymphocyte cultures, depleted of T gamma cells, were performed and compared with unfractionated cultures from the same donors. Our results show no differences in the in vitro IgE production when T gamma cells were depleted as compared with the unfractionated cultures.

The presence of Fc receptors for IgE on epidermal Langerhans cells (LC) from patients with atopic dermatitis (AD) was demonstrated by three different types of experiments. Firstly, cell-bound IgE on LC was removed by acid elution and restored by highly purified human myeloma IgE (IgE kappa). Secondly, after pepsin digestion of cell-bound IgE the number of LC staining with anti-human light chain (kappa, lambda) antibodies significantly decreased in contrast to the number of LC staining with anti-human epsilon heavy chain antibody. Thirdly, LC formed rosettes with sheep red blood cells (SRBC) coated with IgE kappa. Epidermal LC from normal non-atopic controls, did not form rosettes with SRBC-IgE. The SRBC-IgE rosette formation could be inhibited by preincubation with IgE kappa and BB10 (MoAb directed against the Fc receptor for IgE on human eosinophils, platelets and macrophages), but also with human IgG, whereas the SRBC-IgG rosette formation could be inhibited neither by IgE kappa nor by BB10. Both the SRBC-IgE and the SRBC-IgG rosette formation could be inhibited by OKT6 (anti-CD1) antibody. The results of inhibition studies with OKT6 antibody on the reconstitution of IgE on epidermal LC after acid elution suggest an associated expression of the CD1 antigen and the Fc receptor for IgE.

Immunological studies were performed with the expanded T gamma cells of five patients with T gamma lymphocytosis. All patients showed a stable clinical picture with persistent T gamma lymphocytosis and neutropenia, with or without recurrent infections. The expanded T gamma cells in the blood had the T1-3+4-8+11+M1- phenotype, with the exception of one patient whose cells lacked the T8 marker. The expanded T gamma cell population did not proliferate in response to T cell mitogens and did not show immunoregulatory activity on pokeweed mitogen driven immunoglobulin synthesis. In four of the five patients the T gamma cells had killer cell activity against IgG sensitized mouse mastocytoma cells. Taken together, these results and the data from the literature, it is concluded that T gamma lymphocytosis represents a spectrum of T cell expansions clearly distinct from clinically progressive mature T cell neoplasias.

The question of whether hematogenous macrophages are present in the brain has remained incompletely resolved for many years. In the present study, a modified tissue culture system was employed, which enabled the isolation and visualization of cells which migrated from the surface of the hypothalamic third ventricle. Cultured cells were examined for macrophage characteristics, such as surface fine structure and cell spreading, phagocytic activity, nonspecific esterase activity, and the presence of cell surface receptors for the Fc portion of the immunoglobulin IgG. Markers of these characteristics were correlated cell by cell with light microscopy and scanning electron microscopy, utilizing both secondary and back-scattered electron imaging. Cells with all characteristic markers of the monocyte/macrophage line were identified and represent ventricular macrophages.

A total of 32 Marek's disease virus (MDV)-induced cell lines, 1 avian leukosis virus-induced cell line, and 1 reticuloendotheliosis virus (REV)-induced lymphoblastoid cell line were investigated for the presence of Fc receptors, surface IgM, and Ia-like antigen. Surface IgM and Fc receptors could not be demonstrated on any of the cell lines. Ia-like antigen was detected on all MDV-induced cell lines and on the 1 REV-induced cell line. Ia-like antigen was unrelated to other antigens reported to be present on Marek's disease tumor cells. It was also unimportant as a target antigen for MDV-related, allogeneic cell-mediated cytotoxicity. The densities of the cells of 5 MDV-induced cell lines were established on continuous Percoll gradients. Most cells had densities between 1.05 and 1.06 g/ml.

As neoplasms of the immune system, lymphomas can be characterized by a variety of immunologic technics. These technics, used in conjunction with morphology and cytochemistry, have promoted the development of lymphoma classifications which relate more closely to our current understanding of the anatomy and function of the immune system than earlier classifications. This brief review of the development and function of the immune system and discussion of technics used in distinguishing B and T lymphocytes is intended to provide background and perspective for the other papers presented in this symposium.

Receptors for the Fc part of IgG on polymorphonuclear cells (FcR) of patients with rheumatoid arthritis (RA), Felty's syndrome (FS) and healthy controls (HC) were studied by means of a rosetting technique with rabbit IgG coated ox erythrocytes. When cold isolated polymorphonuclear cells (PMN) were incubated at room temperature the percentage of rosette forming PMN (RF-PMN) from HC was more than twice that measured directly after isolation at 4 degrees C. The same phenomenon was observed for PMN from patients with RA although the RF-PMN increased by only 1/3. In contrast warming of PMN from patients with FS did not influence the RF-PMN. The presence of surface bound immunoglobulins and intracytoplasmic immunoglobulins was measured by immunofluorescence and appeared to be inversely related to the RF-PMN. A good correlation between the results of the C1q binding assay (C1qBA) and the immunofluorescence score was observed but no correlation existed between the C1qBA and the RF-PMN. These results indicate that the number of PMN expressing FcR in patients with RA and FS is decreased presumably because of the phagocytosis of immune complex like material. The decrease in the availability of FcR may influence the functions of the PMN.

Follicular dendritic cells (FDC) were isolated from human tonsils and adenoids. With a simple modification of an isolation method described previously, FDC could be enriched up to 50%. The isolated FDC were characterized immunocytochemically. In contrast to previous studies, CD4 antigen was not detected on freed FDC, thereby suggesting that the CD4 molecule does not play a role in the infection process of FDC in AIDS, as has been demonstrated for T helper cells. Fc receptors could not be found on FDC by the panel of monoclonal antibodies applied, whereas C3 receptors were observed in abundance. Therefore, antigen trapping in germinal centres most probably involves only C3 receptors. This concept is in contrast with the current one (also developed on isolated cells), which postulates the involvement of Fc receptors. The extent to which C3 receptors are involved in the pathogenesis of AIDS will be examined in further studies.

To study the expression of Fc receptors in human alveolar macrophages (AM), the cells were collected from 12 healthy controls and 22 patients with sarcoidosis and the activity involved in binding to 125I-soluble immune complexes (IC) was investigated. The binding of 125I-IC was significantly suppressed in cells from the patients. A Scatchard plot analysis revealed that this suppression was due to a reduction in the number of Fc receptors on the surface membrane and not the result of a decrease in the binding affinity of the receptors. Rosette formation was observed by incubating AM with antibody-coated ox red blood cells. The presence of rosette forming cells was about 70% in the AM from healthy controls, while, a rate of only 50% was seen in those with sarcoidosis. These results indicate that the decrease of the 125I-IC binding in the AM from patients with sarcoidosis is to some extent the result of an increase in the population of the Fc receptor negative macrophages.

An inherited defect os suppressor T-lymphocytes has been hypothesized in Hashimoto's thyroiditis. To assess this hypothesis, human T-lymphocyte subsets (TG, T lymphocytes with surface receptors for the Fc fragment of immunoglobulin G; TM, T lymphocytes with Fc receptor for immunoglobulin M) have been studied in nine patients affected by the disease. To cells have been previously shown to be suppressors in the pokeweed mitogen-stimulated B-cell differentiation and have proved abnormal in several autoimmune or immunodeficiency disorders. The number of TG lymphocytes in the patients did not differ from that in normal controls. It is possible that 1) suppressor T-lymphocytes are not involved in the pathogenesis of Hashimoto's disease or 2) antigen-specific suppressor T-cells are involved, but too are low in number with respect to total TG.

A method is described allowing the isolation and culture of relatively pure preparations of murine Kupffer cells for long-term morphological and functional studies. In vivo labelling experiments showed no evidence of significant blood monocyte contamination. The use of a density gradient allowed removal of fibroblasts, cell debris and a relative enrichment of Kupffer cells. After 24 hr in culture the cells were phagocytic, contained non-specific esterase and exhibited an Fc receptor. During the first 3 weeks, cell clumps, epithelioid cells and multinucleate giant cells appeared. Mitoses were seen in the Kupffer cells, cell numbers increased and in vitro labelling with 3H-thymidine at 49 days showed that 33% of the cells underwent DNA synthesis in a 24-hr period. Experiments suggested that giant cell formation was produced both by cell fusion and nuclear division. The experiments show that Kupffer cells are capable of cell division and giant cell formation in culture.

Proportions of T cells and T cell subsets, as identified by their Fc receptors (FcR) for IgM and IgG (Tmu and T gamma), were determined in the peripheral blood lymphocyte (PBL) and cerebrospinal fluid (CSF) lymphocyte populations in patients with multiple sclerosis (MS). On average, MS patients had 79% total T cells (62% of which were T gamma, 66% Tmu) in CSF lymphocytes compared to 66% total T cells (30% T gamma, 63% Tmu) in PBL. Normal age- and sex-matched controls PBL had 74% total T cells (20% T gamma, 54% Tmu). By direct observation using an indirect immunofluorescence assay, 41% of the CSF T gamma cells in MS patients bore receptors for IgM; these cells were designated T gamma mu and, according to the double-marker analysis, did not seem to correlate with disease stage. In MS PBL, 20% of T gamma cells were T gamma mu compared to 9% in the control PBL T gamma population. Thus, MS patients had a higher proportion of total T cells, T gamma cells and T gamma mu cells in their CSF than in their peripheral blood and than those populations found in normal control blood. The significance of this T gamma mu population for the continuing disease state in MS is discussed.