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Severe trauma can lead to a compromised immune response, thereby increasing susceptibility to infections. Here we will study to what extent these early changes in the immune status upon trauma affect a primary immune response to keyhole limpet haemocyanin (KLH). Because glutamine is the preferred respiratory substrate for immune competent cells and known to be depleted after trauma, we studied the immune status and the primary sensitization in relation to the glutamine plasma concentration in a group of severe trauma patients [injury severity score (ISS) >17]. Trauma patients ( n = 31) were sensitized with KLH within 12 h after trauma; plasma glutamine concentrations and immune parameters were determined, after which KLH-specific immune responsiveness was evaluated on days 9 and 14. Low plasma glutamine concentrations were found after trauma. Significantly elevated numbers of granulocytes and CD14-positive leucocytes were found, whereas the HLA-DR expression on CD14-positive cells was significantly lower in trauma patients than in healthy controls. Trauma did not change the in vitro proliferative capacity of lymphocytes when cultured with glutamine; however, when lymphocytes were cultured without glutamine, trauma resulted in lower proliferation than healthy controls. Phytohaemagglutinin-(PHA)-induced interferon (IFN)- γ and interleukin (IL)-10 production was significantly lower after trauma, whereas IL-4 production was not affected. KLH sensitization following trauma resulted in poor skin test reactivity and low in vitro KLH-induced lymphocyte proliferation compared to controls. In contrast, the development of anti-KLH IgM, IgG, IgA, IgG1, IgG2, IgG3 and IgG4 production on days 9 and 14 following trauma was not different from that in healthy controls. Major trauma was associated with a reduced cell-mediated immune response, correlating with low plasma glutamine concentrations, while no effects of trauma were found on the development of a primary humoral immune response. [ABSTRACT FROM AUTHOR]

In previous work, we have shown that local administration of active cyctophosphamide (CY) derivatives, or other cytostatic drugs, at the sensitixation site induced a similar immunopotentiation to that of systemic CY. Since it is well documented that CY can inhibit suppressor cells, it was proposed that immunoenhancement by locally administered drugs might be based on a similar principle. The objective of the present study was to test this hypothesis, using an experimental model of Ts mediated suppression of delayed type hypersensitivity to sheep erythrocytes. In this model, mice are made tolerant to sheep erythrocytes by i.v. injection of a high dose of sheep erythrocytes. Local treatment of sheep erythrocytes-tolerant mice with the active CY derivative Z7557 at the site of attempted sensitization reversed suppression in a dose-dependent manner. Local treatment with the cytostatic drug etoposide (VP-16) and systemic CY treatment were also effective. In transfer experiments, the function of afferently acting suppressor cells was blocked by local treatment with Z7557 or systemic CY. These data support the concept of anti-.suppressor cell activity of locally administered cytostatic drugs. As with CY the pharmacological basis of this effect remains to be determined. [ABSTRACT FROM AUTHOR]

The immunomodulating effects of two locally administered cytostatic drugs, the active cyclophosphamide- derivative Z 7557 and the plant alkaloid VP-16, were compared with the effects of systemically administered cyclophosphamide and several established adjuvants: Freund's complete adjuvant, dextran sulphate, and dimethyl dioctadecyl ammonium bromide (DDA). All agents tested promoted the development of delayed-type hypersensitivity (DTH) to keyhole limpet haemocyanin (KLH) in mice. Locally administered cytostatic drugs were the most effective immunostimulatory compounds, whereas DDA was the least toxic agent tested. In order to increase the effectiveness and/ or reduce the toxicity of these agents we tested the efficacy of combinations of cytostatic drugs and DDA to enhance DTH. The results show that DDA and suboptimal amounts of locally administered cytostatic drugs act synergistically on DTH. [ABSTRACT FROM AUTHOR]

Using an experimental contact sensitivity model in guinea-pigs, evidence is presented that hapten (DNCB or oxazolone) specific T lymphocytes may persist for several months in previous sites of inflammation. Immunological memory, revealed by accelerated contact skin reactions upon retesting with ihe hapten. was limited to the original contact skin reaction sites. This 'local skin memory" to DNCB or oxazolone could be induced in both specific and non-specific skin inflammatory reactions, provided the animals had been sensitized to the hapten not longer than 2 weeks before. In animals which had been sensitized more than 1 month earlier. Local skin memory could be induced if the animals received a booster application of hapten shortly (0-2 days) before primary skin testing. from these results we conclude that recently activated T cells may enter inflammatory sites non-specifically, producing specific local immunological memory. This memory may last several months. Accumulation of hapten specific T cells at inflammatory sites may be important in retest reactivity, in flare-up reactivity and in chronic inflammation. [ABSTRACT FROM AUTHOR]

The detection of antigen-specific T cell responsiveness, particularly of resting memory lymphocytes, in cultures of peripheral blood mononuclear cells (PBMC) may be hampered by a less than optimal antigen presentation in vitro. Augmented sensitivity of the test system may be achieved by the addition of reagents with a beneficial effect on lymphocyte and antigen-presenting cell (APC) functions. In this study the effect of several biological response modifiers on antigen-specific T cell proliferation was determined, using nickel sulphate and tetanus toxoid as test antigens. IL-1α (100 U/ml), interferon-gamma (IFN-γ) (10 U/ml), and indomethacin (2 μM) were found to significantly enhance nickel-induced proliferation in PBMC cultures from nickel-hypersensitive donors (n = 6). Tetanus-induced proliferation (n = 5) was similarly enhanced, both by the above supplements and by the addition of polyethylene glycol (PEG) or a neuraminidase treatment of the PBMC before culture. The addition to PBMC cultures of a combination of IL-1α (30 U/ml), IFN-γ (10 U/ml), and indomethacin (2 μM) is recommended to specifically enhance antigen-induced lymphoproliferative signals. [ABSTRACT FROM AUTHOR]

In patients with head and neck carcinomas and in patients with chronic purulent upper airway infections, low molecular weight retroviral p15E-like factors are found. These factors are responsible for partial defects in the cellular immune response. We studied the distribution of these p15E-related proteins in neoplastic, inflamed and normal human tissues and related these findings with the presence of p15E-like factors in patients' sera. Demonstration of p15E-like proteins in sera of patients with upper airway infections and of patients with head and neck carcinomas correlated exclusively with the presence of p15E in normal and pathologic epithelium of the upper respiratory tract, p15E was not demonstrated in epithelia of other localizations. Our results suggest that chronic stimulation or neoplastic transformation of the epithelia of the upper respiratory tract stimulates the production of p15E-like proteins leading to their reported immunosuppressive actions. [ABSTRACT FROM AUTHOR]

From animal studies we know that oral administration of T-dependent antigens before sensitization effectively induces systemic immune unresponsiveness. Such 'oral tolerance' is persistent, dose dependent, antigen-specific and presumably T suppressor cell-mediated. Oral tolerance induction could be an effective way to prevent undesired T cell-mediated immune functions, such as playing a role in allograft reaction, autoimmune and allergic diseases. In the present study allergic contact hypersensitivity (ACH) to nickel, currently presenting the most frequent contact allergy in man, was chosen to establish the feasibility of oral prevention of undesired T cell-mediated immunity in man. Potentially tolerizing (oral nickel contacts via orthodontic braces) as well as sensitizing (ear piercing) events were studied retrospectively in 2176 patients attending nine European patch test clinics. Patients were interviewed by means of a confidential questionnaire. The results show that ear piercing strongly favoured development of nickel ACH, More importantly, patients having had oral contacts with nickel-releasing appliances (dental braces) at an early age, but only if prior to ear piercing, showed a reduced frequency of nickel hypersensitivity. Frequencies of other hypersensitivities, in particular to fragrance, were not affected. These results support our view that induction of specific systemic immunologic tolerance by timely oral administration of antigens is feasible in man. [ABSTRACT FROM AUTHOR]