The city of hope-quality of life-ostomy questionnaire: persian translation and validation.

BACKGROUND: Since there is no disease-specific instrument for measuring quality-of-life (QOL) in Ostomy patients in Persian language. AIM: This study was designed to translate and evaluate the validity and reliability of City of Hope-quality of life-Ostomy questionnaire (COH-QOL-Ostomy questionnaire). SUBJECTS AND METHODS: This study was designed as cross-sectional study. Reliability of the subscales and the summary scores were demonstrated by intra-class correlation coefficients. Pearson's correlations of an item with its own scale and other scales were calculated to evaluated convergent and discriminant validity. Clinical validity was also evaluated by known-group comparisons. RESULTS: Cronbach's alpha coefficient for all subscales was about 0.70 or higher. Results of interscale correlation were satisfactory and each subscale only measured a single and specified trait. All subscales met the standards of convergent and discriminant validity. Known group comparison analysis showed significant differences in social and spiritual well-being. CONCLUSION: The findings confirmed the reliability and validity of Persian version of COH-QOL-Ostomy questionnaire. The instrument was also well received by the Iranian patients. It can be considered as a valuable instrument to assess the different aspects of health related quality-of-life in Ostomy patients and used in clinical research in the future.

Synthesis of alpha-gal epitopes on influenza virus vaccines, by recombinant alpha 1,3galactosyltransferase, enables the formation of immune complexes with the natural anti-Gal antibody.

Synthesis of the carbohydrate structure Gal alpha 1-3Gal beta 1-4GlcNAc-R (termed the alpha-gal epitope) on viral glycoproteins is of interest because of the large amounts of natural antibody (anti-Gal) produced in humans against this epitope. The presence of alpha-gal epitopes on inactivated virus or subviral vaccines is likely to enhance vaccine immunogenicity through in vivo complexing with anti-Gal and the subsequent targeting of the vaccine to Fcy receptors on antigen presenting cells. Our previous studies have demonstrated the increased in vitro immunogenicity of inactivated influenza virus complexed with the anti-Gal antibody. Here we demonstrate a method for engineering the expression of alpha-gal epitopes on influenza virus hemagglutinin (HA) by recombinant alpha 1,3galactosyltransferase (r alpha 1,3GT). We further demonstrate the formation of immune complexes between this de novo synthesized epitope and anti-Gal. HA has multiple N-acetyllactosamine structures which serve as excellent acceptors for r alpha 1,3GT. The luminal portion of marmoset alpha 1,3GT cDNA was produced in large amounts in the baculo virus system and isolated by affinity chromatography on nickel-Sepharose columns. r alpha 1,3GT effectively transferred galactose from UDP-Gal to the N-acetyllactosamine residues of HA on the intact virion or to isolated HA molecules. At least 3000 alpha-gal epitopes were de novo synthesized per virion. The natural anti-Gal antibody bound to these epitopes in ELISA, in western blots and in solution, forming distinct immune complexes. These data suggest that in vivo administration of such vaccines will result in their complexing with anti-Gal, and thus may lead to their increased immunogenicity.

Reduction of metastatic properties of BL6 melanoma cells expressing terminal fucose(alpha)1-2-galactose after alpha1,2-fucosyltransferase cDNA transfection.

We reported previously that transfection of BL6 melanoma cells that do not express the alpha1,3-galactosyltransferase (alpha1,3GT) gene with the alpha1,3GT cDNA resulted in synthesis and expression of alpha-galactosyl epitopes (Gal(alpha)1-3Gal(beta)1-4GlcNAc-R) and an impairment of their metastatic potentials. It was of interest to test whether inhibition of metastatic properties of BL6 melanoma cells is specifically associated with the appearance of the terminal alpha-Gal or whether capping N-acetyllactosamine with another oligosaccharide would also affect the metastatic properties of BL6 melanoma cells. For this purpose, BL6-2 clone isolated from B16BL6 melanoma was transfected with the alpha1,2-fucosyltransferase (alpha1,2FT) cDNA. The alpha1,2FT catalyzes a transglycosylation reaction, resulting in syntheses of the Fuc(alpha)1-2Gal(beta)1-4GlcNAc-R structure, which is known as the H antigen of O blood group in humans and is also synthesized in some cells of mice. Transfection of BL6 melanoma cells with the alpha1,2FT cDNA resulted in the appearance of the terminal Fuc(alpha)1-2Gal(beta)1-4GlcNAc-R epitopes reacting with the Ulex europaeus agglutinin lectin. In parallel, the transfected cells showed a decrease in N-acetyllactosamine sialylation. Decline in sialylation of the transfected cells is likely to be the result of competition between alphal,2FT and alpha2,3- or alpha2,6-sialyltransferases for the common substrate N-acetyllactosamine (Gal(beta)1-4GlcNAc-R) on N-linked carbohydrate chains of glycoproteins and glycolipids. The alpha1,2FT-transfected BL6-2 cells showed an increase in homotypic aggregation. In parallel, metastatic ability of the alpha1,2FT-transfected BL6-2 cells was reduced significantly in the immunocompetent as well as immunosuppressed (X-irradiated) mice. Thus, these data imply that capping N-acetyllactosamine with alphaGal or alphaFuc and the corresponding reduction in sialylation of BL6-2 melanoma cells were associated with reduction of their metastatic potential.

Synthesis of alpha-galactosyl epitopes by recombinant alpha1,3galactosyl transferase for opsonization of human tumor cell vaccines by anti-galactose.

The immunogenicity of tumor-associated antigens in autologous tumor vaccines is limited because of insufficient uptake by antigen-presenting cells (APC). Anti-Galactose (Gal) IgG, abundantly produced in humans, can serve as a natural adjuvant increasing the uptake of vaccinating autologous tumor cell membranes by APC. Anti-Gal interacts with the alpha-galactosyl epitope (Ga1alpha1-3Galbeta1-4GlcNAc-R), which is normally absent in humans. This epitope is produced in large amounts in nonprimate mammals and New World monkeys due to the intracellular activity of the glycosylation enzyme alphal,3galactosyltransferase. alpha-Galactosyl epitopes were synthesized in vitro on human tumor cells by soluble recombinant alphal,3galactosyltransferase. Anti-Gal binding to these epitopes induces the effective uptake of the tumor cells by APC with Fc receptors that interact with the Fc portion of this natural antibody. It is suggested that synthesis of alpha-galactosyl epitopes on freshly isolated human tumor cell membranes, followed by their administration back to the patient, will result in the in situ opsonization of the membranes by anti-Gal, thereby improving the uptake, processing, and presentation of autologous tumor-associated antigens by APC with Fc receptors.

Enhancement of antigen presentation of influenza virus hemagglutinin by the natural human anti-Gal antibody.

Immunogenicity of inactivated virus or subviral vaccines may be enhanced by complexing with an IgG antibody. Such antibody would increase the uptake, processing and presentation of the vaccine's antigens by antigen presenting cells (APC), via the adhesion of the antibody-vaccine complex to Fc-receptors on macrophages and other APC. A natural antibody in humans, which may be generally exploited for this purpose, is the natural anti-Gal antibody. This antibody is ubiquitously produced as 1% of circulating IgG in humans and Old World primates, and it interacts specifically with the carbohydrate epitope Gal alpha 1-3 Gal beta 1-4 GlcNAc-R (termed the alpha-galactosyl epitope). This epitope is synthesized in large amounts in cells of nonprimate mammals and New World monkeys by the glycosylation enzyme alpha 1,3 galactosyltransferase. Here we describe in vitro studies on the ability of anti-Gal to bind to alpha-galactosyl epitopes on influenza virus propagated in mammalian cells, and to enhance presentation by APC of viral hemagglutinin antigenic determinants to specific helper T cell clones. The various approaches for achieving alpha-galactosyl epitope expression on virion and subviral vaccines are discussed.

alpha-galactosyl (Galalpha1-3Galbeta1-4GlcNAc-R) epitopes on human cells: synthesis of the epitope on human red cells by recombinant primate alpha1,3galactosyltransferase expressed in E.coli.

Developing methods for in vitro synthesis of the carbohydrate structure Galalpha1-3Galbeta1-4GlcNAc-R (termed the alpha-galactosyl epitope) on human tumour cells may be of potential clinical significance in cancer immunotherapy. Tumour vaccines with this epitope would be opsonized in vivo by the natural anti-Gal antibody, which is present in large amounts in humans, and which interacts specifically with alpha-galactosyl epitopes. Binding of anti-Gal to alpha-galactosyl epitopes on tumour cell membranes is likely to increase uptake of the cell membranes by antigen-presenting cells, such as macrophages, via the adhesion of the Fc portion of anti-Gal to Fc receptors on these cells. This, in turn, may increase processing and presentation of tumour-associated antigens by antigen-presenting cells, and induce an effective immune response against tumour cells with these antigens. The present study describes a method for the synthesis of alpha-galactosyl epitopes on human cells (red cells used as a model) by recombinant alpha1,3galactosyltransferase (rec. alpha1,3GT) expressed in bacteria. Escherichia coli was transformed with cDNA of the luminal portion of New World monkey rec. alpha1,3GT linked to six histidines (His)6 at the N-terminus. The enzyme produced by the bacteria was isolated from bacterial lysates on a nickel-Sepharose column and eluted with imidazole. This recombinant enzyme displayed acceptor specificity similar to that of rec. alpha1,3GT produced in COS cells. Red cells were pre-treated with sialidase for exposure of N-acetyllactosamine acceptors, then subjected to rec. alpha1,3GT activity. This enzyme synthesized at least 4 x 10(4) alpha-galactosyl epitopes/red cell. These epitopes were found to be accessible for binding of anti-Gal, as well as Bandeiraea simplicifolia IB4 lectin. It is argued that the method presented can be used for the synthesis of alpha-galactosyl epitopes on membranes of autologous tumour vaccines in humans.

Alterations of cell surface carbohydrates and inhibition of metastatic property of murine melanomas by alpha 1,3 galactosyltransferase gene transfection.

Three melanomas of C57BL/6 mice (BL6, JB/MS, and JB/RH) share several phenotypic properties. All these cells contain melanoma-specific ecotropic C-type retrovirus that encodes melanoma-associated antigen recognizable by MM2-9B6 mAb. They do not express H-2Kb molecules, and the alpha-galactosyl epitopes (Gal alpha 1-3Gal beta 1-4GlcNAc-R) they fail to react with soybean agglutinin (SBA), peanut agglutinin (PNA), and vicia villosa (VV) lectins. Previously, we found that failure of BL6 melanoma cells to express alpha-galactosyl epitopes is due to down-regulation of alpha 1,3 galactosyltransferase (alpha 1,3GT) gene expression. To evaluate the possible role of alpha-galactosyl cell membrane carbohydrates in regulation of metastatic properties, individual clones isolated from BL6, JB/MS, and JB/RH melanomas were transfected with alpha 1,3GT cDNA. This resulted in appearance of alpha-galactosyl epitopes, as well as of carbohydrates reacting with SBA, PNA, or VV lectins, but did not affect expression of H-2 class I molecules or melanoma-associated antigen. Appearance of SBA, PNA, and VV lectin binding carbohydrates in the alpha 1,3GT gene-transfected melanoma cells is a result of reduction of cell membrane sialylation and unmasking of these carbohydrates. Reduction in cell membrane sialylation in the alpha 1,3GT gene-transfected melanoma cells is probably due to the competition between alpha 1,3GT with alpha 2,3 sialyltransferase or alha 2,6 sialyltransferase for the common acceptor N-acetyllactosamine in the Golgi apparatus. As a result of this competition, cell membranes of alpha 1,3GT gene-transfected melanoma cells became galactosylated and less sialylated. In parallel with alteration of cell membrane carbohydrates, transfection of the alpha 1,3GT gene leads to the loss of metastatic properties of the transfected melanoma cells in the immunocompetent and immunosuppressed C57BL/6 mice. Thus, the use of specific glycosyltransferase cDNA transfection presents direct experimental confirmation of the importance of cell membrane carbohydrates in the regulation of metastatic properties of tumor cells.

Variations in activity of the human natural anti-Gal antibody in young and elderly populations.

BACKGROUND: Anti-Gal is a natural antibody which constitutes approximately 1% of circulating IgG in humans and which interacts specifically with the mammalian carbohydrate epitope Gal alpha 1-3Gal beta 1-4GlcNAc-R (termed the alpha-galactosyl epitope). The purpose of this study was to determine whether there are age-associated changes in the affinity of anti-Gal in elderly individuals. METHODS: The age-associated variations in affinity of anti-Gal were determined by the extent of this antibody binding to solid-phase alpha-galactosyl epitopes (mouse laminin) in ELISA, performed at various serum dilutions with serum samples from 140 elderly and 127 young individuals. The data were expressed as the mean of optical density (O.D.) values measured at serum dilutions of 1:40, 1:80, and 1:160, and correlated with the affinity of anti-Gal as measured in equilibrium dialysis. RESULTS: The proportion of individuals with low-affinity anti-Gal is sixfold higher in the elderly than in the young population. Whereas low-affinity binding of anti-Gal (mean O.D. value < or = 1.0) was observed in only 6% of the young population, as many as 35% of the elderly population displayed such low-affinity anti-Gal. Anti-Gal affinity in ELISA assay correlated with the affinity of this antibody as measured in equilibrium dialysis. CONCLUSION: The proportion of individuals with low affinity anti-Gal increases in the elderly population in comparison with the young population. The possible molecular mechanisms which may result in the age-associated decrease in the antibody affinity are discussed.

Defining the minimal size of catalytically active primate alpha 1,3 galactosyltransferase: structure-function studies on the recombinant truncated enzyme.

The glycosylation enzyme alpha 1,3 galactosyltransferase, which synthesizes the carbohydrate Gal alpha 1-3Gal beta 1-4GlcNAc-R, is active in non-primate mammals, prosimians and New World monkeys, but not in Old World monkeys, apes and humans. In this study, we have cloned and sequenced the enzyme expressed in a New World monkey, determined the exact size of the stem region and assessed the minimal size of catalytically active alpha 1,3 galactosyltransferase (alpha 1,3GT). Various primer sets were used in the polymerase chain reaction to generate cDNAs which coded for forms of alpha 1,3GT with deletions at the N- or C-terminal domains. The cDNA was inserted into the expression vector pPROTA which contains the coding sequence for protein A, and subsequently transfected into COS cells. The soluble chimeric products (truncated enzyme and protein A) were harvested from the cell culture medium using IgG-Sepharose beads and assayed for enzymatic activity. As many as 67 amino acids could be truncated at the amino terminal region of the luminal portion of the enzyme without affecting its catalytic activity. Truncation of 68, 69 and 74 amino acids resulted in a 50, 75 and > 95% loss in the in vitro catalytic actively, respectively. Introduction of a frameshift mutation which is characteristic of apes and human alpha 1,3GT gene resulted in the complete loss of enzyme activity. Moreover, truncation of as few as three amino acids at the carboxyl end of alpha 1,3GT resulted in complete loss of the catalytic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

One percent of human circulating B lymphocytes are capable of producing the natural anti-Gal antibody.

The natural anti-Gal antibody constitutes 1% of circulating IgG in humans and interacts specifically with the carbohydrate epitope Gal alpha 1-3Gal beta 1-4GlcNAc-R (the alpha-galactosyl epitope). In view of the unusually large amounts of this antibody in the serum, it was of interest to determine the proportion of circulating B lymphocytes capable of synthesizing anti-Gal. For this purpose, blood B lymphocytes were incubated with Epstein-Barr virus (EBV) and plated in microtiter wells. Proliferation of the EBV transformed B lymphocytes was readily visible after 3 weeks of incubation. The supernatants from wells containing proliferating B-lymphoid clones were assayed for anti-Gal by an agglutination assay with rabbit red blood cells and the specificity of the agglutinating antibodies was further confirmed by their interaction with synthetic oligosaccharides and by enzyme-linked immunosorbent assay with glycoproteins. Approximately 5% of the wells contained anti-Gal antibodies. Limiting dilution studies and IgH gene rearrangement patterns suggested that each well contained an average of five proliferating B-lymphoid clones. Thus, it is concluded that approximately 1% of circulating B lymphocytes are capable of producing anti-Gal. The proportion of anti-Gal--producing lymphoid clones exceeds by fourfold that of clones producing anti-blood group A or anti-blood group B antibodies. Individual anti-Gal clones display fine variations in their combining site, as indicated by their differential interaction with alpha-galactosyl epitopes on glycolipids and on N-linked carbohydrate chains of glycoproteins. The high frequency of precursor B lymphocytes capable of producing anti-Gal, found in every individual and the restricted specificity of this antibody to alpha-galactosyl epitopes, potentially makes anti-Gal--producing lymphocytes an effective system for studying human Ig genes involved in the natural immune response to structurally defined haptens.

Xenogeneic thyroid-stimulating hormone-like activity of the human natural anti-Gal antibody. Interaction of anti-Gal with porcine thyrocytes and with recombinant human thyroid-stimulating hormone receptors expressed on mouse cells.

Anti-Gal is a natural polyclonal antibody that constitutes 1% of circulating IgG in all humans and that interacts specifically with the mammalian carbohydrate epitope Gal alpha 1-3Gal beta 1-4GlcNAc-R (termed the alpha-galactosyl epitope). This epitope is abundant on thyrocytes, as well as, on other cells of nonprimate mammals, prosimians and New World monkeys, but its expression is diminished in Old World monkey, ape, and human tissues. We hypothesized that anti-Gal may bind in vitro to alpha-galactosyl epitopes on xenogeneic TSH receptors (TSHR) and mimic the effect of TSH on xenogeneic thyrocytes. Assays performed with porcine thyrocytes have indicated that anti-Gal can mimic in vitro TSH effects in stimulation for cAMP synthesis, 125I uptake, and cell proliferation. Furthermore, depletion of anti-Gal from serum of patients with Graves' disease resulted in elimination of a large proportion of the thyroid stimulating immunoglobulin activity and half of the thyroglobulin binding inhibiting Ig activity, when the sera were assayed with porcine thyrocytes. The effect of anti-Gal binding to alpha-galactosyl epitopes on TSHR was further demonstrated by the antibody-mediated stimulation for cAMP synthesis in mouse 3T3 cells (cells expressing alpha-galactosyl epitopes), which were transfected with recombinant human TSHR. CHO cells (cells lacking alpha-galactosyl epitopes), transfected with recombinant human TSHR were not stimulated by anti-Gal. It is, therefore, suggested that in studies on antibodies in Graves' disease sera, the effect of anti-Gal may be excluded by using target cells that are devoid of alpha-galactosyl epitopes. Alternatively, anti-Gal could be removed from the tested sera, before the assay with xenogeneic thyrocytes.

Analysis of the basis for persistence of herpes simplex virus type 1 in undifferentiated U937 cells.

Replication of herpes simplex type 1 (HSV-1) is inhibited in the human monocyte-like cell line, U937, when the cells are in the undifferentiated state, but when the cells are stimulated to differentiate by treatment with the phorbol ester, phorbol 12-myristate 13-acetate virus is replicated. Because HSV-1 has been shown to persist in these cells and in their in vitro counterparts freshly isolated human blood monocytes, we initiated an analysis of viral persistence in undifferentiated U937 cells. No appreciable HSV-1 DNA replication was observed in undifferentiated U937 cells compared with differentiated U937 cells and with fully permissive Vero cells. However, using in situ hybridization, we established that a significant percent of the undifferentiated U937 cells contained viral DNA sequences. Interestingly, when analyzed by Southern blot hybridization, this DNA was found to have assumed a nonlinear configuration similar to that found in latently infected neurons. Analysis of viral proteins in undifferentiated U937 cells revealed a marked absence of proteins of all three kinetic classes. However, in transient transfection assays, the major viral transactivating protein ICP4, functioned normally, whereas ICP0, a promiscuous transactivator of both viral and cellular genes, was unable to transactivate viral promoters in undifferentiated U937 cells. Thus, a subtle dysfunction in the activity of ICP0 may account, at least in part, for the inability of undifferentiated U937 cells to support replication of HSV-1.

Transient expression of virus-specific promoters in murine resident peritoneal macrophages.

Monocyte-macrophages (MO), being non-permissive for most viruses, play an important role in resistance to virus infection. In order to establish the mechanism of abortive infection of murine resident peritoneal MO (ResPMO) by herpes simplex virus type 1 (HSV-1), it is desirable to transfect these cells with viral promoters linked to an assayable gene, for example, the bacterial chloramphenicol acetyl transferase (CAT) gene. This will facilitate studies designed to measure levels of promoter activation or repression in these specialized cells. Transient expression of CAT in ResPMO was achieved with DEAE-dextran, but not using either calcium phosphate precipitate or lipofectin. CAT expression driven by various virus-specific promoters was less efficient in ResPMO compared with Vero cells and approximately 50% of input plasmid DNA remained in Vero cells at 48 h post transfection, but only 9% was detectable in ResPMO. However, approximately 6% of ResPMO and 9% of Vero cells contained CAT-specific DNA at 24 h post transfection. In addition, 2% of cells of either cell type contained CAT-specific polypeptide at 48 h. This is therefore the first report that the non-replicating murine ResPMO can be transfected in vitro and more importantly, that these cells express the transfected gene products.

Molecular localization of abortive infection of resident peritoneal macrophages by herpes simplex virus type 1.

Mononuclear phagocytes exhibit different patterns of intrinsic resistance to herpes simplex virus type 1 (HSV-1) that are related to the heterogeneity of macrophage populations and may reflect the particular differentiation or maturation state of the macrophages. In this study, we characterized the molecular basis for the block in HSV-1 replication in resident peritoneal macrophages from B6C3F1 mice. Infected resident peritoneal macrophages were analyzed for the presence of virus-specific mRNA by Northern (RNA) blotting and in situ hybridization and for proteins by immunofluorescence. The data were compared with those obtained in HSV-1-infected permissive Vero cells. The immediate-early genes ICP4, ICP0, ICP22, and ICP27 were transcribed in resident peritoneal macrophages, as was the early gene tk. Virus-specific mRNA for the major DNA-binding protein ICP8 was barely detectable, and that for another early gene, the viral DNA polymerase, was not detected. In addition, transcripts for the delayed-early gene glycoprotein D and the true late gene glycoprotein C (gC) were not detectable in resident peritoneal macrophages. In situ hybridization and immunofluorescence studies confirmed that transcripts and proteins for the immediate-early and some early HSV-1 genes were present. These data also established that 14% of the resident peritoneal macrophages were positive for RNA and polypeptide specific for the immediate-early gene ICP4 and that 7 to 11% were positive for RNA or polypeptides specific for the early genes tk and ICP8. The fact that only a few cells expressed viral products emphasizes the heterogeneity that exists even in this relatively homogeneous resident peritoneal macrophage population. Consistent with the Northern blot analysis, no RNA specific for the early DNA polymerase gene or the late gC gene was detected by in situ hybridization nor could the polypeptide for the gC gene be seen by immunofluorescence. Thus, while early transcriptional events were initiated in some resident peritoneal macrophages, there was a block in replication localized at the level of expression of the early to delayed-early viral genes.

In vitro suppression of lymphocyte blastogenic response to mitogen and antigen by Leishmania tropica.

Cell-mediated immune (CMI) responses are important in the immunity against Leishmania spp. infection in man. However, an infection continues to persist for a limited or indefinite period of time in spite of demonstrable CMI. The factors which allow the infection to persist in the presence of the CMI are hitherto unknown. Evidence is presented here that Leishmania tropica or their products suppress the in vitro proliferative response of normal human lymphocytes to mitogen and specific antigens. The suppressive effect of L. tropica is neither due to a direct toxic action on lymphocytes nor to competition for nutrients or antigens. In vivo such an immunosuppressive effect could both facilitate macrophage parasitization and the intracellular survival of L. tropica, even after the CMI develops to processed L. tropica antigen. Persistence of infection is seen in many other bacterial, viral and fungal infections. The in vitro suppressive effect of L. tropica on the immune response observed in our study therefore becomes relevant to the understanding of the host-parasite interaction, which may determine the eventual outcome of infection in many other intracellular infections.

Cell-mediated immunity in professional and voluntary blood donors.

Cell-mediated immunity (CMI) was compared in professional and voluntary blood donors. Depressed CMI in professional donors was revealed by the presence of significantly lower numbers of positive delayed reactive hypersensitivity responses to Candida albicans, streptokinase and streptodornase, as well as a decrease in lymphoblast transformation response to phytohaemagglutinin. Furthermore, the serum protein and albumin levels in professional donors did not correlate with the depression in CMI. The blood of professional blood donors should be considered to be a poor source of therapeutic immune cell fractions.

Specificity of transfer factor. In vitro lymphoblast transformation of peripheral lymphocytes to Leishmania major antigen in the presence of transfer factor.

The in vivo and in vitro demonstration of specificity of transfer factor (TF) has so far been hampered by lack of a suitable antigen. The host partiality of Leishmania suggested that in the case of leishmania antigen it should be possible to obtain lymphocytes of both donors and recipients of TF which were either sensitized or truly virgin. Lymphoblast transformation of normal donor lymphocytes to leishmania major antigen (LMA) was therefore measured in the presence of TF prepared from donors with a history of cutaneous leishmania infection (LSTFd) and normal donors (NSTFd). A clear augmentation of the lymphoblast transformation equal to that usually seen when lymphocytes from sensitized individuals are exposed to LMA was observed with LSTFd. An insignificant increase in lymphoblast transformation, however, occurred when NSTFd was used together with LMA and when LSTFd or NSTFd was used alone. The results, although limited by the number of TF preparations, tested, clearly substantiate the in vitro specificity of TF.