Different effect of granulocyte colony-stimulating factor or bacterial infection on bone-marrow cells of cyclophosphamide-treated or irradiated mice.

In the present study, the effect of treatment with granulocyte colony-stimulating factor (G-CSF) on cellular composition of the bone marrow and the number of circulating leucocytes of granulocytopenic mice, whether or not infected with Staphylococcus aureus, was assessed. With two monoclonal antibodies, six morphologically distinct cell populations in the bone marrow could be characterised and quantitated by two-dimensional flow cytometry. Granulocytopenia was induced by cyclophosphamide or sublethal irradiation. Cyclophosphamide predominantly affected the later stages of dividing cells in the bone marrow resulting in a decrease in number of granulocytic cells, monocytic cells, lymphoid cells and myeloid blasts. G-CSF administration to cyclophosphamide-treated mice increased the number of early blasts, myeloid blasts and granulocytic cells in the bone marrow, which indicates that this growth factor stimulates the proliferation of these cells in the bone marrow. During infection in cyclophosphamide-treated mice the number of myeloid blasts increased. However, when an infection was induced in cyclophosphamide and G-CSF-treated mice, the proliferation of bone-marrow cells was not changed compared to that in noninfected similarly treated mice. Sublethal irradiation affected all bone-marrow cell populations, including the early blasts. G-CSF-treatment of irradiated mice increased only the number of myeloid blasts slightly, whereas an infection in irradiated mice, whether or not treated with G-CSF, did not affect the number of bone-marrow cells. Together, these studies demonstrated that irradiation affects the early blasts and myeloid blasts in the bone marrow more severely than treatment with cyclophosphamide. Irradiation probably depletes the bone marrow from G-CSF-responsive cells, while cyclophosphamide spared G-CSF responsive cells, thus enabling the enhanced G-CSF-mediated recovery after cyclophosphamide treatment. Only in these mice, bone marrow recovery is followed by a strong mobilisation of mature granulocytes and their band forms from the bone marrow into the circulation during a bacterial infection.

Anti-tumor necrosis factor antibodies inhibit the influx of granulocytes and monocytes into an inflammatory exudate and enhance the growth of Listeria monocytogenes in various organs.

This study concerns the effect of anti-tumor necrosis factor (TNF) antibodies on the course of a sterile inflammatory reaction in the peritoneum and a generalized infection with gram-positive bacteria. Mice received an intravenous injection of rabbit anti-TNF serum or normal rabbit serum 24 h before an intraperitoneal injection of heat-killed Listeria monocytogenes or an intramuscular injection of live L. monocytogenes. The course of the leukocytes in blood and the peritoneal cavity was followed for 72 h; the infection was evaluated for 144 h. The results lead to the conclusion that anti-TNF inhibits the migration of granulocytes and monocytes from bone marrow to the circulation and from the circulation to the peritoneal cavity during an acute inflammation. Furthermore, treatment of mice with anti-TNF serum enhanced the growth of Listeria monocytogenes in thigh muscle, liver, and spleen. The results of this study indicate that treatment with anti-TNF antibodies can inhibit the development of a cellular inflammatory exudate and can have a deleterious effect on the course of an infection with gram-positive bacteria.

Characteristics of anti-Legionella antibodies in patients infected with Legionella pneumophila serogroups 1, 6, and 10.

Nosocomial infections with Legionella pneumophila serogroups 1 and 10 in the Leiden University Hospital and infections with L. pneumophila serogroup 6 in neighboring hospitals gave us an opportunity to study the development of opsonizing antibodies against L. pneumophila serogroups 1, 6, and 10 in the serum of 13 patients. Seven of these patients were infected with L. pneumophila serogroup 1, two were infected with serogroup 6, and four were infected with serogroup 10. The opsonic cross-reactivity of antibodies against these serogroups of L. pneumophila and complement involvement in opsonization were also investigated. Convalescent-phase sera from patients infected with L. pneumophila serogroup 1 or 6 were able to promote ingestion of these serogroups by polymorphonuclear leukocytes, whereas ingestion of L. pneumophila serogroup 10 was enhanced only in the presence of convalescent-phase sera from patients infected with this serogroup. Opsonization of L. pneumophila serogroups 1, 6, and 10 was complement dependent.

Immunocytochemical detection of 5-bromo-2-deoxyuridine incorporation in individual cells.

5-Bromo-2-deoxyuridine (BrdUrd) is a thymidine analogue which can be used to detect DNA synthesis in cells. The present paper describes a method for the fixation and DNA denaturation of cells that affects neither the morphology of the cells not their adhesion to a glass surface. The cells were fixed in absolute ethanol and glacial acetic acid followed by gradual rehydration. Denaturation of DNA was achieved by very brief exposure of the cells to low pH, followed by heating to high temperature and rapid cooling. Incorporation of BrdUrd was assessed from the binding of monoclonal antibody to BrdUrd in single-stranded DNA as detected with an immunocytochemical method. This method makes it possible to demonstrate BrdUrd labeling of individual, morphologically identifiable cells. The results obtained with this method correspond well with the autoradiographic data on [3H]thymidine incorporation.

Effect of concanavalin A on intracellular killing of Staphylococcus aureus by human phagocytes.

This study concerns the influence of concanavalin A (Con A) on phagocytosis and intracellular killing of Staphylococcus aureus by human monocytes and granulocytes. Con A binds to S. aureus, monocytes, and granulocytes, and is not opsonic. Con A stimulates the killing of intracellular serum opsonized S. aureus by monocytes, but not by granulocytes. This stimulation of intracellular killing was inhibited by alpha-methyl-mannoside, indicating that the process occurs via Con A specific membrane binding sites. Unlike (tetravalent) Con A, divalent succinyl-Con A does not stimulate intracellular killing, indicating that the lectin valency is important for this stimulation. Con A bound to Sephadex particles, that can not be ingested by monocytes, does not stimulate intracellular killing of S. aureus either, although it, like free Con A, stimulates H2O2 production. Pre-incubation of monocytes with Con A inhibited Fc gamma and C3b-mediated ingestion of S. aureus as well as stimulation of the killing by serum. Divalent Con A had no effect on these functions. This inhibition by Con A is in all probability due to a steric impedance of Con A with respect to the interaction of IgG and C3b with their membrane receptors. Fluorescence techniques showed that Con A was localized on the membrane and in the cytoplasm of the monocytes, whereas granulocytes had only membrane bound lectin. Taken together, these findings suggest that cell penetration by the lectin is obligatory for the stimulation of intracellular killing.

Extracellular stimulation by serum proteins required for maximal intracellular killing of microorganisms by mouse peritoneal macrophages.

Intracellular killing of catalase-positive Staphylococcus aureus by resident mouse peritoneal macrophages was very low in the absence of serum but maximal in the presence of fresh normal serum. A large proportion of catalase-negative Streptococcus pyogenes were killed in the absence of extracellular serum, and maximal killing was reached only when serum was present extracellularly. Further investigations revealed that stimulation of intracellular killing by extracellular serum is dependent on the interaction of immunoglobulin G and Fc receptors and of complement component C3b with C3b receptors in the macrophage membrane.

Effect of thioglycolate on phagocytic and microbicidal activities of peritoneal macrophages.

Brewer thioglycolate-elicited mouse peritoneal macrophages were as active as resident peritoneal macrophages in the phagocytosis of opsonized Staphylococcus epidermidis but were unable to kill ingested microorganisms. This decreased functional activity was restricted to Brewer thioglycolate-elicited macrophages, since peritoneal macrophages elicited with NIH thioglycolate, alone or supplemented with agar and methylene blue, were as active as resident peritoneal macrophages. No effect of agar on the functional activities of macrophages was observed. A defective intracellular killing by peritoneal macrophages due to Brewer thioglycolate was seen only after an intraperitoneal injection with thioglycolate, not after in vitro incubation of resident macrophages with thioglycolate. The results of this study show that, depending on the kind of thioglycolate used, the functional characteristics of elicited macrophages may alter. However, none of the forms of thioglycolate investigated induced the recruitment of activated macrophages.

Cytochemical, functional, and proliferative characteristics of promonocytes and monocytes from patients with monocytic leukemia.

This article deals with a prospective study on the cytochemical, functional, and proliferative characteristics of promonocytes and bone marrow and peripheral blood monocytes of 20 patients with acute monocytic leukemia and 7 patients with chronic monocytic leukemia. The results show a wide variation in the peroxidase and esterase activities in these cells, whereas the percentages of mononuclear phagocytes with Fc gamma and C3b receptors did not differ appreciably from those in normal individuals. A discriminant analysis of these data and corresponding data from normal individuals showed that a below-normal peroxidase activity of circulating monocytes has predictive value for the presence of monocytic leukemia; a below-normal esterase activity has less, but nevertheless some, predictive value in this respect. An increase in the percentage of circulating monocytes, a decrease in the percentage of Fc gamma or C3b receptors, and a decline in the ability to phagocytose bacteria has no predictive value for the presence of monocytic leukemia. The mean percentage of patients' promonocytes that incorporated 3H-thymidine amounted to 80.9%, which is close to the control value in normal individuals. The mean values for the labeling indices of cultured bone marrow and peripheral blood monocytes are 1.0% and 0.74%, respectively; when 3H-thymidine was added to whole blood, the labeling index of the monocytes amounted to 3.6%. These percentages are only a little higher than those found for monocytes of normal individuals. These results indicate that the majority of the circulating monocytes in acute and chronic monocytic leukemia are not actively dividing or blast cells.

Characteristics of human monocytes cultured in the Teflon culture bag.

Blood monocytes from healthy volunteers were isolated by Ficoll-Isopaque centrifugation and cultured (together with lymphocytes) in medium 199 with 20% heat-inactivated newborn calf serum in a Teflon culture bag. Quantifiable data on survival showed that up to 21 days of culture, approximately 40% of the initial number of monocytes were still viable. Such cultures could be maintained for more than 8 weeks without refeeding. The monocytes exhibited the morphology of macrophages after 5-7 days of culture, and increased in size during culture. Less than 1% of the cells became giant cells even after long culture periods. Almost all cultured monocytes were positive for alpha-naphthyl butyrate esterase, whereas the peroxidase-positive granules disappeared during the first week of culture. After long culture times increasing amounts of lysozyme and angiotensin-converting enzyme were detected in the culture supernatants. Phagocytosis of staphylococci did not decrease appreciably during culture, and the same holds for intracellular killing of these bacteria. Chemotactic activity decreased during culture, whereas the chemokinetic response of the monocytes persisted.

Phagocytosis and intracellular killing by peripheral blood monocytes of patients with monocytic leukemia.

This article concerns a study on the endocytic functions of circulating monocytes from 12 patients with acute or chronic monocytic leukemia. The results show that phagocytosis and intracellular killing of Staphylococcus aureus are impaired in only two patients and that the opsonic activity of the serum of all patients is normal. With respect to the intracellular killing of ingested Staphylococcus aureus, an interesting phenomenon was found in that the cells of patients with monocytic leukemia proved to be in a state of activation, as shown by the finding that patients' monocytes with normal phagocytosis killed about 64% of the ingested bacteria in the absence of extracellular stimulation by serum factors. When extracellular serum was present, the mean killing index rose to only 69%. This is unlike the situation seen in monocytes from healthy donors, where no killing occurs in the absence of extracellular serum and extracellular stimulation by serum factors is mandatory for optimal intracellular killing.

Characteristics and functions of monocytes and promonocytes in monocytic leukemia.

The characteristics of mononuclear phagocytes (promonocytes and bone-marrow and blood monocytes) of 27 patients with acute or chronic monocytic leukemia were studied. The percentages of promonocytes with peroxidase and esterase activity and of cells with Fcgamma and C3b receptors showed some divergence from those found in normal individuals. The phagocytic activity of monocytes and their ability to kill ingested Staphylococcus aureus were not decreased in this group of patients. The 3H-thymidine-labeling index of the promonocytes did not differ greatly from normal values, which indicates that the percentage of dividing promonocytes had not increased. The very low labeling index of the circulating monocytes means that these cells do not divide and therefore cannot be blast cells or monoblasts.

Effect of extracellular serum in the stimulation of intracellular killing of streptococci by human monocytes.

This study shows that the intracellular killing of Streptococcus pyogenes, Streptococcus faecalis, and Streptococcus pneumoniae by human monocytes is stimulated by the extracellular presence of both heat-stable and heat-labile serum factors. A similar kind of stimulation of monocytes has been described in respect of catalase-positive microorganisms. However, killing of these bacteria is negligible in the absence of extracellular serum factors, whereas a large proportion of the ingested catalase-negative bacteria are killed in the absence of such extracellular stimuli. Monocytes from patients with chronic granulomatous disease, which are unable to kill Staphylococcus aureus even in the presence of extracellular serum, killed S. pyogenes equally effectively whether serum was present or absent. This index proved to be the same as that for killing by monocytes of healthy subjects in the absence of serum. Taken together, these results indicate that catalase-negative microorganisms possess some kind of suicide mechanism that leads to the death of these bacteria after their ingestion by monocytes in the absence of an extracellular stimulus. Furthermore, the mechanism by which extracellular serum stimulates intracellular killing probably involves enzymes of the O2-dependent bactericidal mechanisms of the monocytes.

Characteristics of human mononuclear phagocytes.

In this study human mononuclear phagocytes from the bone marrow (promonocytes and monocytes), peripheral blood monocytes, and tissue macrophages from the skin and the peritoneal cavity were studied with respect to their morphological, cytochemical, and functional characteristics, cell surface receptors, and 3H-thymidine incorporation in vitro. The results show similarities between mononuclear phagocytes of the three body compartments with respect to esterase staining, the presence of peroxidase-positive granules, the presence of IgG and C receptors, and pinocytic and phagocytic activity. Promonocytes are the most immature mononuclear phagocytes identified in human bone marrow, and since about 80% of these cells incorporate 3H-thymidine, they are actively dividing cells. Monocytes, whether in bone marrow or the peripheral blood, and both skin and peritoneal macrophages label minimally with 3H-thymidine and thus are nondividing cells. Since the characteristics of mononuclear phagocytes in man and mouse do not diverge greatly, it is probable that the cell sequence based on in vitro and in vivo 3H-thymidine labeling studies in the mouse holds for man as well. The successive stages of development of the human mononuclear phagocyte cell line will then be as follows: monoblasts (not yet characterized in man) divide to form promonocytes, and these cells in turn divide and give rise to monocytes that do not divide further; they leave the bone marrow, circulate in the peripheral blood, and finally become macrophages in the various tissues.

Kinetics of phagocytosis of Staphylococcus aureus and Escherichia coli by human granulocytes.

Although phagocytosis of micro-organisms by granulocytes is one of the most important defence mechanisms against infection, little is known about the kinetics of this process. The present study showed that the rate of ingestion of Staphylococcus aureus and Escherichia coli depends on the concentrations of the granulocytes and bacteria. Phagocytosis of bacteria at a bacteria-to-cell ratio in the range between 100:1 and 1:10 showed an exponential course during the first 30 min. At a bacteria-to-cell ratio of 1:1, application of a correction for the outgrowth of extracellular bacteria gave an exponential course of ingestion over the first 90-min period. Since it was found that the phagocytosis of bacteria by granulocytes at various bacteria-to-cell ratios can be described with Michaelis-Menten kinetics, we studied the kinetics of phagocytosis on the basis of the initial rate for the first 30-min period. The rate of phagocytosis and the maximal degree of ingestion of bacteria by granulocytes proved to be related to the concentration of serum used in the assay. The minimal serum concentration required for maximal ingestion was 2.5% for Staphylococcus aureus and 5% for Escherichia coli. When bacteria were pre-opsonized, the duration of pre-opsonization proved to be limiting for the rate of phagocytosis in dependence on the serum concentration. The effect of temperature on the phagocytosis of micro-organisms proved to be two-fold. First, at temperatures between 4 and 33 degrees a decrease in the functioning of the cells leads to a decrease in the rate of phagocytosis. Above 42 degrees, the temperature affects mainly the opsonization of the micro-organisms and has only a slight influence on the ingestion process. From the data obtained in this study, maximal rates of 6.3 X 10(6) Staphylococcus aureus/5 X 10(6) granulocytes/min and of 7.1 X 10(6) Escherichia coli/5 X 10(6) granulocytes/min were calculated for phagocytosis at a bacteria-to-cell ratio of 100:1 at 37 degrees, i.e. on average about one bacterium per granulocyte per min. The maximum calculated number of bacteria ingested by one granulocyte lies between 40 and 50.

Hairy-cell leukaemia: a B-lymphocytic disorder.

Fifteen cases of histologically proven hairy-cell leukaemia (HCL) were studied with immunofluorescence, rosette, and phagocytosis techniques. Unfixed hairy cells (HC) bound all kinds of labelled antiserum; but after fixation with formaldehyde a much more selective binding was observed. In two cases no surface-bound Ig was detected; four cases showed gamma and in nine cases two or three heavy chains were found, alpha and delta being the most frequent. Few cases were clearly positive for mu. The picture was invariably monoclonal with respect to light chains. Cytoplasmic Ig was present in only 3/15 cases; it was always IgM. HC did not form E-rosettes or react with a fluorescent anti-T cell antiserum. No EAIgMC-rosettes were formed. All cases showed Fc receptors, which were detected with EAIgG-rosettes (13/13) or with antigen-antibody complexes (6/6). The density of Fc receptors varied widely. Incubation with latex particles resulted in cell-associated particles in 16-63% of the HC; with Staphylococcus epidermidis, the percentage was 2-36. After enzyme treatment (lysostaphin), however, no ingested bacteria were found, which suggests that HC are essentially non-phagocytic. At least 13 cases were therefore classified as B-cell malignancies.

Requirement of extracellular complement and immunoglobulin for intracellular killing of micro-organisms by human monocytes.

The role of serum factors in the intracellular killing of bacteria by monocytes was studied on the basis of an assay independent of phagocytosis. After 3 min of phagocytosis of preopsonized bacteria and removal of noningested bacteria, the monocytes containing bacteria are reincubated for various periods and the number of unkilled bacteria is determined by a microbiological method after lysis of the cells. Evidence that this assay measures the killing of ingested bacteria was provided by scanning electron microscopy, lysostaphin treatment, and the effect on the rate of intracellular killing of inactivated serum lacking specific opsonic activity. Intracellular killing of Staphylococcus aureaus, S. epidermidis, and Escherichia coli by human monocytes does not occur or is low in the absence of serum, and maximal killing is only reached when fresh serum is present; intermediate values are obtained in the presence of heat-inactivated serum. These findings indicate that complement stimulates intracellular killing. Isolated heterogeneous immunoglobulin (Ig)G, pFc fragments of heterogeneous IgG, and both IgG1 and IgG3 stimulate intracellular killing of S. aureaus by monocytes to the same degree as heat-inactivated serum. Sphingomyelinase, which decreases the number of Fc receptors, and neuraminidase, which increases these receptors, respectively, decreased and increased the intracellular killing, whereas anti-monocyte serum completely abolished the stimulation of intracellular killing by inactivated serum. These results prove that interaction of the Fc receptor with the Fc part of IgG is required for the intracellular killing. Inhibition of the activation of complement components via the alternative pathway gave a considerable reduction in the intracellular killing of S. aureaus; impairment of the activation via the classical pathway had no effect. The addition of complement components to heat-inactivated serum showed that intracellular killing is maximal only when C3b is generated. Reduction of the number of C3b receptors in the membrane by trypsin or pronase decreased intracellular killing in the presence of fresh serum; anti-monocyte serum completely abolished the stimulation of intracellular killing by fresh serum. These results lead to the conclusion that intracellular killing is also dependent on the interaction between C3b and its receptor in the membrane.

Culture of mononuclear phagocytes on a teflon surface to prevent adherence.

A method is described for the culture of mononuclear phagocytes in suspension by incubation on a Teflon film to which the cells do not adhere. The characteristics of peritoneal macrophages, bone marrow mononuclear phagocytes, macrophage cell lines, and fibroblasts cultured in this way are similar to those observed after culture on glass or plastic surfaces. Culture of mononuclear phagocytes in Teflon film dishes has three important advantages: the cells can be easily harvested without damage, recovery is almost complete, and the cells are not functionally impaired. Thus, this method makes it possible to use cultured mononuclear phagocytes for many studied that could previously only be done in freshly collected cells.

The morphology of dyserythropoiesis in a patient with acute erythroleukaemia associated with multiple myeloma.

A patient with multiple myeloma in whom acute erythroleukaemia developed 5 years following treatment with irradiation and melphalan is reported. Immunoglobulin synthesis and immunofluorescence investigations provided evidence that the blast cells in the peripheral blood did not belong to the plasma cell series; ultrastructure examination demonstrated their myeloid origin. Chromosomally abnormal cells were observed in both the bone marrow and peripheral blood. Light-and electron microscopy of erythropoiesis in this case showed distinct features of dyserythropoiesis, similar to those described in other entities. The erythroid cell abnormalities are discussed in the light of their being either indications of malignancy or of a reactive process.