Re-examination of peripheral blood T cell subsets in dysthyroid orbitopathy.

Patients with dysthyroid orbitopathy (DO) were grouped according to a multifactorial assessment of disease severity and the rate of disease progression. Using this system and flow cytometric measurements of T cell subsets in the peripheral blood, a significant increase in the percentage of CD4+ lymphocytes correlated with disease severity in DO patients with progressive disease. These observations are consistent with the hypothesis that the CD4+ peripheral blood T helper cells play a significant role in the progression of DO.

Correlation of serum immunoglobulin E elevations with clinical stages of dysthyroid orbitopathy.

Total immunoglobulin E (IgE) was measured by an enzyme-linked immunoassay in serum samples from patients with dysthyroid orbitopathy and from a group of healthy volunteers. All the serum donors had no symptoms of allergy or infection and were not given any immunoregulative treatments for at least 6 months before the sampling. One hundred thirty-seven dysthyroid orbitopathy patients were rated clinically as belonging to one of the following groups: (1) stable dysthyroid orbitopathy; (2) active dysthyroid orbitopathy; (3) chronic or recurrent dysthyroid orbitopathy; or (4) dysthyroid orbitopathy characterized by limited myopathy. The serum IgE levels of all these groups were compared with 26 healthy, nonatopic volunteers. The mean IgE levels of groups 3 and 4 were significantly higher than the mean IgE level of the control group as well as that of the group with stable dysthyroid orbitopathy. Furthermore, serial readings on several patients were consistent with the hypothesis that serum IgE is elevated in connection with certain stages of rapid dysthyroid orbitopathy progression and also with two unusual clinical forms of dysthyroid orbitopathy.

Immunohistochemical evidence for IgE involvement in Graves' orbitopathy.

Orbital muscle and adipose tissues from seven Graves' orbitopathy patients were studied with in situ assays for IgE. The cases varied in disease severity and site biopsied. Two monoclonal and one polyclonal anti-IgE reagents produced similar results. Identically prepared monoclonal anti-IgM and anti-IgG antibodies and tissues obtained from five patients treated for unrelated orbital disorders were used as controls. Graves' tissues exhibited extravasated leukocytes and leukocyte-rich vessels. These leukocytes were mostly lymphoid. Some basophils and mast cells were identified and polymorphonuclear cells were abundant within vessels of adipose tissue. IgE-positive material was found in association with the majority of leukocytes and with muscle fibers. Parallel sections reacted with anti-IgM antibody were negative, whereas anti-IgG produced diffuse staining with no specific structures highlighted. Control, non-Graves' tissues had no evidence of immune cell activity and were either negative or displayed reactions with anti-IgE reagents that were in most cases different from those of Graves' tissue. Serum IgE was measured in six of the seven patients and was elevated in the two patients with fulminating disease.

Mitogenic augmentation of T cells from immunodepressed cancer patients by a murine interleukin-1 (IL-1).

An interleukin-1 (IL-1) lymphocyte-activating factor, with an approximate molecular weight of 13,000-16,000 was isolated from the culture supernatants of a murine macrophage-like cell line, P388D1. Contrary to the general belief that murine mediator is incapable of stimulating human lymphocyte mitogenic responses, leukoagglutinin (LA)-induced mitogenesis of peripheral blood lymphocyte (PBL) were significantly affected by murine IL-1. On one hand, when PBL were obtained from either normal healthy individuals or from cancer patients who still possessed normal levels of general immunocompetence, their mitogenic responses were not augmented any further by the murine mediator. Instead, slight but significant suppression were noted in most cases. On the other hand, the LA-induced responses of PBL from 5 immunodepressed cancer patients were markedly augmented by murine IL-1.

Clinical significance of the preoperative plasma carcinoembryonic antigen (CEA) level in patients with carcinoma of the large bowel.

Preoperative levels of perchloric acid extractable plasma CEA were measured in 911 patients with complaints of the digestive system. A final diagnosis of benign disease was made for 579 patients; 332 patients were found to have cancer. Data for the preoperative CEA values were examined for clinical significance as an aide to diagnosis, preoperative disease staging, and prognosis. The results of our analysis support the conclusions of many investigators that the CEA assay is not a clinically useful diagnostic test, but it shows limited value in preoperative staging and a somewhat stronger correlation with prognosis.

Clinical evaluation of the Makari Intradermal Test in patients with cancer of the colon and rectum.

A clinical study to evaluate the Makari Intradermal Test (MIT) involved 180 patients seen with symptoms suggestive of malignant disease, 85 of whom were subsequently shown to have carcinoma of the large bowel, and 66 asymptomatic volunteers. The prognostic value of initial and serial studies relative to patient-survival rate and the efficacy of serial studies in detecting disease in long-term follow-up of patients with resected malignant lesions were evaluated. On the basis of this study, the MIT appears to merit further investigation, not as a definitive diagnostic procedure, but as a survey for identifying patients with early malignancy or individuals at high risk to malignant epigenesis.

Immunoprofile studies for patients with bronchogenic carcinoma. I. Correlation of pretherapy studies with survival.

The general immune competence of 146 patients with bronchogenic carcinoma was measured, prior to irradiation therapy, by determining dinitrochlorobenzene (DNCB) reactivity, delayed cutaneous hypersensitivity (DCH) response to microbial antigens, peripheral lymphocyte counts, peripheral T and B lymphocyte counts, and the response of patient's lymphocytes to stimulation by phytohemagglutinin (PHA), concanavallin A (Con A) and pokeweed mitogen (PWM). Analyses were performed by the life-table method to determine the correlation of the immune status of these patients with survival rates. Statistically significant differences in survival were noted between the groups of patients with normal values when compared with the patients with abnormal values for the majority of the tests of general immunity. A stage of disease correlation with survival rate was noted for all groups of patients with abnormal immune measurements, but it was absent for many of the immune parameters when patients with normal values were compared. The effects of histology, age, and sex did not appear to influence the survival data as significantly as did the immune status of the patient. These data indicate that measurements of general immune competence may be of significant prognostic value for the management of patients with bronchogenic carcinoma. The measurement of DNCB reactivity shows the strongest correlation with survival rate.

Lymphocyte mitogen stimulation studies for patients with lung cancer: evaluation of prognostic significance of preirradiation therapy studies.

The responses of lymphocytes to stimulation by three common plant mitogens (PHA, Con A, and PWM) have been studied prior to irradiation treatment in 65 patients with bronchogenic carcinoma. The lymphocyte mitogen stimulation (LMS) responses of these patients were determined to be normal or abnormal based on data obtained from similar studies in healthy volunteers. The data for the patients with lung cancer were analyzed for correlations between the lymphocyte responses and (1) the stage of disease, (2) prognostic significance, and (3) period of survival. Statistically significant correlations were observed between the responses of lymphocytes and the stage of disease and the period of survival. However, this study indicates that these correlated responses will be of limited prognostic clinical value for individual patients.