Batya Shohat

Elevated levels of serum interleukin-1β in combat-related posttraumatic stress disorder

Levels of serum interleukin-1 beta (IL-1 beta) and soluble interleukin-2 receptor (sIL-2R) were assessed in 19 male patients with combat-related posttraumatic stress disorder (PTSD) in comparison to 19 age- and sex-matched healthy volunteers. Serum IL-1 beta levels (but not sIL-2R) were significantly higher (p < .001) in the PTSD patients than in the controls. IL-1 beta levels did not correlate with cortisol levels, severity of PTSD, anxiety, depressive symptoms, or alexithymia score; however, they did correlate significantly (r = .54, p < .005) with the duration of PTSD symptoms. It is possible that desensitization of the hypothalamic-pituitary-adrenal axis in chronic PTSD patients counteracts the stimulatory effect of IL-1 beta on cortisol secretion.

Levels of T-lymphocyte subpopulations, interleukin-1β, and soluble interleukin-2 receptor in acute myocardial infarction

T-lymphocyte levels may adversely affect the clinical course and outcome of patients with acute myocardial infarction (AMI). To characterize the T-lymphocyte profile during AMI and to explore whether these cells play a detrimental role in the extent of myocardial insult, levels of T-lymphocyte subpopulations, free soluble interleukin-2 receptor (sIL-2R), and interleukin-1 beta (IL-1 beta), were measured during the first week of AMI. Results were correlated with left ventricular ejection fraction (LVEF), age, sex, survival rate, thrombolytic therapy, and the occurrence of reinfarction. Thirty-nine patients, 20 men and 19 women aged 30 to 80 years, with first AMI were included. Patients were divided into two groups. Group A (13 patients) experienced reinfarction; group B (26 patients) did not. T-helper and-suppressor cells were measured by the indirect immunofluorescence method and sIL-2R and IL-1 serum levels by enzyme-linked immunosorbent assay (ELISA) methods on days 1, 4, and 7 after AMI. A low count of T-helper cells (CD4) was found on the first day after AMI in both AMI groups; however, the count returned to normal in group B but not in group A. A significant correlation (r = 0.63) was found between T-helper cell count on day 4 of AMI and LVEF assessed by radionuclide ventriculography, and between the CD4/CD8 ratio on day 1 and the creatine phosphokinase level (r = -0.6950). High sIL-2R levels were found in groups A and B of the AMI patients as compared with the control group (p < or = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

T Lymphocyte Activation in Stable Angina Pectoris and After Percutaneous Transluminal Coronary Angioplasty

BACKGROUND Inflammatory reactions have an important part in atherosclerosis. Smooth muscle cells, endothelial cells, monocytes, and T lymphocytes are actively involved. The purpose of this study was to assess whether T lymphocytes are activated in patients with stable angina pectoris who are candidates for a percutaneous transluminal coronary angioplasty (PTCA) and the influence of PTCA on this process. METHODS AND RESULTS Twenty-four patients participated in the study. All were 40- to 60-year-old men, and all but one underwent successful PTCA. Blood samples were taken 1 day before PTCA and 1 week, 1 month, and 2 months after. Two groups of patients were detected: group A, 11 patients who had high levels of soluble interleukin-2 receptor (sIL-2R) before PTCA that decreased toward normal during the follow-up period in most of them; and group B, 13 patients who did not have elevated sIL-2R levels before PTCA and in whom sIL-2R levels did not change after the procedure. Group C consisted of 15 healthy men whose sIL-2R levels were in the normal range (control subjects). CONCLUSIONS (1) T lymphocytes are activated in stable angina patients. (2) The level of sIL-2R can be a reliable laboratory marker for follow-up of patients after PTCA, especially those with high sIL-2R levels before the procedure.

Generalized vitiligo following Sezary syndrome

A patient with Sézary syndrome is reported in whom generalized vitiligo occurred. This is, to our knowledge, the first patient reported with vitiligo following T cell cutaneous lymphoma.

T lymphocytes and plasma inhibitory factor in ACTH-dependent Cushing's patients

Abstract In this study the cell-mediated immune activity of lymphocytes obtained from seven patients with ACTH-dependent adrenal hyperplasia (Cushings disease) was investigated. The percentage of E rosette-forming peripheral blood mononuclear cells as well as the absolute T cell number was greatly decreased in the patient group (618 ± 333 cells/mm 3 ) as compared to the controls (1222 ± 456 T cells/mm 3 ). The functional activity of T lymphocytes of patients with Cushings disease, as measured by a local graft versus host reaction (GVHR), was normal, resulting in a reaction of same magnitude as those produced by 20 × 10 6 normal human lymphocytes. The whole heparinized plasma obtained from the seven patients abolished the ability of normal human lymphocytes to mount a normal local GVHR and to form spontaneous E rosettes. The inhibitory factor was not found in the two patients tested 1 year following left adrenalectomy and irradiation of the hypophysis. Fractionation of the plasma demonstrated that the inhibitory factor is found in the lipid fraction corresponding chromatographically to triglycerides. Control experiments performed with different concentrations of triolein demonstrated that the compound effects normal human lymphocytes.

Suppressor mononuclear cells in giant lymph node hyperplasia and thymoma.

The existence of suppressor mononuclear cells were demonstrated in two lymphoproliferative disorders: giant lymph node hyperplasia and thymona. The three patients tested also showed cell‐mediated immunodeficiency as expressed in the low number of T cells, negative graft versus host reactions and negative skin tests; the one patient tested with phytohemagglutinin (PHA) and concavalin A (Con A) showed a low response. Suppressor activity was tested with a new experimental model, the local xenogeneic graft versus host reaction. It is proposed that this model be used for testing suppressor activities in other human disorders as well.

Effect of parathyroid adenoma excision on interleukin-6 (IL-6) and IL-2 receptor levels.

1,25-Dihydroxycholecalciferol [1,25(OH)2D], besides its role in calcium and phosphorus homeostasis, is also an important immunoregulatory molecule. Plasma levels of this hormone may be normal or elevated in patients with primary hyperparathyroidism. 1,25(OH)2D has been reported to inhibit production of the cytokines interleukin-2 (IL-2) and IL-6. In the present study, we examined the effect of parathyroid adenoma excision on serum IL-2 receptor (IL-2R) levels and the release and production of IL-2R and IL-6 by peripheral blood lymphocytes (each measurement was performed twice). Ten patients (5 females and 5 males aged 45 to 78 years) with primary hyperparathyroidism were enrolled in the study. The diagnosis of primary hyperparathyroidism was based on the presence of asymptomatic hypercalcemia, hypophosphatemia, and elevated serum intact PTH levels. Three weeks after removal of the parathyroid adenoma, there was a significant increase in the serum level of IL-2R, as well as the PHA-stimulated peripheral blood lymphocyte production of IL-6 and release of IL-2R. The results indicate that the removal of a parathyroid adenoma in patients with primary hyperparathyroidism causes a significant increase in IL-2R and IL-6 levels. The mechanism by which hyperparathyroidism may affect these cytokines and how they seem related to the levels of vitamin D is discussed.

An unusual case report: Tinea capitis, verrucae vulgares and other infections in a girl with T and B cell disturbances

Hereby described is a case of a young girl suffering from widespread dermatophytosis caused byTrichophyton violaceum which proved intractable to accepted methods of therapy throughout a number of years. The girl was also found to have a history or recurrent respiratory tract infection and pyoderma in addition to verrucae vulgares, and Giardia lamblia in the gastrointestinal tract. Investigation revealed a marked immunological deficit seen in both the cellular and humoral system. It is suggested that in similar cases resistant to therapy it may be helpful to carry out a comprehensive investigation of the immunological system.

Cell‐mediated immunity in patients with mycosis fungoides in clinical remission. Effect of thymic humoral factor on the immunocompetence of the lymphocytes

In 10 patients with mycosis fungoides (MF) who were in clinical remission following local treatment with nitrogen mustard, cell‐mediated immunity was investigated by means of tests for lymphocytes, forming rosettes in the peripheral blood, and the graft‐vs‐host reaction as well as intradermal skin tests. The effect of thymic humoral factor (THF) on T lymphocytes with impaired immunecompetence was also investigated. The results provided evidence of various kinds of damage to the immunologic system in most of the patients. Of the 10 patients, 4 had low percentages of T cells. Eight of the 10 had a graft‐vs.‐host reaction which was weak or negative, and in 4 of these, the administration of THF to the lymphocytes induced an improvement in immunereactivity. These results together with other recently reported data indicate that the determination of cell‐mediated immunity in patients with MF may be of prognostic importance. Those patients whose T lymphocytes respond to treatment with THF are probably the best candidates for immunotherapy. Cancer 46:41–44, 1980.

Impaired cellular immunecompetence in infectious mononucleosis as assessed by a local graft-versus-host reaction in rats and restoration of the immunecompetence by trypsin

Abstract Lymphocytes from 11 patients with acute infectious mononucleosis were tested for functional capacity by means of a local graft-versus-host reaction (GVHR) and for T lymphocyte markers by the spontaneous rosette-formation test (E rosette). All of the patients showed an increased percentage (49–75%) and high absolute numbers (2078–8736/mm 3 ) of E rosette-forming cells but no functional activity, i.e., a negative GVHR. Repeated examinations performed in four patients at intervals up to 6 months after the initial test showed a significant drop in the number of E rosette-forming cells although the GVHR remained negative. Trypsinization of lymphocytes performed in nine of the 11 patients resulted in recovery of immunecompetence of the T lymphocytes in five; in contrast, trypsinization of normal control lymphocyte abolished their ability to mount a normal GVHR. In view of the number of cases in which infectious mononucleosis has been followed by lymphoproliferative diseases, the importance of long-term follow-up in patients who have undergone an episode of infectious mononucleosis is stressed.